With the start of a new 12-month business cycle, it’s crucial to have a strategy in place that addresses the practice’s main priorities and challenges. Former practice business manager Gary Hughes explains how to draw this up and put it into action
When it’s busy, and you are firefighting, it’s easy to settle for keeping your head above water. However, it’s important to take time to pause and reset. The start of a business or calendar year is an ideal time to do this and an opportunity to make plans that set the direction and priorities for the year ahead.
Do I need to make a business plan?
General practice is a business, just like any other, and success can depend on strong and clear business plans that set out your goals and the path to achieving them. It’s important to prepare for a new financial year to ensure everything continues to operate effectively and efficiently, and that the practice maintains a healthy financial position. At the end of a challenging year, it is also not unusual to have lost clarity on where you’re heading. Stopping to redraw your plans is a great way to address this.
How do I make a business plan?
1. Take a step back and review the year that is ending
Set time aside, and away from the immediate work and issues to consider:
- What has gone well that you should build on?
- What hasn’t worked and is time to change?
- What changes can you make that will have a positive impact?
As a practice manager your own views are essential but you should also get input from of all key members of the team to help you make and agree the final plans.
2. Clean up your ‘To Do’ list
It eases the pressure if you begin the year with as clean a slate as possible, so review the jobs on your to do list. Which ones are so old they are never likely to happen? If you haven’t completed a particular task, or you haven’t been chased to complete it, then it can come off the list. A reprieve like this will make you feel better and let you focus on what’s new.
3. Break your plan down to cover the vital areas
Business planning can be a complex task but it’s a lot easier broken down into four key areas:
- Finance – your plan for the money
- Workforce – your plan about the practice team
- Governance – your plan to meet regulations and compliance
- Systems, schedules and processes – your plan to keep the practice running smoothly.
You can create these as individual sections under a single overarching plan, or create four standalone plans, whichever you’re more comfortable with.
Below you will find a checklist of the main items to include in each section to guide you as you build your own plan.
Finance – your plan for the money
- Budgets. Probably the biggest task of all is to create full year budgets. You can base these on the previous 12-month period, but make sure they reflect any changes happening in the coming year. If you’re able to, incorporate some cash flow forecasting into this part of your financial plan.
- Debtors. Chase up the debtors you’ve carried over and set new calendar dates to regularly chase debtors during the year ahead.
- Bank reconciliation. Make sure the business bank account was reconciled at the year end and set calendar dates for regular monthly reconciliations.
- Stock take. Review the year end stock take just completed and plan any stock changes needed in the year ahead.
- Start a new payroll year. Close down the previous payroll year and start the new one with all the changes made e.g. starters, leavers, payroll changes etc.
- Premises repairs and maintenance. Make plans and budget for any repairs or improvements needed. It is important to do this as these can be significant items of expenditure.
- Asset register. Review and update the register and budget for any replacements or new purchases.
Workforce – your plan about the practice team
- Workforce numbers. Review the size and skills of the practice team against the needs for the year ahead. Is anyone leaving or have you got existing gaps in the team? Are new or improved skills needed and have you factored in succession planning? The answers to these questions will help you make your recruitment and training plans.
- Training plan. Make sure all appraisals and personal development plans are completed so you can pull together all the team’s development needs into a training plan. Share the annual training plan with the practice team, making sure dates and responsibilities are clear and that it aligns to the needs of the practice and individuals.
- Staff leave. Reconcile leave taken from previous year and start a new year.
- Locum bookings. Look ahead to plan where you need locum cover for staff leave or to meet demand. Booking as early as possible will give you the best chance of being able to secure the locums you work best with.
Governance – your plan to meet regulations and compliance
- Risk register. A risk register is different to a risk assessment and lists the risks and threats to the practice and what plans will be put in place to manage them.
- Risk assessments. Review and update all your risk assessments e.g. health and safety, fire safety, Control of Substances Hazardous to Health and so forth, making plans for any actions needed.
- Policies and protocols. Make a plan to review and update all policies and protocols. Make sure responsibility for reviewing each one is assigned to the best person ( for example, safeguarding policies should be allocated to the safeguarding lead, or information governance policies to the data protection lead or Caldicott Guardian), with calendar dates set for when they are due.
- Contracts and registrations. Which contracts and registrations will need renewing? Set your calendar dates to do these for the year ahead.
- Insurance. Make sure your insurances (e.g. public & employer’s liability, professional indemnity and any others needed) are up to date and in place, and the renewal dates are added to your calendar.
Systems, schedules and processes – your plan to keep the practice running smoothly
- Appointment schedules. Review your appointment structure to make sure it maximises access and makes best use of all staff. Make sure it reflects the need of any service or staff changes in the year ahead.
- Recall schedules. Make sure searches, recalls and invitations are scheduled for all services needing reminders, e.g. QOF, enhanced services, immunisations, screening.
- Audit schedules. Make sure there is a practice plan for audit cycles, including significant events and complaints, with calendar dates set to do these.
- Meetings schedule. Review the practice meetings and agree those that are needed for the new year and create a schedule to share. Meetings can be a significant drain on time, so stop any that are no longer relevant or consider where a suitable alternative to a meeting is possible.
- Workflow and communication processes. Review practice processes to identify where things can be done quicker or more efficiently, and where duplication can be removed.
Putting the plan into action
If you have finished your plan, congratulations! It now needs to be implemented, and there are some important things to remember.
Implementation should not be the responsibility of just one person, not even the practice manager. Hopefully you have involved the team in building the plan, so all staff members will be on-board. Delegate the tasks within the plan and make sure all responsibilities are agreed and allocated, and that everyone is clear on their role and how it contributes to success.
Prioritise the tasks to be completed and get started straight away. If you delay, it can mean opportunities are missed, or creates more work later in order to catch up. In addition, motivation will be lost if sticking to the plan is not seen as important.
The final thing, and one last vital part of your plan, is a system for monitoring and measuring progress.
- Key Performance Indicators (KPIs). Decide how you are going to measure progress against your plans and who will be responsible for doing that. Share the results and celebrate every success along the way!
Creating your business plans can feel like a significant task but done correctly it will pay dividends throughout the year.
You can download a printer-friendly version of the business plan checklist here.
Gary Hughes is a director at Venn Health providing support to primary care. He has been a Practice Business Manager and Federation Director and has an MBA and a Post Graduate Certificate in Medical Education.
