1. Practice Finance Update
Peter Farrier (FCCA)
Director
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

2. KEY AREAS Optimising revenue streams
Checking NHS statements and managing claims
Controlling costs – Variable -v- Fixed
Avoid surprises
Characteristics of a high earning practice
Challenges and opportunities ahead
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

3. OPTIMISING REVENUE STREAMS
Financial Governance
Partners must be aware, and review regularly levels of actual cash held in all bank accounts.
Payment procedures to be reviewed to mitigate possible fraud or ‘scams’; especially when change has occurred.
Cyber security checks now vital.
Build a bespoke follow up system for activity based income streams to ensure payment received correctly.
Check profitability of services offered, e.g. are any enhanced services costing you money.
Budget and review!
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

4. OPTIMISING REVENUE STREAMS cont.
As always, review the following….
Accurate coding and internal audits on a regular basis
Private Fees, ensure good credit control system in place. Ensure you are charging the right amount for the services provided -
Will GDPR alter work you get paid for?
Floor space use, are all rooms fully utilised. By whom and for what?
Research income – any available? If so, is it profitable?
Training – Scope to be a GP training practice? Pilot training for other clinicians?
Drugs – Ensure adequate controls in place for prescribing to include income, stock and ordering.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

5. CHECKING NHS STATEMENTS
AND MANAGING CLAIMS
Need to create a quasi invoice system. Ensure claims sent are followed up and agreed to payments received. This task should be completed monthly.
Chase PCSE immediately if there are any concerns via the enquiries form;
pcse.england.nhs.uk/contact-us/
Check PCSE website regularly for updates and newsletters.
Use your accounting system or spreadsheet to compare same month/quarter year on year for trends, omissions, or errors on payments made.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

6. CHECKING NHS STATEMENTS AND MANAGING CLAIMS cont.
If using a spreadsheet for collating claims before submitting, always check formula to avoid over/under claiming.
MUST check superannuation contributions for all new partners, salaried GPs, leaving partners/GPs and any GP who has opted in or out of the scheme.
Make sure NPL3s are completed as PCSE will do nothing without one.
Being paid for services you aren’t delivering? Remember to set aside the income ready for any claw backs.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

7. CHECKING NHS STATEMENTS AND MANAGING CLAIMS cont.
Type 2 Self Assessment of Tiered Contributions
Type /17 certificates are being processed – check for amendments made.
These amendments will cover all salaried GPs at the practice during the year, including any that are no longer with you.
Be aware the PCSE are actively chasing Type 2s back to 2009/10!
Don’t assume monies are necessarily to be paid/taken from salaried GP, the payroll may have been correct! If in doubt contact your accountant.
2017/18 certificates are not yet available.
It’s a requirement under NHSPS regulations for the Type 2 to complete these. Failure to comply could result in nil pensionable pay for the year.
Ensure you are notifying PCSE of any pay changes during a year to ensure correct contributions are being taken including maternity leave. PCSE no longer complete their annual reconciliation.
Supply your salaried GPs with their pensionable pay and contributions paid for each year.
BMA amnesty re type 2 certs going back to 2009/10 to 2014/15, then 2015/16 is if you didn’t know about annualising but submitted you don’t need to worry, but 2016/17 should have been correct and submitted.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

8. CONTROLLING COSTS – Variable -v- Fixed
Variable costs are normally linked to activity, so ensure income claim is made as well.
Staff costs can vary, there must be systems in place to authorise overtime, pay rises and other increases.
Many costs in general practice are fixed, so hard to change.
Look for monthly payment options and ensure you are happy with the cost/benefit of these costs.
Buying groups (IPC, etc.) can be of benefit.
Make sure internally only certain staff can order and authorisation system in place.
Partner approval should be evidenced on all invoices before payment is made.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

9. AVOID SURPRISES Do not wait for the Accountant!
Reconcile your bank account regularly.
LCS advance from 2011 should now be clawed back…….
Profit and Loss accounts, and cash summaries are all vital reports that should be generated monthly.
If a dramatic change in the practice, flex the budget, but consider why you have the difference.
5% surcharge for unpaid tax balancing payments for 2016/17 due 31 January. Came in to effect from 28 February.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

10. AVOID SURPRISES cont.
Ensure any superannuation not correctly deducted from March 2018 statements has been paid. Promise was made that all superannuation certificates will have been processed by 30 April 2018!
Income tax payment on account for 31 July 2018 should always be reviewed for material profit changes in most recent financial accounts.
Likewise superannuation payments on account must be checked monthly, along with seniority payments checked quarterly.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

11. OF A HIGH EARNING PRACTICE
CHARACTERISTICS
OF A HIGH EARNING PRACTICE
Caveat – Every practice is different!
Good ratio of full time equivalent partners per patient is a strong start
Some geographical rewards and opportunities that cannot be changed or copied
Strong internal controls on financial aspects for both income and expenses
Good level of non-core income from NHS and Non-NHS sources
Actual -v- budgeted results monitored and acted upon
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

12. OF A HIGH EARNING PRACTICE cont.
CHARACTERISTICS
OF A HIGH EARNING PRACTICE cont.
Multi-skilled staff across all admin and lower medical care, monitoring of actual staff salary costs against budget.
Partners’ rotas planned and partners covering each other where possible to reduce unnecessary locums.
The right blend of ‘triage’ offered without a GP
Lowering patient expectation to a realistic level to allow the service to be delivered.
There is no panacea for size of practice, small or big, single or multi site, can be strong or poor earners.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

13. CHALLENGES AND OPPORTUNITIES AHEAD
Returner/Retention schemes
Making tax digital Why? When? Who? How?
Apply for all funding offered, is there any resilience funding?
2018/19 contract – still being negotiated, but only minor changes expected.
BMA/GPC pressing for uplift in line with RPI.
ACSs renamed ICSs (Integrated Care Systems) and working ‘at scale’
Extended access for 100% population by 1 October 2018.
2019 Professional Indemnity Scheme changes.
GP Premises Cost Directions updates.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

14. QUESTIONS?

15. DISCLAIMER
These notes have been prepared for the use of delegates at WSPMA annual conference held on 7 June They are not a substitute for detailed professional advice either for those delegates attending the presentation or any other person who may read the notes. No responsibility can be accepted by the speaker or Morris Crocker for the consequences of any action taken or refrained from being taken as a consequence of reading these notes or attending the seminar for which they were prepared.
Peter Farrier, Director, Morris Crocker, Station House, North Street, Havant Hampshire PO9 1QU
Tel:

16. Station House, North Street
Peter Farrier (FCCA)
Director
Morris Crocker
Station House, North Street
Havant, Hampshire
PO9 1QU
Tel: