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General Practice Finances. What you need to know!.
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General Practice Finances What you need to know!
Maximising income and minimising expenditure are the bedrocks of any business. It is crucial, therefore, that going forward into Practice you are aware of what is needed to maximise profit and to keep the Practice functioning as a stable business. Talking about money – about income and expenditure is not easy for some doctors. Don’t be a ‘wuss’ just do it!
We love our acronyms! A Quiz QOF (easy) KPI (harder) DES (easier) SIP (impossible) GMS (easy) PMS (easy)
Income • National GP contract – Quality & Outcomes Framework (QOF) – clinical and organisational:- CHD Hypothyroidism Heart Failure Cancer Stroke &TIA Palliative care Hypertension Mental Health Diabetes Asthma COPD Dementia Epilepsy Depression CKD Atrial Fibrillation Obesity learning Disabilities Smoking CVD risk
QOF contd-Organisational • BP – age > 45 – 65% and 80% • Records summaries – 60%, 70% and 80% • Ethnicity recorded • Smoking status recorded • Medication reviews – 4 or more & repeats • Cytology • Contraceptive services • Patient experience survey results
Local GP Contract • January 2011 • Replaces previous GMS/PMS contracts • Rationale? – (1) standardisation – more like a dumbing down of standards for high performing practices – working at the lowest common denominator • Rationale? - (2) cost reduction (I am a cynic!)
Contract KPIs • Availability Convenience & Choice • Palliative Care Cancer • Childhood vaccs Flu imms • Obesity Sexual Health • Smoking cessation Stroke/TIAs • QOF Quality Accounts • Data Quality Infection control • Effective activity management • Cost effective prescribing Appropriate access • Engagement in commissioning Specifics? Questions?
Enhanced Services • LARC IUCD • MSS/SCC Alcohol • Near patient testing Learning Disability • Extended access Patient participation Specifics? Questions?
SIPs • Examples: - Acupuncture Insulin Initiation Housebound patients Specifics? Questions?
Other income • Training – grants – GPR, Foundation years, HYMS students • GPSI • Private income eg standard medicals, insurance medicals & reports, shotgun licences(!), • OOH, Hospice, Police doctor, Private companies • Reimbursements eg flu, pneumovax imms, yellow fever etc (speculate to accumulate!)
Expenditure • Partner drawings • Staff costs – salaried GPs, locum GPs, nursing and non clinical staff • Surgery expenditure – surgery supplies eg vaccs, dressings • Rent, utilities • Tax, superannuation
Planning • Business Plan • Budgets – Income & Expenditure • Reconciliations • Cash flow forecasts
The End & a Tip • You need to know this • You need to get up to speed on this • You are not trained to do this • You probably just want to be a doctor but ignoring this will affect you greatly – financially, emotionally ------------------------------------------------------------------ • Employ someone like me to take the pain away! • Trust people