When you set out on your journey to develop as a GP federation,

what end goal did you have in mind and are you achieving that outcome?

Most of you will have wanted to develop a successful organisation, one that holds multiple contracts, is profitable, efficient, supports the member practices and offers local patients a great service.

The reality can be far removed from that. As an NHS management consultant of 15 years, I often find businesses have been formed but never really got going. Federations, member practices and teams are overwhelmed with work, recruitment is tough and even though you’re working flat out you still can’t seem to make ends meet as a business. The long-term vision feels so out of reach you’re now wondering whether it’s even worth carrying on.

I know only too well the pressure you are under. I know what it takes to run a sustainable and successful GP federation and I can help you achieve this too. I’ve overseen the development of more than 50 GP Federations – taking them from either their start point or when on the brink of collapse, to robust and resilient operations. Some of them are now £multi million organisations, holding directly commissioned CCG contracts and/or hospital subcontracts. Many of them now work with and support their Primary Care Networks. It’s never too late to make your organisation a success.

All of them followed the same three phases of development, following the proven frameworks I provide.

Three key phases of your GP Federation Development

From £0 to £1m: Your focus needs to be on cash in the bank to develop the business and make it sustainable. Whether you borrow money from the Member Practices, with agreement to repay over 4 or 5 years, or charge an annual membership fee, or get an initial contract that enables you to get started, matters not. The key is you need a plan to become self-sustainable and quickly.

With proper planning and an early focus on basic projects that are in the gift of the member practices (they are already delivering the work), you can quickly establish the federation and develop a platform for growth into the next phase. I used simple projects with all the federations I have supported to secure and drive engagement and start to build one company with one vision – essential if you are to reach the £multi-million state.

From £1m to £5m: is all about resilience and sustainability founded upon profitability, which requires a focus on only taking on work and contracts that contribute positively to the bottom line and rejecting unfunded or underfunded work. Every business, whether a for profit, not for profit or social enterprise, needs a profit to remain in business. The first principle needs to be not for loss.

Turnover is vanity, profit is sanity, but cash is king! Put simply, there is no point in generating turnover that you cannot make a profit on, and if you don’t remain profitable and keep the cash coming into your company, you can quickly run into problems.

From £5m to £10m: the development of the business is all about people and process. This is by far the hardest phase, as it will mean putting in place and growing an infrastructure, becoming responsible for a team of people. I now have a number that have gone through this barrier, one of them I have worked with a day a month for the last 5 years and just had my contract renewed for a further 5 years. They started with a loan of £40,000 from the Practices and are now a £multi-million company holding a mix of subcontracts from the hospitals and directly commissioned services from the CCG.

Get the GP federation you always envisioned

  1. Schedule a call so we can explore your challenges and identify the solution
  2. We’ll plan the right approach to get you back on track
  3. Relax knowing you’re transforming your federation into a harmonious and efficient workplace where staff are not over-burdened, and patients get access to the excellent service they need

If you want to develop a business-ready at scale provider organisation, Primary Care Network, GP federation, Super Practice, PCH or ICS, or are about to deliver any form of change and are looking for a model to engage every stakeholder, Scott McKenzie Consultancy UK Ltd can help. We’re passionate about General Practice and believe it’s the jewel in the crown of our NHS. We know you genuinely care about getting the best outcomes for your patients and want to support you to achieve this.

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