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Independent financial review of general practices

markpcc
MarkPCC 12 September 2024

Background

We were commissioned by an integrated care board (ICB) to undertake a financial review of three primary medical care practices to assess whether they were appropriately funded. We were asked to recommend remedial work, where appropriate, to improve the practice’s resilience and performance. The ICB intended using the review to inform a financial benchmarking exercise and support future contract negotiations. The ICB wanted the review to consider three areas:

  • Were the practices correctly funded
  • Was ownership of the premises a significant factor in service provision, profitability and resilience
  • What was the effect of deprivation on the contract sum

Structure of the review

  • Comparing the three practices against other practices in the ICB
  • Benchmarking funding levels across the ICB, looking at:
    • Contract income
    • Quality and outcomes framework (QOF) achievements
    • Enhanced service provision
    • Section 96 grants
    • Deprivation
    • Staff cost/mix
    • Premises expenditure.

What we did

We appointed an experienced practice manager from our associate team to undertake the review who:

  • Visited the practices and held meeting with staff
  • Reviewed the practices finances, taking into account contract profitability and service delivery
  • Assessed the constraints on each of the practices under review; financial, managerial, personnel or premises
  • Utilised the Healthcare Financial Management Association financial resilience framework, concentrating on:
  • Business and financial planning
  • Budget setting
  • Reporting and monitoring
  • Forecasting
  • Cost Improvement/efficiency plans
  • Board reporting
  • Financial governance framework
  • Culture, training and development

We provided the ICB with a report explaining, our methodology, the review against the relevant areas, our conclusions and recommendations. The recommendations were included for the ICB’s consideration in how they may wish to address the issues identified during the review.  The recommendations were unique to each of the practices under review.

A benchmarking report was produced showing the three practices against other practices in the ICB in order to recommend appropriate funding levels required. The benchmarking report will enable the ICB to make future commissioning decisions.

For information on how PCC can support you contact enquiries@pcc-cic.org.uk or visit www.pcc-cic.org.uk

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