The process

GPs are responsible for running the business affairs of the practice, providing adequate premises and infrastructure to provide safe patient services and employ and train practice staff. As the 5 year forward view is being rolled out, this is becoming an increasing burden for GP’s to run their businesses efficiently and cost effectively to maintain an adequate sustainable income. Many GP’s do not have the business acumen to affect the change management needed within their practice, whilst maintaining their clinical knowledge to ensure patients receive the best possible service and outcome for their health concerns.

This has led to an increasing number of GP’s looking at ways to retain their work within general practice and relinquish the overall management of their practice to an alternative provider with excellent business skills and extensive knowledge of the Primary Care Sector.

This may be as part of a larger group of practices who have already established effective working practices and developed CQC/CCG compliant policies and procedures that can be applied within the practice over a short period of time. This would see new patient and clinical pathways being implemented through change management for the benefit of all service users and staff.

This route can effectively save you the sleepless nights worrying about managing your practice whilst at the same time enabling your practice to realise the asset value in financial terms. Talk to us now in confidence to assist you in making the right decision for you and your practice by booking a no obligation Healthcheck report including making arrangements for a free QOF audit.

What are the implications of the General Practice Forward View? Or GPFV. In principle the GPFV, through the injection of new funding is vital to re-energise and re-vitalise general practice. More significant though, is the recognition of the importance of the whole primary health care team, including practice and community nurses, pharmacists, practice managers and admin staff. It is encouraging that NHS England is commissioning work from those delivering care at the front line, and listening to and applying the findings. We must modernise and connect with partners beyond the parameters of the NHS including housing and local government. This will also include private healthcare providers who deliver services on behalf of the NHS. Do you want to be innovative or stand still?

We can support your practice to implement ways to meet the requirements needed to ensure that your practice maximises the opportunities available both in terms of delivery of services and improving sustainable income.

Below are 10 High Impact Actions as determined by NHS General Practice Development

1. Active Signposting – Provide patients with a first point of contact which directs them to the most appropriate source of help. Web and app-based portals can provide self-help and self-management resources as well as signposting to the most appropriate professional. Receptionists acting as care navigators can ensure the patient is booked with the right person first time.
2. New Consultation Types – Introduce new communication methods for some consultations, such as phone and email. Where clinically appropriate, these can improve continuity and convenience for the patient, and reduce clinical time per contact.
3. Reduce DNA’s – Maximise the use of appointment slots and improve continuity by reducing DNAs. Changes may include redesigning the appointment system, encouraging patients to write appointment cards themselves, issuing appointment reminders by text message, and making it quick for patients to cancel or rearrange an appointment.
4. Develop the Team – Broaden the workforce, to reduce demand for GP time and connect the patient more directly with the most appropriate professional. This may include training a senior nurse to provide a minor illness service, employing a community pharmacist or providing direct access to physiotherapy, counselling or welfare rights advice.
5. Productive work flows – Introduce new ways of working which enable staff to work smarter, not just harder. These can reduce wasted time, reduce queues, ensure more problems are dealt with first time and that uncomplicated follow-ups are less reliant on GPs consultations.
6. Personal productivity – Support staff to develop their personal resilience, as well as specific skills to allow them to work in the most efficient way possible. This may include improving the environment, reducing waste in routine processes, streamlining information systems and enhancing skills such as reading and typing speed.
7. Partnership/Collaboration – Create partnerships and collaborations with other practices and other providers in the local health and social care system. This offers benefits in terms of improved organisational resilience and efficiency, and is essential for implementing many recent innovations in access and enhanced long term conditions care. This may include a merger or acquisition of practices to tender for healthcare contracts
8. Social Prescribing – Use referral and signposting to non-medical services in the community which increase wellbeing and independence. Examples include leisure and social community activities, befriending, carer respite, dementia support, housing, debt management and benefits advice, one to one specialist advocacy and support, employment support and sensory impairment services.
9. Support Self Care Management – Take every opportunity to support people to play a greater role in their own health and care. This begins before the consultation, with methods of signposting patients to sources of information, advice and support in the community. Common examples include patient information websites, community pharmacies and patient support groups. For people with long term conditions, this involves working in partnership to understand patients’ mental and social needs as well as physical. Many patients will benefit from training in managing their condition, as well as connections to care and support services in the community
10. Develop QI Expertise – Develop a specialist team of facilitators to support service redesign and continuous quality improvement. Such a team will enable faster and more sustainable progress to be made on the other nine high impact changes. The team could be based in a CCG or federation. They should ideally include clinicians and managers, and have skills in leading change, using recognised improvement tools such as Lean, PDSA (Plan Do Study Act) and SPC (Statistical Process Control), and coaching GP practice teams.

