1. Financial Management for GP Practices Barry Prendiville Partner Nolan & Partners Chartered Accountants www.nolanca.ie PracticeManager.ie Annual National Meeting Stillorgan Park Hotel 21 April 2012

2. Overview - areas covered  Revenue Audits  Practice Finances & Profitability  Banking Facilities

3. Revenue Audits

4.  Revenue’s focus on the medical profession  Basis for selection  Recent developments – interview  Preparation in advance of audit  On the day – the audit  Risk Areas

5. Revenue Focus  Background – locums  “Determining accuracy of a return, declaration of tax liability or claim to repayment” (Code of Practice for Revenue Audit)  Cash receipts and expenses

6. Basis for Audit Selection  Sector wide  Late Returns  Unusual features  Insufficient drawings  Random  Third party information / comparisons

7. Recent Development  Revenue interview  Per attached letter  Not a Revenue audit but not to be dismissed

10. Preparation for audit On the day - the audit

11. Risk Areas  Spouse & other family members on payroll  Pension contributions  One bank account for practice and personal  Maintenance of accurate and complete books and records

13. Any questions?

14. Practice Finances & Profitability

15.  Introduction  Annual budget  Cost base  Top line growth – “category management”  Marketing / business development  Measurement of revenue generating initiatives

16. Introduction

17. Annual Budget  Set your stall out before the beginning of the financial year  Partner sign-off – psychologically important  Measurement of actual v budget  Management accounts

18. Cost Base  Delegating area of cost base  Empowering staff  Areas to attack:  Light & heat  Telephone audit  Insurance  Professional fees  Etc.  Cost base constantly in focus

19. Top Line Growth  Concept of “Category Management”  Patient care  Allocation of resources  Purge on GMS income  Additional income through existing patients or  Take on new patients

20. Marketing / Business Development  Key area  Branding – brand values  Develop marketing strategy  What influences your income?  Qualitative market research  Corporate account

21. Measurement of Revenue Generating Initiatives  Key area for practice profitability  Existing patients  Incremental revenue streams  Analysis / measurement over several areas, e.g.:  Income from each revenue initiative  Income per consultation  Income per patient  Gross income per partner  Etc.

22. Banking Facilities

23.  Overdraft  Focus on annual review date  Term Loans  Mortgages  Commercial – committed or demand  Leasing  Tax efficient mechanism of financing surgery fit-out and purchase of equipment

24. Questions?

25. Contact Details Barry Prendiville Nolan & Partners Chartered Accountants 301 Q House Furze Road Sandyford Business Park Dublin 18 T: 01-2176510 E: barry@nolanca.iebarry@nolanca.ie W: www.nolanca.iewww.nolanca.ie