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How to...Keep practice expenses down

Identify your main areas of expenditure and recognise that savings can be made through three basic methods; reduce; replace; remove.

1 Have a good look at your previous three years' annual accounts. Note unusual trends in expenditure. Are there unique reasons for these such as the appointment of an additional doctor?

2 Categorise expenditure under clearly defined headings that include buildings, facilities, staff, equipment, administration, utilities and professional services.

3 Involve all practice personnel in looking for ways to make savings.

4 Embrace technology. There is excellent software and hardware in the marketplace for speeding up mundane tasks such as scanning documents, organising payroll, planning rotas. Digital voice recognition recorders can considerably cut down on secretarial time.

5 Share with other practices. Do you need a dedicated full-time practice manager, specialist nurses, data inputters, administrators? What better way is there to signal your commitment to practice-based commissioning than sharing resources?

6 Continuously review suppliers of all goods and services with a view to maximising value. Negotiate with suppliers since you are likely to be considered a major customer. Bulk purchase (again this can be in conjunction with other practices to increase purchasing power).

7 Downsize. Do you really need all those consulting rooms? Can you rent out rooms to other professionals, Social Services and secondary providers? Is it practical to vary some of your surgery times and try hot-desking?

8 Remove costly drains on capital. If you are an owner occupier, think of selling your building to a third-party investor such as a bank or property developer (provided of course that your PCT will continue reimbursing the market rental).

9 Replace equity principals as they retire with salaried associates. Recent published figures suggest savings in excess of £40,000 per annum can be made on salaries alone.

10 Make greater use of flexible short-term contracts for staff. General practice services are being increasingly exposed to market forces with alternative providers bidding, successfully or not, to provide services on a year-to-year basis. You should not be committed to retaining staff you no longer need.

11 Merge. Industry is full of companies that have merged to reduce costs. They can't all be wrong! Reducing practice expenses should be part of a regular audit cycle of your practice finances. Review your performance annually and never be complacent.

Dr Jim Sherifi is a GP in Sudbury, Suffolk

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