There’s no doubt that 2023/24 is going to be a very difficult year for practices. The contract has been imposed without inflationary pressures being funded, and at the same time, the Government and the media seem intent on setting the public against general practice. What steps can practices take to manage the year ahead?

In this month’s Practice Index podcast, Robyn Clark and Nicola Davies talk through all the changes that we know are coming this year, including the changes to the PCN DES with its new focus on access. There’s no escaping from the fact that very few, if any of these, are going to make life easier for practices.

So, what can practices do? What actions can they take to make the most of the situation they’re in?

I’ve been in the fortunate position of being able to ask a number of people that question in recent weeks, and there are five actions that have stood out:

1. Look after your staff. This might sound obvious but good staff are at a premium and retention is the key to survival. If we’re losing staff, not only do we incur all the costs of finding a replacement, but we lose all the knowledge, experience and trust that they have. This takes a long time to rebuild, and sometimes can never be replaced. Holding on to staff when times are tough should be our number-one priority.
2. Ensure you’re making the most of the PCN. Any additional general practice resource is going into PCNs right now. Practices are more likely to thrive by embracing the opportunity of the PCN, rather than by working to keep it at arm’s length. Practices need to ensure that the PCN resources are supporting the member practices and their patients, and that the ARRS roles are being deployed as effectively as possible. PCNs also create a great opportunity for sharing and learning from other practices, and finding new ways of doing things that others have already invented.
3. Ensure enhanced services are value for money. Many practices will perform the enhanced services that are offered, without really undertaking a full due diligence on them. But, knowing the pressures practices are now under, it’s time to be more ruthless about analysing the enhanced services to ensure they’re benefitting the practice’s patients and that they’re profitable. Culling those that aren’t can free up both time and resource.
4. Push back on unfunded work. There’s huge variation around the country as to which services are funded and which are not. While practices have tolerated this for many years, now may well be the time to work with other local practices and stop doing the work that isn’t being paid for. Practices have very limited capacity and with the current pressures, cannot continue to operate on goodwill.
5. Get your patients in your corner. Everyone knows how much strain the NHS is under right now, and even though the media seems intent on doing the service down, the huge majority of patients are still extremely supportive of their local surgery. Harnessing this support and getting patients to advocate on behalf of the practice will be increasingly important as the year progresses and the profession seeks to secure the resources it needs to be able to continue into the future.