1. Maxine Pott FCA Director of Healthcare Group RMT Accountants & Business Advisors Ltd SPECIALISTS IN GP PRACTICE FINANCE General Practice Management Conference Manchester 29 January 2015 2. The Practice/Business Manager 3. Summary National context direction of travel GP Practice finances current and future, challenges and initiatives Opportunities arising for GP Practices survive and thrive! 4. The National Picture The five year forward view Need for radical change Health and wellbeing gap Care and quality gap Funding and efficiency gap Additional government funding Public and private collaboration 5. The National Picture Finances remain tight 30bn gap Budget pressures are expected to continue Solution? GP Practices are central to success in all 3 areas!!! Patient Demand Resources Reduce Demand How? Prevent Poor Health Empower Patients Engage Communities Why? 6. The GP Picture Current and Future Challenges GMS v PMS ongoing debate GMS 0.28% increase/1% pay rise DDRB staff costs decreasing! MPIG loss over 7 years Seniority loss over 6 years, nothing for new starters from April 2014 Recruitment, retention and succession issues Outdated premises 7. The GP Picture Current and Future Challenges Contd Practice operating costs increasing 3% p.a QOF points are harder to achieve and falling Enhanced services viability? Extra costs for locums Squeeze on margins Very little new funding so cashflow visibility is essential Protect and improve income 8. Protect and Improve Income/Profitability Main Income Streams Global Sum or PMS Baseline = list size QOF = targets + KPIs Enhanced services = list size + patient demographic Dispensing = systems + internal controls Main Costs/Investments People = accountability + flexibility + multi skilled Premises = fit for purpose IT = future proof + integrated 9. New Initiatives Premises Recognition of huge historic underfunding in GP premises GPs invited by 16th February 2015 to submit bids using money from 1bn building fund announced last year 4 year period 250m tranches. Purpose Make improvement to existing premises Building new ones Success Factors Capacity to do more Provide value for money Improve access to services for the frail and elderly 10. New Initiatives People NHS England providing 10m to expand General Practice focus on areas where difficulty recruiting Recruit Retain Return Develop roles of other Primary Care Staff Nurses Pharmacists 11. Opportunities Moving service provision to primary care and other secondary care providers Collaboration GP Practices alliances/mergers Other NHS providers Private healthcare companies 3rd Party Contracts Specialisms long term contracts Premises Multidisciplinary healthcare hubs Maximise income from excess space Join Ventures Establish separate entities to provide services into the NHS or private users 12. Strategic planning Consider six key questions What do we want to do? What have we done well in the past? What must we do well to succeed? What could we do? What might we do? What should we do? 13. Calm and in Control 14. Thank you for listening Questions? 15. Experts in Practice Finance Experience within medical sector in excess of 25 years Founder members of AISMA Contributor to Medical Press and National Seminars Expert team of 20+ dealing with in excess of 100 GP practices and over 1,000 other healthcare professionals Part of a full service Practice Maxine Pott FCA Director of Healthcare Group Tel: 0191 256 9580 Mobile:07977 446 872 Email: maxine.pott@r-m-t.co.uk Web: www.rmthealthgroup.co.uk Web: www.r-m-t.co.uk