Nookal vs Cliniko for UK Clinics: Which Practice Management System Suits Your Practice?

A practical, GBP-priced comparison of two of the most considered PMS options in UK private healthcare, covering pricing, Healthcode integration, GDPR posture, and which fits which clinic.

UK private healthcare has grown into a substantial market, recently valued by LaingBuisson at £13.79 billion for the private acute sector, with independent clinics and privately practising doctors accounting for roughly £5.7 billion of that.

Private medical insurance (PMI) cover has reached 8.43 million people, the strongest market coverage since 2008. Against that backdrop, more clinicians are running their own clinics, and more practice owners are taking the choice of practice management software (PMS) more seriously than they used to.

Two cloud-based systems come up repeatedly when UK clinics evaluate options: Nookal and Cliniko. Both are Australasian-built (Nookal in Brisbane, Cliniko in Melbourne). However, both have meaningful UK customer bases; and both publish UK pricing in GBP. Both tools also integrate with the patient communications and accounting tools UK practices rely on, and maintain UK GDPR compliance posture.

Both platforms are similar enough to be worth comparing head-to-head, and different enough that the right answer depends on the shape of the clinic. A solo osteopath in Bristol billing privately is solving a different problem than a multi-site physiotherapy group in London processing PMI claims through Bupa, AXA Health, and AVIVA at thousands of authorisations per quarter.

BookedSolid integrates directly with both platforms, so the perspective is neutral; the goal is to help UK clinics make the right choice for their context, not to steer them toward either vendor.

Two Australian Platforms, Adapted for the UK

Both Nookal and Cliniko are cloud-based, web-accessible from any device, and require no on-premises installation. Both are built specifically for allied health (physiotherapy, chiropractic, osteopathy, podiatry, psychology, speech and language therapy, and similar disciplines). Both publish UK GDPR compliance statements, and both encrypt patient data at rest and in transit.

At the feature level, both platforms cover:

• Visual diary scheduling across one or many practitioners and locations
• Patient online bookings, embeddable into a clinic website
• Customisable clinical note templates
• Automated SMS and email appointment reminders to reduce no-shows
• Invoicing, payments, and core financial reporting
• Xero integration for accounting
• Multi-location and multi-practitioner support
• A 30-day free trial on each platform

For UK clinics with relatively standard requirements (self-pay billing, online booking, decent clinical notes, a handful of practitioners) both systems will run a clinic well. The differences sharpen around pricing structure and currency, third-party insurance billing, reporting depth, and configuration overhead. The rest of this guide focuses on those.

Pricing

Both Nookal and Cliniko publish UK pricing in GBP. Both base their pricing on the number of practitioners in your clinic, while admin and reception users are included.

There is no single cheapest option. The better value depends on your clinic size, because the two platforms use different pricing bands.

Nookal is cheaper for solo practitioners, two-practitioner clinics, and some clinics around the 13–14 practitioner mark. Cliniko is cheaper across much of the 3–12 practitioner range and again from around 16 practitioners upwards.

The main difference is how the pricing is structured. Nookal uses smaller bands at the lower end, then increases by practitioner from 13 to 20. Clinics above 20 practitioners need to contact Nookal for a custom quote. Cliniko uses wider bands, with published pricing all the way up to 200 practitioners.

Cliniko also offers an annual billing discount worth one free month, roughly 8.3% off. Nookal does not currently publish an equivalent discount.

Where the prices cross

Because the pricing bands do not line up neatly, the cheaper platform changes depending on headcount. The table below compares each vendor's published UK pricing across a few common clinic sizes:

Pass-through costs and pricing visibility at scale

Both vendors charge separately for SMS credits beyond the headline subscription. Nookal sits at 6.5p per outbound message in the UK, with inbound replies free. Cliniko sits at 5p per message. For clinics relying heavily on automated reminders, these costs accumulate: a practice sending 2,000 reminders per month pays around £100 to £130 in SMS on top of the subscription.

Healthcode claim fees apply separately on Nookal at 0.3% per successful claim; Cliniko does not offer Healthcode integration natively, so clinics needing it pay Healthcode directly.

For larger UK clinics and multi-site groups, pricing visibility itself is a differentiator. Cliniko publishes pricing all the way to 200 practitioners (£199 up to 25, £259 for 26–200). Nookal's public UK pricing stops at 20 practitioners; clinics above that contact sales for a bespoke quote. For a clinic group modelling acquisitions or organic growth past twenty clinicians, Cliniko's published ceiling is easier to plan against. Both vendors offer free data migration from other PMSs, and both run 30-day free trials.

Pricing was verified against each vendor's UK pricing page on 22 April 2026.

