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3. healthcare

1
HEALTHCARE CONFIDENCE INDEX
Insight from primary healthcare professionals
March 2015
2
WHAT’S IN THIS REPORT
OUR CONTRIBUTORS
Ian Crompton
Head of Healthcare
Banking Services, Lloyds
Bank Commercial Banking
Bob Senior
Head of Medical Services,
Baker Tilly
Dr Arvind Madan
GP and CEO of
Hurley Group
Hiten Rawal
CEO of Wellbrooke
Products Limited
Kevin Nichols
Managing Director, The
Pharmacy Consultancy
Graham Rew
Specialist Dental Accountant
at Hazlewoods
Jas Matharoo
Director, Nice Teeth Limited
Adam Thompson
Director, Primary
Care Surveyors
Lynne Abbess
Partner, Hempsons
WHAT’S IN THIS REPORT
3
4
6
8
10
FOREWORD
IAN CROMPTON
METHODOLOGY AND OVERALL RESULTS
GP RESULTS
BOB SENIOR
DR ARVIND MADAN
PHARMACIST RESULTS
HITEN RAWAL
KEVIN NICHOLS
DENTIST RESULTS
GRAHAM REW
JAS MATHAROO
12
INTRODUCING NEW COSMETIC DENTAL
CHOICES TO THE LOCAL COMMUNITY
13
BENEFITS OF INTEGRATED HEALTHCARE
SERVICES UNDER ONE ROOF
14
FUTURE PLANNING
ADAM THOMPSON
15
CLOSING THOUGHTS
LYNNE ABBESS
3
FOREWORD
FOREWORD
Ian Crompton
Head of Healthcare
Banking Services, Lloyds
Bank Commercial Banking
Welcome to the Spring 2015 edition of the
Lloyds Bank Commercial Banking Healthcare
Confidence Index, the sixth wave of research
based on primary healthcare providers’
outlook for their businesses.
The latest wave of the Lloyds Bank
Commercial Banking Healthcare Confidence
Index has indicated a rise in confidence
across all three sectors, likely mirroring
more confidence in the general economy.
The sector, by and large, hasn’t been through
any new or unexpected turbulence in the last
12 months, and things certainly seem to be
on an upward trend.
GPs remain more pessimistic than their
counterparts, with perhaps a sense of
resignation amongst some reflecting the
fact that 41 per cent are planning to either
retire or leave the sector within the next
ten years.
On a more positive note there is a marked
increase in the number of GPs intending
to bid for additional services. Nearly two
thirds are now looking to get involved either
independently or as part of a federation,
compared with only 37 per cent in the last
survey. Interestingly, 59 per cent of GPs
would still recommend their profession
to friends or family.
Pharmacists remain the most optimistic
group in the longer term with 69 per cent
looking to grow their business, whilst
39 per cent of pharmacists are planning
to acquire additional units, a significant
increase from the quarter of respondents
we saw in the last survey.
Pharmacists are also the most bullish
around bidding for new contracts with
80 per cent keen to either start bidding (22%)
or take on more than they already hold (58%).
Dentists too are more optimistic, reflected
in the 78 per cent that are planning to expand,
whether at their current site, or by branching
out into more locations. There remains a lack
of confidence that the long anticipated new
NHS contract will be adequately funded and
there is the expectation that private dentistry
will in the near future become the more
profitable of the two options.
On the whole, this is an encouraging report
that indicates a brighter outlook for the sector,
and the following pages provide deeper insight
from our individual sector specialists.
59%
of GPs would recommend their
profession to friends or family.
4
METHODOLOGY AND OVERALL RESULTS
METHODOLOGY AND
OVERALL RESULTS
A blended figure of both the short-term
and long-term projections is used to provide
a measure of overall business confidence
within the primary healthcare sector.
As in our previous indexes, we have sought
to gain responses from three primary healthcare
professions: GPs, dentists and pharmacists.
The responses for each profession are given
equal weighting within the overall index figure.
This is a dispersement index, so any figure
greater than zero represents a positive outlook.
The maximum value achievable is +100 and the
minimum result is -100.
This wave of the survey has continued a
trend that has seen the long-term combined
figure rise to -63 from -65 in the previous survey.
This marks an 11 point improvement from the
2012 figure, which stood at -74, suggesting the
outlook is slowly improving across the primary
healthcare sectors.
