The BMA’s guidance on reducing workload may have led you to consider stopping all non-essential work, but it’s worth bearing in mind that with QOF income much reduced, enhanced services are now the second-largest contributor to income after the global sum. In my experience as a specialist medical accountant, practices that are discerning about which services to provide are more profitable than those who grab every service that comes their way.
These three tips will ensure you get the most out of what you offer.
1 Wait for the specifications before starting a service
The timescales in the decision-making process are often tight and sometimes the information that is needed to decide on a service, including the financial terms, isn’t available until after the new contract year begins on 1 April. However, clinicians and practice managers should try to work out the payment on offer per procedure or patient, checking any caps (for example, there may be a cap on the number of minor surgery procedures allowed in the contract period). Look out for the Avoiding Unplanned Admissions DES in England, which is the most lucrative enhanced service for next year.
2 Don’t overlook associated costs
Some variables are easily overlooked when costing a service. For example, some GPs forget to include employer’s national insurance and pension contributions for the people carrying out the service, and the cost of admin time involved in claiming for payment. They might also need to take account of DNAs and overtime pay for healthcare assistants to fit in services. Undertaking a service such as the NHS Health Check scheme might also occupy a room that might be more profitably leased to other service providers.
3 Weigh up the benefits of cutting a service with the risk of losing patients
Even if you decide running a service isn’t worth the cost, think before you cut it. If it is offered by a neighbouring practice, patients might de-register, losing you global sum and QOF income. However, if your list is over-subscribed then losing patients may ease the burden.
Luke Bennett is a partner at Francis Clark LLP and a committee member of the Association of Independent Specialist Medical Accountants.
