‘NHS general practice isn't financially viable'
I am not saying that. It was a recent GPonline news headline on the views of half of the GPs it surveyed. While GP Partners wait for better funding that may never come, what strategic choices are you making? If NHS general practice as a business is no longer financially viable, then being a business owner requires you to make strategic choices.
As a clinician you ask:
What is best for this patient?
As the business owner you also need to ask:
What is best for the long-term future of this business?
I do not think enough is asked about that second question either at individual practice level or nationally by the DHSC/NHSE. In its place is a continued hope for a significant funding uplift, but that is not likely to happen. If you are basing the future of your business on the likelihood of something you cannot control then yore placing it in a vulnerable position. If you genuinely believe your business is no longer financially viable, what would any sensible business owner do next? In any other business, the owners would be looking at their strategic options….and in general practice there are options, and waiting and hoping is not one of them.
If you believe that NHS general practice is no longer viable then this is what a business owner should be considering:
Diversify While the GMS contracts puts restrictions in place there are still ways to diversify and some practices already successfully do this. Diversification only works if it genuinely improves the overall business rather than distracting from it, but it's worth thinking differently and considering what you could do alongside your NHS practice.
Scale That might be through merger, acquisition, or new business. Expanding in this way can reduce non-patient facing costs, achieving economies that otherwise you could not which ultimately improves sustainability. It can also create a stronger, more resilient business with greater capacity to invest in its people, systems, and future development.
Streamline This is about stripping back unnecessary activity and focusing resources where they add the greatest value. It's a commercial mindset that many practices avoid, and instead do everything for everyone because that's what we've always done. Instead of working this way ask, "is this adding value" or "could it be done differently"?
Exit This might be the most uncomfortable nuclear option one that you would rather not acknowledge. Businesses close and sell all the time but handing back a contract is almost unthinkable, yet strategically it is a perfectly valid option if a business is genuinely unsustainable.
If your practice genuinely is not financially viable, what strategic choice are you making as its owners? Because if your answer is, "none, we're just hoping funding improves", then you are not making a strategic choice.
William Greenwood
Chief Executive