BUSINESS PLAN ‘UNVEILLED’!

How to write a Business Plan?

Writing a Business Plan from cold is almost impossible without some input and direction from those that want the “plan” written. So, who has asked for the ‘plan’? Is it simply for the Practice? Has the Care Quality Commission asked for a plan or is it the local Clinical Commissioning Group. The content of your ‘plan’should be what you are prepared to share publicly. This might not include financial details.

Structure of Plan

It has not been unusual for health authorities such as FPCs, FHSAs or Primary Care Trust now CCGs to ask for an Annual Programme, or an Annual Plan or more recently a Business Plan. I recall being asked to write a Business  Plan from cold with no suggestion of input from others. I knew that It needed a ‘mission statement’ to open the ‘Plan’. Then it needed ‘content’ from which derived aims and objectives. The aims were what the Practice wanted to do, and the objectives were how the Practice would get you there. At that point no one knew what was wanted. The objectives could then be passed down the line at Appraisals to individuals, groups or teams to enact.

Planning Meeting

As a starting point you will probably need a practice meeting for them to tell you what they want to do or stop doing and how it might be achieved. It might be a simple case of pooling ideas, analysing what the Practice is doing well and not so well and then deciding a way forward.

Post It Notes, and a flip chart are useful tools for such an exercise. You could even design a form asking everyone what they think is good in the Practice and what they think is not so good. It might already be clear in the short term what challenges face the Practice, but it might not be so clear in the long term. But there again it might not be so obvious.

Some examples might be:

• Introduce Electronic Prescriptions Service and more online services for patients
• Appoint replacement doctors, partners or salaried doctors
• Appoint a nurse practitioner, with prescribing status
• Introduce telephone consultations and same day appointment triage
• Provide improved surgery facilities, notice boards, new chairs, furniture
• Provide a defibrillator and new vaccine refrigerator
• Introduce a pay structure for staff and terms and conditions of service handbook
• Review Practice Policies including personnel, Protocols and Procedures for CQC purposes
• Review the Scale of Charges for private non NHS work
• Review the content and look of the Practice web site and update the NHS Choices web site
• Review the arrangements for the Patient Participation Group
• Prepare a new Partnership Agreement
• Prepare a Practice Management Manual

And so on, the list might just go on and on ……

THE BUSINESS PLAN

Mission Statement

The Mission Statement should encapsulate what the Business/Practice is about. Try around fifty words.

Example –

“The Practice intends to provide family medical services, under an independent NHS contract, with efficiency and effectiveness within the manpower and financial resources available”

Introduction:

Introduce the background to and the history of Practice, its doctors, the partnership, it’s location, the type of premises, neighbourhood, the Practice list size, number and type of doctors, along with the total number of sessions needed, Add in the staffing structure, type and number of nurses and staff. Hours worked.

What is the overall income of the Practice and what expenses drain the profit. (They might not want to go public here). Is the list rising or falling and for what reason? Are there any local housing developments.

To Develop the Plan:

Taking each ‘department’ (Practice Staff, Nursing Team, Administration etc) comment about whether it is running satisfactorily or needs improvement and if so, what so what needs to be improved?

Set out the aims of your Practice and develop objectives for each aspect as to how each aim/objective can be achieved.

The list might include:

• Premises – for existing premises, you might need more consulting space, close a surgery? For new premises you might be setting out your accommodation needs.

Example:

Aim – To improve the surgery accommodation to meet current and future needs.
Objectives – To convert a store room to a consulting room and obtain funding for works to be carried out

• Computing – You might need more or new computers.  You might be aiming to become more paperless, scanning all Lloyd George Records. You might want to Start using EPS, online appointments, and access to record.

• Administration – facilities, services…. You might need more staff, a new switchboard, text services, dictation system, furniture, equipment etc

• Manpower – Doctors, Nurses, Staff…. You may be using too many Locums, want to provide more telephone consultations, introduce triage and a nurse practitioner etc.

• Training Culture – another often-overlooked area. You might need to ensure that Practice Nurse training is up to date and that training for practice staff covers safeguarding, life savings skills etc.

• Finance – Staff costs might be too high and inconsistent, locum costs too high, there may be no clarity about pay scales and no consistency of terms and conditions for staff.

• Extended Hours – You might be joining other practices to provide out of hours services and want to provide a ‘centre’ for such services. It may involve a CCG or Federation.

• New Services – Your practice might be keen to offer new services, with a Federation.

Financial Appraisal:

There is a cost to new ways of working and you might need to draw some conclusions about income and expenditure and suggest where does new money come from.  This might need a separate Business Case. This section might need to have limited circulation and be kept confidential.

Conclusions:

Summarise your conclusions in the form of objectives and set out a time table may be year by year to achieve it all.

Set a date for review and revision.

Business Case(s)

As a result of writing a general business plan you might end up writing individual business cases for each objective.

Robert Campbell
November 2018

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