How can you survive financially in General Practice? Are you self-employed or salaried?

Consider:

INCOME:

N.H.S Income:

Basic allowances, capitation fees, item of service fees etc

You should know all the available payments, including target payments

How are cervical cytology target income calculated in a 3 doctor 5,000 patient practice?

You have 92% childhood immunisation targets, and a family arrive on your list refusing any
immunisations. Your target will fall to 88%. What should you do?

How do you claim for your payments?  (Note the 1996 forms)  What do you know about
about electronically linked claims?

You need to know about deprivation payments, temporary residents, emergency treatment
(and immediately necessary treatment) etcetera.

There is a comprehensive list of NHS payments in "The Red Book" and in Medeconomics.  Do
read these.

N.H.S. income also includes:

Reimbursements

Staff pay  (what proportion?)
Computer reimbursements
P.G.E.A.
Premises reimbursements:
	Cost Rent
	Health Centre charges
	etc

Dispensing

There are many sources of income from the N.H.S. :  Try to list most of them. 
If you don't understand them, please discuss them with your trainer.

Hospital  Clinical Assistant work:
	  Clinical Assistant
	  Hospital Practitioner

Non - N.H.S Income:

Insurance medical examinations
Elderly driver medical examinations
HGV + PSV medical examinations
Private Patients (Holiday-makers from the USA?)
Private certificates
Passport form signing
Etcetera 
 
List: Any other non-NHS sources of income you know



EXPENSES

Premises
Rent
Staff  (including payroll management)
Equipment
Rates
Loans
Telephone
Computer:
		Hardware
		Software
Accountancy
TAX
Superannuation (Pensions)
		Your own
		Staff

V.A.T.  - is it applicable?

Any other expenses you can think of.

Arrange to see a set of practice accounts, which, although not always itemised in great
detail, will help you to understand finances. Also look at a quarterly payment summary from
the Health Authority.

Primary Care Groups and Primary Care Trusts: WATCH THIS SPACE

Learn what you can about:

(i) Purchasing of secondary (hospital-based) care
(ii) Funding of primary care
(iii) Funding of district nurses, practice attached staff
(iv) Funding of other community based care


Please suggest any other questions you have about practice finance





                             This tutorial supplied by Andrew Crawshaw - Mevagissey 1999