Talk to us now in confidence to assist you in making the right decision for you and your practice by booking a no obligation Healthcheck report including making arrangements for a free QOF audit.

Elite GP are experienced practice value and exit planners. As with most things in the current climate of NHS transformational change the earlier and better planned an exit is the more fruitful it will be. If you are unsure about the future of general practice and your role as a business partner as transformational change gathers pace, now is a good time to talk to us. Each practice is unique and so is each exit strategy. Depending on the composition of the turnover of your practice and cost base, some practices may need to work hard in the preceding years to maximise the value of the practice leading to its transfer of assets, whereas other practices that are already profitable due to delivering a range of additional services and high QOF prevalence may consider exiting sooner rather than later to obtain the maximum value for their practice.

We offer each practice regardless of situation or geographical location a ‘free practice healthcheck’ with no strings! We’ll even arrange a QOF audit for the practice, again free with no strings! This means that whatever your situation you will have an upto date valuation of our practice assets and what’s more if you decide, as a practice to offer it to market, you do not have to use our services. We are only too happy to support informed decision making and as the Healthcheck aims to offer you advice on how to plan your exit and obtain the maximum for your assets, should you decide when the time is right to exit. Each Healthcare check takes about an hour and is done at a time convenient to the practice at a time when preferably there is no-one else around. We then send you a full comprehensive report compromising of ‘more than just a valuation figure’ detailing;

• An Indication of the value of the Practice Assets, by partner and the Likely Sale Terms of each offer.
• A comprehensive breakdown of the valuation of the practice and how this has been derived.
• Suggestions as to how to improve profitability and therefore value to the practice.

This offers you an external perspective of your business and a unique profile in how a potential purchaser will view the practice when you decide that the time is right to sell your assets. Whatever you decide to do after receiving your valuation report you will be better informed as to what you want to do and the likely timescale you want to work to. We can and will support you, whatever that decision is.

Asset Valuation Basis

General Practice Valuations or asset transfer valuations are becoming more scientific yet they still require an element of subjectivity due to the number of factors that affect the valuation of a general practice business inclusive but not exclusive to: Turnover, Geographical Position, List Size, Additional Services Offered, Private Work

We value your practice on a multiple of the adjusted net profits of the practice, referred to in the accounting world as EBITDA. Commonly a practice would be valued in terms of a simple percentage of turnover. This method of valuation is unequivocally now incorrect and has led, in the past to a number of practices being sold for a price well below their market value.

When a buyer goes through the process of raising finance, the first thing a bank will ask is what is the EBITDA of the practice before agreeing to any lending proposal. Banks see the EBITDA as an indicator as to how successful that business will be in the future.

The EBITDA is then multiplied by a factor to establish a value for the practice, sometimes a further premium is added if there is specialist equipment, where specific pieces hold a higher value outside of the standard business valuation.

Whilst percentages of turnover valuations in some cases may be higher, this is often short-lived as prospective purchasers consult accountants, banks and business advisors they are often left in a position where their offer has to be reduced or is withdrawn altogether!

Confidentiality

Only purchasers who we have formally registered and taken a precise specification will be sent full details about your practice. Transfer of assets can cause a considerable amount of uncertainty for your practice staff and if miss-handled can cause considerable discomfort for all stakeholders. Therefore, all our purchasers must commit to a declaration of confidentiality before being sent advanced details about your practice. Equally, our team are accessible outside practice working hours and weekends so that you don’t have to keep sneaking off to make/take mysterious calls that could cause alarm.

Talk to us now in confidence to assist you in making the right decision for you and your practice by booking a no obligation Healthcheck report including making arrangements for a free QOF audit.