Healthcode and PMI Claims

For UK clinics with significant private medical insurance (PMI) volume, the most consequential difference between Nookal and Cliniko is how each handles claims to insurers.

The UK private healthcare ecosystem runs heavily on Healthcode, the standard clearing and billing platform that connects healthcare providers with the major PMI insurers (Bupa, AXA Health, AVIVA, Vitality, WPA, and others). Practices treating insured patients typically need to submit claims through Healthcode, and the friction of doing so is one of the larger operational considerations in UK clinic admin.

Nookal integrates directly with Healthcode. Cases can be set up with the payer specified, treatment budgets tracked against authorisation limits, and claims submitted from inside the system. Nookal charges a small per-claim fee on successful claims (from 0.3%, payable only on claims that go through), but the time saving on admin is meaningful for high-volume PMI clinics. The integration also means one source of truth: the same patient record, treatment notes, and case data flow through to the claim, with no double entry.

Cliniko does not currently offer native Healthcode integration. UK clinics on Cliniko that bill PMI typically route claims through a connected app called Effra, which sits in Cliniko's connected-apps directory. Effra reads invoices from Cliniko, helps validate authorisation codes and policy numbers before submission, sends claims to the major UK insurers (Bupa, AXA Health, AVIVA, Vitality, and others) through Healthcode, and posts remittances back to Cliniko. The integration works in production, but it is a separate commercial agreement on top of the Cliniko subscription, and one more vendor relationship for the clinic to maintain.

For self-pay-heavy clinics, this difference is largely academic. For clinics where 30% or more of revenue comes through PMI, it is likely the single most important factor in the decision; the time and error-rate savings from native integration tend to outweigh the headline pricing gap.

Features: Where the Two Diverge

Both systems cover the core well, but the depth varies in specific areas.

Clinical notes and case management

Cliniko's clinical notes are widely praised for their simplicity. Templates are quick to build, body charts are drag-and-drop, and most practitioners are confident writing notes within their first week. The trade-off is less depth for clinics that need highly structured, discipline-specific documentation workflows.

Nookal's clinical notes offer more structure, including case-level notes that tie directly to specific treatment plans, payers, and authorisation limits. For practices running long PMI-authorised treatment courses, MSK rehabilitation programmes, or complex case loads where the same patient may have multiple parallel cases (one self-pay, one PMI, for example), Nookal's case-based architecture maps more naturally to how the work actually runs.

Scheduling and online bookings

Both systems offer solid embeddable booking modules that patients can use 24/7.

Cliniko's booking flow is famously low-friction and is one of the most cited reasons clinics pick it; the patient-facing experience is unusually clean.

Nookal's booking is more configurable, with finer-grained control over slot logic, online booking permissions, and embedding options.

Recurring appointments, waitlists, and class attendance tracking are available in both, but Nookal tends to offer more configuration depth.

Group classes and structured programmes

For clinics where group programmes are a meaningful share of revenue, the architectural difference between the two systems matters.

In Nookal, classes are a first-class entity: each class type carries its own service code, capacity limit, per-payer pricing (so a third-party-funded place can be priced differently from a private place), claimable status against insurer authorisations, and pre-paid pass support.

In Cliniko, group sessions are an extension of the standard appointment-type model, with capacity enforced through the appointment type itself.

For pilates studios, hydrotherapy programmes, or clinics that run rehab classes, Nookal's purpose-built model maps more naturally to how the work runs. For clinics where group work is incidental, Cliniko's approach is adequate and simpler to set up.

Telehealth

This is one of the clearer architectural differences between the two systems.

Cliniko offers native, browser-based telehealth bundled at every subscription tier; the patient receives a join link in their confirmation email, taps it, and joins the video call directly in the browser without downloading any software, with the call running peer-to-peer encrypted. Group telehealth (up to four participants) is supported on the same infrastructure.

Nookal does not include native telehealth. Instead, the platform integrates with third-party video platforms (Coviu, Doxy.me, Zoom, and Physitrack), each of which the clinic subscribes to separately. From inside Nookal, a practitioner opens a booking and triggers a video session through the chosen integration, which then runs on the third-party platform.

Reporting and analytics

Nookal's reporting is noticeably deeper. Real-time occupancy, clinician performance dashboards, and KPI views are part of the standard feature set. For clinic owners actively managing utilisation and per-practitioner economics, this matters.

Cliniko's reporting is solid for the operational core (revenue, cancellations, no-shows, outstanding invoices), but is less granular on analytics. For practice owners who want a clean monthly numbers view rather than active KPI management, this is usually sufficient.

