Practice management and finance tips for 2013

Medeconomics' panel of experts provide their top tips for GP practices in the year ahead.

2013 looks set to be a challenging year for GP practices (Picture: iStock)
2013 looks set to be a challenging year for GP practices (Picture: iStock)

Practice finance: Jenny Stone, partner, Ramsay Brown & Partners

For the past few years, practices have seen profits falling and it is expected they will fall again in 2013.

Practices are faced with cuts in the QOF, uncertainty about enhanced services income and the prospect of losing MPIG correction factors, resulting in further reduction in profits. 

Practices need to be constantly reviewing their expenses and looking at ways to work more efficiently. Staff costs are the biggest outlay, so these need to be reviewed to see where efficiencies can be made – if you are overstaffed, cuts should be made.

Practices need to ensure their QOF registers are accurate and their locums and salaried GPs are recording QOF outcomes to ensure maximum points are achieved.

Partners should be reviewing their drawings to ensure they are not overdrawing, otherwise they could find themselves having to pay back unexpected amounts at the end of the year. Partners should also review the amount of cash they leave in the business to ensure there is enough to meet day-to-day expenditure.

If profits are falling, partners should consider whether tax payments on account should be reduced and should also ensure realistic estimates of pensionable profits are submitted, so the right level of superannuation is deducted.

Legal matters: Lynne Abbess, partner and head of practitioner team, Hempsons

The best advice I can offer is to ensure you have your own house in order, to enable you not only to take full advantage of any opportunities as they present – but even more fundamentally, to ensure you are in a strong position to survive the changes that lie ahead. 

It is not going too far to say that every GP practice will face challenges in one form or another. Unless the partners are united in their approach and can address those challenges together, they face the serious threat of the implosion of their practice – and the loss of their livelihood – which would enable the NHS Commissioning Board and other members of their CCG to ‘pick over the pieces’ and make the most of salvaging whatever is up for grabs. 

A Partnership at Will is the most unstable business platform there is, so you owe it to yourselves to ensure your own house is in order. This should extend to ensuring all your staff (clinical and management) are tied into contracts, so that together, you can perform as a united – and thriving – team to face the future. 

Premises: John Hearle, chairman and head of healthcare, Aitchison Raffety

When it comes to property improvement or development, the top tip must be: don’t give up.

With the huge changes that are about to take place on 1 April, including some 3,000 staff being moved from PCTs to NHS Property Services (NHS PropCo), it is potentially going to be difficult even to find out who you should be talking to.

On top of this, over the next two years, there will be a period of transition and consolidation while NHS PropCo understands exactly what it has taken on in terms of buildings and occupiers.
During this period it will have to complete numerous leases and look at making savings. There is very little prospect of any significant new development monies within this period.

However, the DH is fully aware that new infrastructure is required and by the end of the two-year consolidation period, there will be pent-up demand, with a lot of catching up to do. Property development projects can take up to three years and you can start on your new project now and be at the front of the queue.

Some development will be inevitable and where leases are coming to an end or premises are no longer fit for purpose, improvements will have to be made. Those at the front of the queue, shouting the loudest, are more likely to get assistance.

There will be a general election in a couple of years and the government is looking to kickstart the economy with major infrastructure projects. If you are considering a new surgery project, but getting little help from the local NHS, a top tip would be to contact your MP, who may be keen to support a major project in their area.

Pensions: Kevin Quinn, chartered financial planner, Ramsay Brown Financial Services Limited

My top tip for the start of 2013 is to request an up to date statement of your accrued NHS Pension Scheme (NHSPS) benefits, with a breakdown of your pensionable service and pensionable earnings to date. 

Fortunately, this is easy to facilitate because all you need to do is contact your NHSPS administrator, outlining your request and providing a copy of your personal NHSPS reference number and/or your NI number.

Generally, you will only be entitled to receive one statement free of charge during any 12-month period.

With the statement, you will be well placed to check that the service and pay information is correct and to deal with any retirement/pension questions that might arise. 

For example, are you on track to achieve your retirement objectives or do you need to make extra provision? Are you likely to exceed the annual allowance and/or lifetime allowance limits and if so, what options do you have?

CQC registration: Gerry Kennedy, healthcare consultant and director, Healthcare Regulation Solutions

As 2012 draws to a close and we wonder what lies ahead in 2013, NHS GP practices may consider 1 April 2013 is the real start of the new year, as a new chapter begins in healthcare regulation.

Care Quality Commission (CQC) registration is fast approaching. Applying to register with the CQC is not difficult; staying compliant is the challenge.

GP practices that have already submitted their applications may be wondering what an inspection will look like. So now is the time to ensure that you have evidence of compliance with the essential standards in place.

Practices will need to be ready to deal with short notice or unannounced inspections, which will be ‘scheduled’, ‘responsive’ or ‘themed’.

CQC compliance assessors will make a point of talking to patients and practice staff to confirm outcomes and personal experiences of using services. Providing compliance evidence is crucial.

Having your evidence in place in the practice and a continuing system of governance that is readily accessible will make this task much easier.

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