Provision of primary care represents a significant operational and financial risk to partners and operators. We help our clients to navigate an increasingly complex environment and organise themselves to best cope with uncertainty.
scaling through technology
We are passionate about the potential of emerging technologies and work with our clients to identify opportunities to engage with technology providers in a way that makes sense for all.
professionalising senior teams
Primary care providers have tended to rely upon clinicians to manage non clinical business functions. We help our clients to professionalise their legal, financial, commercial and operational capabilities in order for them to compete effectively and with confidence.
ADAPTING CORPORATE STRUCTURES
Where appropriate, we can provide access to our proprietary structures that have been legally tested and have designed to optimise the tax position of partners.
Areas of Practice
redefining the relationship with patients
Currently individuals are largely seen by the NHS as a cost waiting to happen. By contrast, our approach proposes treating every person on the practice list as an asset from which better self-management of health can be encouraged and profits can be earned.
The traditional view of the care sector in the UK divides the market into two forms of provision: public (i.e. NHS) paid through taxation and small charges and private (largely) hospital services either paid for by insurance direct payments to surgeons or physicians. However, there is a growing and little understood third group of provision which tends to cover wellness as well as health and includes exercise, diet, physiotherapies and psychotherapies. This wellbeing market is expected to grow at 11% per annum while the private medical market is expected to grow by 10%.
New primary care organisations will be able to benefit from provision of such services, and many more.
redefining relationship with other care providers
Better outcomes are almost always associated with better prevention and management of conditions, both of which tend to be cheaper than hospital interventions. Defining the contract on the basis of small populations and/or small-scale services reduces risk and increases the chance of success.
Many of the services that would be moved out of hospitals have become unprofitable due to the deflation of the price of most tariffs.
economics of prevention
At the current time, most primary care providers tend to focus on the (short term) economics of symptom/illness treatment due to nature of reimbursement mechanisms.
We work with clients to model the expected financial impact of wellness and monitoring programmes that can deliver downstream impact on population health and hence demand on resources and therefore long term profitability of operations.
REBUILDING FINANCIAL MODELS
We have developed a bottom-up financial model that articulates how transformative changes to the workforce, investment in technology, training and pharmacy services can materially enhance the profitability of APMS/GMS contracts. This model enables a practice owner to articulate a growth plan and understand the cashflow implications and investment demands arising.
It is typically the case that Primary Care does not differentiate between clinical and organisational leadership. In consequence it is not unusual to find a disproportionate number of ‘equal’ partners, making decision –making slow and highly inefficient.
At Carradale Futures we have worked with a number of primary care providers to review their governance arrangements, separating out operations from clinical decision-making to optimise the efficiency of the business. Such an approach has the added benefit of making the business more attractive to external investors should these be desired.
developing and implementing a tecHnology roadmap
Primary care is yet to embrace the wealth of technologies that can improve the patient experience and transform the business of primary care. At Carradale Futures we work with and engage with a wealth of technology companies and can advise on the myriad of choices and outcomes that can be expected.
Importantly, aside from cost and outcomes, we also help our clients to understand the extent of organisational change that is necessitated by a given technology.
Over time, our model can be used as the foundation for developing gain-share contracts with acute providers with a view to shifting diagnostic and other services out of costly hospital environments into primary, community and even home environments.
Most primary care providers are already beginning to evolve their practice workforce composition as a result of changing demand as well as the supply of key skills (e.g. full time GPs). However, we believe that more radical transformation is both possible and desirable. As part of this workstream we also focus on the proposition of care that is delivered ‘in clinic’ as opposed to at home/remotely.
becoming a data driven organisation
Whilst primary care practices are highly focused on collating data to support QOF and CCG inspections, most are very poor at understanding the basic drivers of value within their businesses. Fewer still capture any meaningful data related to patient satisfaction. In an era of increasing competition and downward margin pressure, a focus on granular performance data will be critical to future prosperity.
IDENtifying best in breed technology providers
We have extensive experience of emerging technologies and understanding how to select the right partner. We work with our clients to triage the choices they face and to build commercial relationships that are productive and enduring.