May 2016 Issue 81
www.independent-practitioner-today.co.uk
INDEPENDENT PRACTITIONER TODAY
The business journal for doctors in private practice
In this issue
Do I quit or is my pension Pension still a pot of gold? Don’t rush to opt out of your NHS pension P36
pot
Getting uninsured patients to pay their bills
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32 FEATURE
lEgAl bRiEFin
Perfect partne g
rs
To be or not to be a member of a limited liability partners hip? That is the question for many indepen dent practitioners. Lynne Abbess (right) gives a legal perspective and some useful tips
There is a developing trend in primary the world of primary healthcare care partnerships that ‘bigger is , the underlying to GPs may be better’. reasons are of the greatest usually This is perceived entirely different. significance to consultants very often has to be the case nothing to do for a number – namely the ability to with of different reasons, the consultants’ adopt a ‘brand’. position and including perceptions Different marketplace evespecialist accountants rything to do concerning with the trust’s. the safeguarding it is essential gested in Independent have sugThe essential of not to presume point behind Practitioner from unwelcome the business bigger is that Today t h a t this necessarily better is that it is far predators, the merely ban easier for the or that sharing of staff one size fits all ding together under trust – or other across a wider within the consultan umbrella private healthcare patch and perhaps ants’ world, name can increase organisation which is a radically their combined – to deal with the least important – regarded as different ‘value’ by as one marketplace. ‘corporate entity’ in the present much as 15%. marketplace than rather than On the basis deal with a disparate to have to – the being in a positon of this latter ‘brand’ the business. ability to of needing band of conpoint alone, it may sultants who to fend off unwelcome be perceived are each ‘doing A similar concept competition there are very positive their own thing’. from other parts is now being reasons for agreeseen within of the private sector, ing to group the world of however, before together. many consultprivate ants healthcare, jumping on are so established But it is not always although for the bandwagon comwithin the and pletely different consultagreeing their specialty ants themselves to follow suit, it reasons, and that this is not who are promotis crucial to appreciwe significant are witnessing a ing this concept. increasing numbers ate the significance risk. increasingly, of consultants of doing so. Because of their it is the organisations grouping together degree of spefor whom they in ‘partnerships cialism, there provide the A history lesson ’ to deal with services who the opportunity is likely to be far less private aspects are behind it. The usual ‘corporate of their practices. to move While it might entity’ which let alone to provide staff around, You might ask is adopted for be easy to assume cover for each yourself, why these purposes a synergy between other at a senior an Nhs trust would is a limited liability these and Nhs level. trouble itself partnership (LLP). And what is of to assist its consultants This is a mid-way least significance into improvbetween a tradiing their value tional partnership – but the reason and a limited company.
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07/03/2016
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When your staff become a spot of bother
How to tackle the billing issues A medico-legal expert answers posed by self-pay doctors’ management dilemmas about staff P46 patients P44
Healthy returns By Robin Stride
Private practice incomes remain healthy and major business oppor tunities beckon for doctors who understand the changing market and take advantage. That was the overwhelming mes sage in this year’s keynote speech given to more than 100 private consultants and GPs at the Indep endent Doctors Federation’s (IDF) annual general meeting. Many members were encouraged by the upbeat state-of-the-market analysis presented to the meeting by a leading adviser to specialists. Based on latest tax return figures and discussions with independent practitioners, he revealed: A further rise in self-pay – some thing he said most consultants have been ‘pretty slow’ to take advantage of; Higher price potential in the self-pay market, if providing a quality service; Predictions of higher fee levels following a drop in senior consult ant numbers in private practice; More beneficial closer working relationships with private medical insurers; Increasing NHS spend in the pri vate sector. Independent Practitioner Today col umnist and medical accountant Ray Stanbridge told doctors: ‘The In association with
gloom and doom merchants are wrong – unless people are overdeclaring their income to the taxman, which I doubt.’ He observed that with the NHS in continuing ‘turmoil’ and the private sector undergoing great change, real opportunities were developing for excellent inde pendent medicine, although ‘the problem is that all doctors state they provide an excellent quality of service and, by definition, this cannot be true’. Mr Stanbridge, of Stanbridge Associates, believed basic market economics meant the NHS could not exist long-term in its current form. It would always be in crisis, innovation would be stifled and it would try to reduce cost of supply. The long-term solution was to reduce the supply of specific ser vices and look at charges and copay. But services in the short term would be rationed and transferred to the private sector to try to cut costs. He said although conflicts con tinued with some insurers, they now accounted for less than 50% of the market. There was an impending shortage of supply of consultants, only those really interested in private practice would remain and insurers were reconsidering their strategies.
Mr Stanbridge forecasted that closer working relationships with insurers would increase quality and efficiency. He said senior insurer officials now recognised that one size did not fit all and they had to change the way they worked with providers. This could potentially mean additional financial rewards for provider quality and clinical effi ciency and for new products and services. Giving what he called ‘a talk of hope’, he said growth in the num ber of consultant groups would be another bonus. Groups were achieving a ‘staggering’ 15%+ compound growth in income. They could increase quality and business efficiency, subspecialise and provide cross-cover, reduce ‘cock-ups’ and cut costs – for example, by negotiating lower medical indemnity. And they could also innovate, invest, develop and market self-pay services and improve practice man agement. He predicted a growth in professional managers running the practice as a business and also a decline in traditional secretaries. Mr Stanbridge told the meeting at Xxxxx the King’s Fund, London: ‘I think we are going to see a lot more innovation in the next few years – there is money to be made.’
Despite Competition and Markets Authority rules, he reported con sultants were investing in new technologies and methods of delivery. There was also a large increase in the number of private investors interested in ‘small-scale’ investment. Mr Stanbridge said insurers were recognising new facilities that pro vided good and cost-efficient ser vices. IDF reports, page 4 Getting self-payers to pay, p44
THE ‘UBER-DOC’ A new smartphone app aims to deliver a private doctor to the patient’s door within an hour. n Find out how on page 6