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Why all practices need good marketing

We live in a marketing age and there is no point in having a Rolls Royce practice if nobody realises how good you are, says Dr Melanie Wynne-Jones

We live in a marketing age and there is no point in having a Rolls Royce practice if nobody realises how good you are, says Dr Melanie Wynne-Jones

General practice is not competitive in the way that most businesses are. Much of our NHS income is fixed by the number of 'customers' on our list. Any extra activity generated by patients tends to reduce rather than boost our profits.

But one thing we do have in common with all businesses ­ inefficient service is a disaster. It results in poor morale, time-consuming complaints and increased staff turnover. It can also damage the practice's ability to take on profit-generating work.But it is not enough these days to be efficient. People must know you are efficient. You must market your practice This can have five main benefits:

  • It increases patient and staff satisfaction by ensuring practice services are both useful and appropriately used
  • It helps maintain list size and attracts new patients
  • It improves practice efficiency and profits
  • It creates the capacity to provide other profitable services
  • It helps the practice thrive in the new marketplace of primary care.

Marketing is not simply better advertising.

Who are our customers and what do they want?

Patients We need to know as much as we can about patients. We need to know things like age/ sex profile, family background, educational level, occupation, mobility, distance from the surgery, deprivation indices, cultural and language needs, morbidity patterns, lifestyle, private health insurance, likely internet use, and other characteristics that dictate their needs and wants.

Of course we can guess some of these needs and wants. Patients will want high-quality health care, good access, personal service, a pleasant environment and information about services. But what do they really think about appointment times? Do they want open surgeries, teenage drop-in clinics or telephone advice?

Our main proxy 'customer' is the PCT, and the PCT has regulatory teeth. It demands information from us, it demands proof that our services meet nGMS targets and standards (QOF), and it demands co-operation and support for local and national directives such as enhanced services, Choose and Book and practice-based commissioning. It wants everything as cheaply as possible!

Medical reports are requested by employers, insurance companies, solicitors and other organisations. All of these customers want a service that is efficient, timely and accurate. Some services can be provided privately to patients. These are mainly certificates and examinations for non-NHS reasons.

Other opportunities by private arrangement include occupational health services, flu immunisations, sporting event cover, and additional services to nursing homes.Medical students, GP registrars and other learners (or their educational establishments) can be considered fee-paying customers.

What are the pressures?

Some pressures are common to all practices. These include limited resources, rising patient demand, the primary-secondary care interface and changes in the law/regulations affecting general practice, including the Government's apparent intention to allow private firms to cherry-pick primary care.

Others pressures are more individual:

  • house building/demographic changes
  • local politics and economy
  • hospital and community services
  • social and voluntary services
  • premises and practice staff
  • availability of managerial skills
  • doctor availability and skills
  • partners' attitudes/aspirations
  • profitability
  • competition from other practices.

A SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis can define these. Asking every member of the practice, or even patients, to take part will generate the widest range of ideas, strengthen team-building and help answer the next question.

Are we delivering?

Are you delivering the services you wish to offer? You may feel you know the answer already, but a partial or complete organisational audit will tell you. This might include:

  • patient-practice contacts ­ effectiveness, telephones, reception, waiting times
  • patient and doctor/nurse contacts ­ patient satisfaction, consultation skills, outcomes
  • the practice environment ­ internal and external appearance of premises, parking, waiting rooms, cloakrooms, provision of information, 'corporate' image
  • appointments ­ look at choice, access, waiting times, flexibility, monitoring/audit
  • home visiting ­ analyse appropriateness and alternatives
  • repeat prescribing arrangements
  • staff performance
  • nurse performance
  • doctor performance ­ surgery timekeeping, approachability, clearing paperwork and admin tasks, keeping good records and collecting QOF points
  • staff and doctor appraisal, training and development
  • clinical governance
  • leadership and management structures
  • team-working
  • skill mix and staffing costs
  • recruitment
  • day-to-day running costs ­ budgeting, stock control, premises, checks and balances
  • relationships with PCT, hospitals, pharmacies and other health care professionals
  • use of resources ­ for example, prescribing and referral
  • health and safety
  • morale
  • patient feedback ­ consider QOF survey, targeted surveys, compliments and complaints, patient participation groups
  • teaching
  • feedback from insurance companies, solicitors, deaneries, etc

Filling the gaps

Filling all the gaps in the service you offer is not only impossible but likely to reduce profits to zero.

No practice can be perfect. Furthermore, the imminent arrival of private competitors may suddenly change both the gaps and our ability to fill them. However, having established the practice's current performance and the expectations of everyone concerned ­ patients, customers, staff and partners alike ­ you should be able to define:

  • What NHS and non-NHS services the practice intends to offer (for example, ICATs, enhanced services or private/niche services such as acupuncture).
  • How these will be provided, including roles, management and staffing structures
  • Training/development needs
  • Premises, equipment and IT
  • Customer care.

And when you know this, your next job is to make sure your patients and other interested parties know it too. Don't hide your light under a bushel!

Melanie Wynne-Jones is a GP in Marple, Cheshire

Marketing includes:

  • Developing a 'corporate image' that conveys quality service ­ caring, efficiency, cleanliness and so on.
  • Developing a code of standards ­ for example telephone answering, waiting room environment, appointment systems, timekeeping, dress code, prompt turnaround for medical reports, online appointments or repeat script service, complaints procedure.
  • Developing a signature house style that ensures clear and concise communication. For example, consider having a special typeface or colour scheme for your practice publicity and information material.
  • Developing a comprehensive menu of information to be provided in reception and waiting rooms, in the practice handbook, in the practice newsletter, on the website and in targeted mailshots.
  • Publicising the practice's successes in-house or in the local media.
  • Specifying goals and putting a realistic time limit on them ­ for example a practice website to be operational by a certain date, or a 10 per cent increase in private income to be achieved by a certain date.
  • Devising appropriate publicity, such as getting your local MP to open the extension to your premises.

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