It’s a challenging time for general practice (GP) finances, but there is always help available.
In this article, Dr Tommy Perkins (GP and co-founder Medics’ Money) and Andy Pow (specialist medical accountant who recently joined Medics’ Money) share seven tips to help sustain and improve your GP practice in 2023.
1. Managing cost inflation.
We all know costs in General Practice are going up far faster than GP income currently is. Understanding your practice finances (not just at year end when your accountant comes to visit) is essential. Practices should use the latest cloud accounting software tools, have access to benchmarking information to compare with similar practices, and appoint good advisors to work alongside the management team. Establishing good financial systems and reporting will help you make better real-time decisions. The Medics’ Money Partnership Course has taught over 450 partners the business skills needed to run a happy, sustainable and profitable practice and you can find out more here.
2. Use your staff resources well.
Cost limitations will make it dif ficult at practice level to increase staffing. Whenever there is a change in staff through resignation or retirement, always review the overall staff structure and don’t necessarily replace like-for-like immediately. Practices need to work closely with their PCN in England to make best possible use of the ARRS resource. For example, could you redirect medication queries to a pharmacist? Efficient triage and signposting is needed to avoid duplicating work: you need to get the patient to see the right clinician first time, every time. This podcast has some great tips for how to utilise ARRS staff.
3. Do you have enough space?
It’s a common problem for General Practice with a lack of investment over the past few years by the NHS. Premises ownership is complex, particularly now where interest rates are high; the cost of leased premises is increasing. Practices need to review and understand their premises costs, ensure utilisation of space is at a maximum and plan for the future. Review banking terms or have regular meetings with your landlord to ensure you are getting the best possible terms. Equally, for property owners it is also important to review your rents – be it NHS notional rent on a three yearly basis, or other tenants tied in with their lease terms.
4. Understanding the NHS pension
The NHS Pension Scheme is a valuable benefit for staff and most commentators would say it is one of the best schemes in the country. The pension should be highlighted as a positive aspect of working in general practice to help with staff retention and recruitment, however, Doctors and non-GP Partners have the added complication of updating their pension records and time will need to be set aside for this. Regardless of extra commitments, it is essential that everyone understands where their pension is up to, and what other benefits membership brings. Changes in the 2023 budget also improved the position for those impacted by the Lifetime or Annual Allowance tax charges. Take time to educate yourself in this, and you won’t worry about the future as much. The Medics’ Money Partnership Course covers the pension in detail. This short video shows you some quick tips to get the most from PCSE: PCSE NHS Pensions survival guide for GPs
And this guide shows you how to check your pension records.
5. Challenging times often lead to increased disputes.
Practices need to make sure that the partnership agreement is fit for purpose so that everyone has a clear understanding of the legal rules. Equally, PCNs need to have clear agreements between not just the member practices, but also any external organisations they work with. De-escalating disputes before they need legal input should also reduce costs.
6. Better use of technology.
With all the talk of decreasing budgets, increasing costs, decreasing GP numbers, and increasing numbers of patients it’s clear new ways of working are needed to survive. Utilising innovative technology can help to improve efficiency and provide better patient care. For example, instead of sending out letters (an expensive process) to invite your patients to call your busy phone lines (labour intensive) to book a flu jab, why not text them a self-booking link to allow the patient to book themselves in online, independently. This is easier and more convenient for your patients, cheaper and less staff time needed. Inside the private community of over 450 partners on our Partnership Course, partners are sharing new ways to using technology including using text messages to complete scoring systems – e.g. Asthma Control Test in advance of any review appointments, using text messages to collect information for QOF, facilitating efficient triage and collecting feedback. By streamlining communication, you can gather data from your patients more efficiently and get the right patient to see the right clinician first time.
7. Understand your tax position
Whilst many partners will leave this to their accountants, it is useful to have a general understanding of the tax bands, particularly if you receive support with childcare. Additionally, practices that do not operate with a 31 March year end need to be aware that HMRC will be changing this on 31 March 2024, with possible tax implications for partners. Understanding your tax positions will help you manage cash flow better. In this article GP and Chartered Accountant Dr Ed Cantelo gives an example of a tax trap to avoid.
Medics’ Money is run by GPs and finance experts, and you can find details of our New to GP Partnership training course to support new partners here.
The course teaches new GP partners everything they need to know to thrive in their new role and for eligible partners it is fully funded by the NHS.