1. FINANCE FOR PRACTICE MANAGERS Jenny Stone, ACA Ramsay Brown and Partners Ramsay House 18 Vera Avenue London N21 1RB Tel: 202 8370 7705 E-mail: Jenny@ramsaybrown.co.ukJenny@ramsaybrown.co.uk

2. Finance Issues Practices are facing  Majority of practices have not had an inflation uplift since new contract  Profits are falling  Cashflow difficulties  Pressure from partners to maintain profit/drawings

3. Funding for 2008/09  For 2008/09 global sum increased by 2.7%  However if receive MPIG then any increase in global sum will reduce MPIG correction factor  Majority of practices have not had an inflation uplift since new contract  Funding for extended hours recycled from access and QOF

4. How to Increase Practice Profit  Practices have seen a drop in profits for the last two years  Profit = Income less Expenses  To increase profit need Increase income Reduce expenses

5. Increasing Income  Under nGMS very difficult to increase NHS income  Increase practice list  Practice Mergers/bidding for vacant practices  Aim to achieve maximum QOF points  Ensure max enhanced services income and taking up new directed enhanced  Correctly claiming reimbursement of rent & rates, vaccines  Ensure private fees charged and monies received  Using existing resources to generate new income

6. Other Income  Need to consider benefit of new service compared to cost  Examples of other income Teaching medical students Becoming a training practice Service charges for use of rooms Nursing homes Dr for Private Schools Occupational health PBC provider

7. Reducing Expenditure  Review all areas for potential savings Cheaper suppliers for telephone, gas, electricity, insurance Keep an eye on stationery expenditure, costs can escalate More use of e-mail as opposed to printing and posting Review work carried out by staff Review use of locums Sharing resources with local practices Setting budgets for all areas of expenses for year, allows you to monitor and control expenses

8. Preparing Budgets  Use of budgets Predication of the profitability of practice Setting a budget allows you to monitor and control income and expenses Set partners monthly drawings  How to prepare a budget Start with last yrs income and expenses Adjust for changes in income and expenses e.g. new services, additional staff Compare monthly budget with actual results Budgets can be reviewed throughout the year and amended

9. Preparing Cash flow Forecasts  Use of Cash flows Difference between cash coming in and cash going out Helps to identify period when may go overdrawn  How to Prepare a cash flow Include all income and expenses in months that they occur Include partners drawings, superannuation, tax (if practice pay it) and loan repayments