Integrations and the wider ecosystem

Cliniko has a well-documented public API and a wide third-party ecosystem; new integrations tend to land there first. Nookal also has an open API and a strong UK-relevant integration set, including Healthcode, Physitrack for exercise prescription, Xero, and a growing number of others. For most UK clinics, both ecosystems are deep enough; the decisive question is usually whether the specific tools a clinic relies on (or plans to add) are supported.

For AI and automation specifically, both platforms integrate directly with BookedSolid. Calls handled by the AI receptionist write straight into the same calendar and patient records the team already uses, in both systems.

UK GDPR, Data Residency, and the ICO

For UK clinics, data protection is not optional. Patient records are special category data under UK GDPR, and clinics are accountable for how their software vendors handle that data. Both vendors publish detail on encryption, subprocessors, breach notification, and Data Processing Addendum terms; Cliniko's security page and Nookal's security page are the right starting point for a Caldicott review or an ICO-aligned data protection impact assessment.

Where the two diverge for UK clinics is in physical data residency.

Cliniko operates three geographically isolated regional shards (one in Australia, one in the United Kingdom, and one in the United States), and UK accounts sit on the UK shard. Account subdomains take the form yoursubdomain.uk1.cliniko.com, and patient data stays in the United Kingdom.

Nookal operates three regional data centres assigned by account region: Sydney for Australian accounts, Ireland for European and UK accounts, and Ohio for North American accounts. UK Nookal accounts are therefore hosted on the Irish data centre, which is inside the EU.

Both arrangements are legally compliant under UK GDPR, and for most private-healthcare clinics either is fine.

Which Suits Which Type of UK Clinic

There is no universally "better" option, but the fit tends to break down along predictable lines.

Cliniko tends to be the stronger fit for:

• Solo practitioners and small teams who want to be operational quickly with minimal training time.
• Self-pay-heavy clinics where Healthcode and PMI claims are not a daily task.
• Clinics with high reception or admin headcount relative to clinicians; free unlimited admin users meaningfully reduce the bill.
• Mid-sized to large multi-practitioner clinics where the 3–12 and 16+ ranges line up with Cliniko's £59, £89, £129, and £199 bands more efficiently than with Nookal's ladder.
• Practices that prioritise the patient-facing booking experience as a marketing asset and conversion lever.

Nookal tends to be the stronger fit for:

• Clinics with significant PMI volume, where native Healthcode integration removes hours of weekly admin and reduces claim error rates.
• Practices running structured group programmes (rehab classes, Pilates, hydrotherapy) alongside one-to-one care, where case and class configuration depth pay back.
• Practice owners who want detailed reporting, real-time occupancy data, and per-practitioner KPIs to actively manage clinic economics.
• Two-practitioner clinics, where Nookal's £45 band is materially cheaper than Cliniko's £59 entry to the 2–5 band, and clinics sitting at 13–14 practitioners where Nookal's per-practitioner pricing dips below Cliniko's £199 ceiling.
• Solo or small clinics that anticipate growing into a multi-stream billing model and want case management depth from the start, rather than migrating systems later.

A practical heuristic: if the clinic's complexity is mainly clinical and self-pay, Cliniko usually fits cleanly. If the complexity is mainly administrative (multiple insurance payers, complex case loads, deeper reporting), Nookal usually pulls ahead.

Nookal vs Cliniko for UK Clinics: Side-by-Side

A summary of the main points for UK clinics:

Where an AI Receptionist Fits Alongside Either PMS

One factor that increasingly shapes the PMS decision is what surrounds it. Both Nookal and Cliniko offer online booking, but most UK clinics still field a significant volume of phone calls for appointments, rescheduling, cancellations, PMI authorisation queries, and general enquiries. That phone volume is what most stretches a front desk, particularly during peak periods, lunch breaks, and after hours.

AI receptionist tools that integrate directly with Nookal or Cliniko can handle these routine calls end-to-end: the AI answers, understands the request, checks real-time availability in the PMS, books or moves the appointment, and sends the same automated confirmation the online booking module would send. Complex or sensitive calls are escalated to a human team member with full context.

BookedSolid is built specifically for this purpose and integrates natively with both Nookal (as Nookal's exclusive AI receptionist integration partner) and Cliniko. The choice between Nookal and Cliniko does not lock a clinic out of call automation either way; but it is worth confirming any AI or automation tool a clinic is evaluating actually integrates with the chosen PMS before committing.

Making the Decision

For most UK clinics, the choice between Nookal and Cliniko comes down to three questions:

1. Where does the clinic sit on each vendor's tier ladder right now? Neither vendor is universally cheaper. Nookal wins at solo, two-practitioner, and the 13–14-practitioner sweet spot; Cliniko wins through most of the 3–12 range and from 16 practitioners upwards. The cleanest first step is to look up the clinic's current headcount in the pricing table above and see which tier each vendor lands in.

