An Introduction to Financial Planning for Primary Care Network Leaders

At THC Primary Care, we provide resources for Primary Care Network leaders.

In this blog, we are tackling the topic of financial planning and sharing some tips to support you in putting together a strong financial plan.

If you want to reduce your chances of conflict, I can't stress enough the importance of planning well and dedicating time to discuss, agree and document your financial

plan.

Let's jump in!

What are the benefits of having a financial plan?

A financial plan will:

✅ Aid decision-making

✅ Reduce conflict

✅ Promote trust and transparency

To watch a more detailed video regarding this blog please click below.

The transcript of the video can be found below.

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What should we consider when putting our plan together?

In no particular order, here are nine tips on what to keep in mind when planning your finances...

1) Start with last year's accounts.

Spend some time looking over last year's accounts and using this as the basis for creating a new financial plan which pulls recurring costs to give you an idea of this year's expenditure.

2) Compromise is key.

A meeting of such magnitude, involving different parties, with differing views, wants and issues, is likely to be subject to debate and disagreement. The only way through will be for everyone to accept that they may not get everything they want and that compromise will be required on all sides.

3) Consider your overarching strategy.

Will your finances be managed centrally, or will you divert or devolve some of your budgets to individual practices or services?

What investment is required and when? Do we have the opportunity to flex our approach if required further down the line?

4) Identify your funding streams and how to best utilise each.

At the time of publication, there are nine funding streams currently available to primary care networks;

➡️ Clinical Director Payment

This is directly allocated to your Clinical Directors.

➡️ PCN Core Funding

This can be used to cover your infrastructure costs; so any subscriptions and/or hardware. The funding can also be used to top up any gaps in salary costs above and beyond the ARRS pot.

➡️ PCN Leadership and Management Payment

This supports the payment of your PCN's operational management team (and administrators) but can also be used to top up the Clinical Director support payment.

➡️ Impact and Investment Funding (IIF)

Ensure that there is a meeting at board level to review last year's allocation and agree on how and where the funding will be reinvested.

Also, plan and agree on how you intend to meet the new indicators, determining who has responsibility for management and achievement of each one.

➡️ Access and Capacity Support payment

Check out my recent blog, where I offer some suggestions about how you might consider allocating the Access and Capacity Support Payments.

➡️ Access and Capacity Improvement Plan funding

This payment will be made in respect of improvements made in the following key areas:

• Patient experience of contact

• Ease of access and demand management

• Accuracy of recording in appointment books

PCNs must have worked with the commissioner to assess and record the

PCN's position at the start of the 2023/24 financial year in relation to the three

key areas set out above.

We must also consider how improvements to the PCN’s position (as at the start

of the 2023/24 financial year) will be measured and set at the appropriate levels

of improvement, which should be achieved by 31 March 2024.

In the original guidance, the submission of the plan was on 12th May 2023.

On 27th April, the submission date was moved to 30th June 2023.

➡️ Additional Roles Reimbursement Scheme (ARRS)

The Additional Roles Reimbursement Scheme is an automatic funding stream

available to Primary Care Networks (PCNs) to support the recruitment of the

following.

1. Clinical pharmacists

2. Pharmacy technicians

3. The social prescribing link worker

4. Health and well-being coaches

5. Care co-ordinators

6. Physician associates

7. First contact physiotherapists

8. Dietitians

9. Podiatrists

10. Occupational therapists

11. Nurse Training Associates

12. Nursing Associates

13. Community Paramedics

14. Advanced Practitioners

15. General Practice Assistant

16. Mental Health Practitioners (Adults and children)

17. The Digital and Transformation Lead

To learn more about the role, please check out our comprehensive guide here:

https://www.thcprimarycare.co.uk/post/a-comprehensive-guide-to-the-

primary-care-networkadditional-role-reimbursement-scheme-2022-23.

➡️ Enhanced Access payment

In the Primary Care Networks (PCN) 2022/23 Network Contract Directed Enhanced Service (DES), PCNs were required to offer patients a new 'enhanced access' model of care, which will see GP practices providing additional services to their population.

Enhanced access is to be provided between 6:30 pm and 8:00 pm Mondays to Fridays and between 9:00 am and 5:00 pm on Saturdays.

➡️ The Care Home Premium

Based on £120 per bed, under the Network Contract DES, each care home will be aligned to a single PCN (and its MDT), which will deliver an enhanced care home service. This service and premium payment is designed to enable consistency of care for people living in that home.

You can find out how much national funding your network is to expect this year here: NHS England Practice and Primary Care Network (PCN) Income Ready Reckoner for 2023/24

5) Keep collaboration and at-scale working front of mind.

If your intention is to simply divvy up funding payments between practices, keep in mind that the establishment of shared principles, mutual understanding, and collaboration is key when it comes to working at scale.

Allocation of regular payments should be agreed upon from the outset.

6) Interlink your financial plan and your workforce plan.

Particularly where the Additional Roles Reimbursement Scheme is concerned, consider the needs of the network and where extra costs, such as costs for training and equipment, may lie when it comes to recruiting to these roles.

Support will need to be fairly balanced and equitable across the financial year. Keep in mind also that the ARRS pot may not adequately everything, so extra monies will be needed.

7) Be honest about how well your finances are being managed right now.

Can you easily answer:

• How much money is in the bank account today?

• Are there any payments owing, and if so, to whom (network to practice or vice-versa)?

• Should we (or do we) use a spreadsheet or a dedicated electronic accountancy system?

• What's our governance framework for the management of our finances?

• Is there anything that we can improve on?

8) Lean on your accountant.

Where possible, commission an experienced accountant who specialises in providing financial services within Primary Care. The value of this cannot be underestimated as a specialist accountant can offer advice about how others manage their finances and what tools or applications could support you.

9) Check out these recommended resources...

There are a few helpful resources available to support you with financial planning:

NHS England Practice and Primary Care Network (PCN) Income Ready Reckoner for 2023/24

The 2023/24 GPRota.NET PCN Calculator / ARRS Workforce Planner

Ardens Manager can also support with income calculation.

Lastly, PCN Managers and administrators that are part of our PCN Management Induction get a further deep dive into the 23/24 PCN funding streams and more top tips to manage the PCN finances.

You can access this online course here.

I hope this helps!

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About the author

I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have now published over 200 episodes.

I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 80 PCNs by providing interim management, training and consultancy.

I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare, I'm published in the London Journal of Primary Care, and I am the author of over 250 blogs.

I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.