Business Structures for General Practice

Like it or not, general practice is a business.  Most general practices are run by self-employed, independent contracting practitioners.  They manage estates, employ staff and in relatively fixed cost contracts, make their businesses profitable by managing expenses as efficiently as possible.  Interestingly, whilst most general practitioners are still taxed as being self-employed, most, if not all, do not fulfil the criteria to be taxed as such. 

The ‘business’ usually has only one main customer, the NHS.  However, whilst the Government and Inland Revenue continue to support self-employment status for general practice, new government policy for the NHS does give new opportunities for this sector’s business structure. 

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Guidance Notes on European Procurement Directives

Background

In certain circumstances, Primary Care Trusts are obliged (i.e. required by law) to seek tenders when entering into a new contract with a service provider to the NHS.  These obligations may arise under European Procurement Directives or national legislation (i.e. UK law), or more locally under the standing orders of the Primary Care Trust itself (i.e. the PCTs own rules).  The latter usually follows procedures under Department of Health Directives.  The DH or PCT standing orders will regulate the manner in which competition is invited, the type of procedure and the financial thresholds above which competition is required.  It is important to know that even where a PCT is not obliged by law to tender, it may often choose to do so as a means of ensuring best value.

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Intelligent Practice Based Commissioning

For Practice Based Commissioning (PBC) to have an impact PCTs need to have robust financial and information systems in place which enable them to (a) monitor practice budgets and (b) secure intelligence for strategic planning purposes.