2. What proportion of revenue comes through PMI? If meaningful, Nookal's native Healthcode integration is likely to pay back its price premium in saved admin time and lower claim error rates. If most billing is self-pay, the case for Nookal on this dimension weakens substantially.

3. How much depth does the practice need from its software? Cliniko is faster to learn and gentler on new staff; Nookal rewards a steeper learning curve with deeper case management, reporting, and configuration options.

Both platforms offer 30-day free trials. Given how central a PMS is to daily operations, a useful approach is to run a full week of real bookings, notes, and invoicing through each, and see which one fits the team's rhythm before committing.

Frequently Asked Questions

Is Nookal or Cliniko cheaper for a UK clinic?

It depends on the clinic's size; neither vendor is universally cheaper. Nookal is the lower-cost option for solo practitioners (£25 vs £29), two-practitioner clinics (£45 vs £59), and clinics at thirteen and fourteen practitioners (£177 and £189 vs £199). The two are effectively tied at fifteen practitioners (£200 vs £199). Cliniko is the lower-cost option through the rest of the 3–12 range (where the £59 and £89 bands cover several Nookal price levels in a single tier) and from sixteen practitioners upwards. Above twenty practitioners, Cliniko continues to publish pricing (£199 up to 25, £259 for 26–200) while Nookal requires a custom quote. Pricing was verified against each vendor's UK pricing page on 22 April 2026.

Does Cliniko integrate with Healthcode?

Cliniko does not currently offer native Healthcode integration. UK clinics processing PMI claims on Cliniko typically handle claims through a separate Healthcode subscription or a third-party billing service, which works but adds a layer of manual effort and a second source of patient and treatment data. Nookal, by contrast, integrates directly with Healthcode, with a per-claim fee (from 0.3% on successful claims) replacing the manual submission step.

Are Nookal and Cliniko both UK GDPR compliant?

Both platforms publish UK GDPR compliance statements and accept Data Processing Agreements for UK customers. Both encrypt patient data at rest and in transit. Specific configuration, including hosting location, subprocessors, and the international transfer mechanism in use, varies and should be reviewed directly with each vendor; particularly for clinics carrying out a Caldicott or ICO-aligned data protection impact assessment.

Can I switch between Nookal and Cliniko later if I change my mind?

Yes. Both platforms offer data export and have migration tools to bring data in from other systems. Nookal provides both free and paid data conversion services. A switch is non-trivial; expect data cleansing, configuration time, and staff retraining; but it is a well-trodden path in both directions. The 30-day free trials each platform offers are the lowest-risk way to test fit before committing.

Which is better for a multi-site UK clinic group?

For multi-site groups with significant PMI volume, Nookal's combination of native Healthcode integration, multi-location reporting, and clinician-level KPIs tends to fit well, particularly where the headcount sits in the 13–14-practitioner range that Nookal prices most efficiently. For multi-site groups that are largely self-pay, sit in the 3–12 or 16–25-practitioner ranges, or plan to grow past twenty clinicians, Cliniko's banded pricing and published visibility up to 200 practitioners are usually the cleaner fit. The decisive factor is the group's billing mix, current size relative to each vendor's tier ladder, and the cost of crossing band cliffs as it grows.

Do Nookal and Cliniko both integrate with AI receptionists?

Yes. Both platforms have public APIs and integrate with BookedSolid's AI receptionist. BookedSolid is Nookal's exclusive AI receptionist integration partner, and integrates directly with Cliniko for real-time appointment booking, rescheduling, and cancellations by phone. For UK clinics, regardless of PMS choice, AI call handling is available; though it is worth confirming that any specific AI or automation tool being evaluated supports the chosen PMS before committing.

Are these platforms used in Ireland and New Zealand too?

Yes. Both platforms operate internationally. Cliniko serves over 65,000 practitioners across more than 95 countries, and Nookal has dedicated regional pricing pages for the UK, Ireland, New Zealand, Canada, the United States, South Africa, and Australia. Most of the comparative points in this guide apply to Irish clinics too, though the third-party billing context differs (Healthcode is UK-specific). For New Zealand clinics, ACC integration and NZD billing are the main local considerations to verify with each vendor. Australian clinics should refer to the Australia edition of this comparison, which covers Medicare, DVA, and NDIS in detail.

Which platform has better customer support in the UK?

Both platforms run distributed support teams and offer email-based support to UK customers, with Cliniko well-known for fast and personable email responses and Nookal offering email, phone, and live chat support. Time-zone overlap is reasonable in both cases (Cliniko's team is fully remote globally; Nookal has a presence across multiple regions). UK clinics evaluating either should sense-check support quality during the 30-day free trial, including response time on a non-trivial question, since lived support experience often diverges from public reviews.