In the short-term, the confidence of
dentists has almost doubled, now standing
at 43 compared to 23 in the previous wave.
The outlook of pharmacists has also shown
promising progress, rising to 23 from 18. GPs
remain the only profession to show a negative
outlook, albeit with an 11 point improvement,
rising from -34 to -23. This is a record high result
for GPs since the survey was launched in 2011.
Key
SHORT-TERM HEALTHCARE CONFIDENCE
60
40
20
0
-20
-40
-60
-80
Wave 1
Autumn 2011
Wave 4
Spring 2013
Wave 5
Spring 2014
Wave 6
Spring 2015
40
20
0
-20
-40
-60
-80
-100
Wave 1
Autumn 2011
Pharmacist
Combined
Wave 3
Autumn 2012
LONG-TERM HEALTHCARE CONFIDENCE
GP
Dentist
Wave 2
Spring 2012
Wave 2
Spring 2012
Wave 3
Autumn 2012
Wave 4
Spring 2013
Wave 5
Spring 2014
Wave 6
Spring 2015
COMBINED HEALTHCARE CONFIDENCE
40
20
0
-20
-40
-60
-80
-100
Wave 1
Autumn 2011
Wave 2
Spring 2012
Wave 3
Autumn 2012
Wave 4
Spring 2013
Wave 5
Spring 2014
Wave 6
Spring 2015
5
METHODOLOGY AND RESULTS
22%
Nearly a quarter of GPs are planning to
retire or leave the profession in the next
five years.
80%
Four fifths of pharmacists intend to bid to
win new services.
62%
Nearly two thirds of dentists do not expect
NHS dentists to be more profitable than
Private in five years’ time.
6
GP RESULTS
GP RESULTS
BOB SENIOR
Head of Medical Services, Baker Tilly
I’m quite surprised by the rise in short-term
confidence among GPs, which seems to go
against the general mood of those within the
profession that I encounter on a day-to-day
basis. From my perspective, finances within
the sector are continuing to tighten, and
potential Government reforms of the NHS
mean that the future for the industry remains
largely uncertain.
Digging deeper into the survey seems to
reflect this view, with 91 per cent of respondents
putting forward the view that financial pressures
are set to increase, whilst just one per cent
believe that the situation will improve.
One of the biggest changes on the agenda
is the idea that practices may have to increase
opening hours and provide services seven
days a week. The potential impact of this could
render it difficult to recruit GPs to offer these
extended services, while young doctors may
be swayed into going to work abroad as
a means of avoiding the perceived ‘red
tape’ of working in a British practice.
This leads to a likelihood that
practices will have to work together far more
to mitigate the impact of potential changes,
and to maintain profitability. Increased
integration has to happen as, from 2020,
practices will be remunerated based on
their patient numbers. While this may not
cause a big problem for practices that serve
a large population, practices in smaller towns
and villages may suffer as the money they
receive will be scaled down.
Again, it comes down to doctors continuing
to work against a backdrop of costs being
driven down, whilst trying to maintain a
comprehensive local service. Stemming patient
demand remains the biggest issue faced by
GPs, and until a solution is found which allows
this to happen without unduly impacting
on profitability, it is difficult to forecast any
significant rise in confidence.
GPS’ CONFIDENCE INDEX
91%
of GPs expect the financial pressures
of their practice to increase over the
next five years.
QUESTION ONE
What are your current plans for bidding
to win/retain additional services?
Short-term
Long-term
Combined
0
Bidding as a
single practice
-10
-20
14%
No plans
to bid
-30
39%
-40
28%
Bidding as part
of a federation
-50
18%
-60
Both of the above
-70
-80
-90
Wave 1
Autumn 2011
Wave 2
Spring 2012
Wave 3
Autumn 2012
Wave 4
Spring 2013
Wave 5
Spring 2014
Wave 6
Spring 2015
7
DR ARVIND MADAN
GP and CEO of Hurley Group
While this report has shown an upturn
in short-term confidence among GPs, it also
points to continued concern in the long-term.
This short-term optimism may be related to
a number of factors, such as a new CEO at
the helm, the new GP contract, or a sense
of change coming because others begin to
recognise our integral role within the NHS.
The RCGP and BMA are also becoming more
effective at influencing the power brokers,
whilst it could be that more and more GPs
are beginning to work together in federations
to try and alleviate the isolation that many
within the profession have felt in recent years.
We are also in a General Election year,
with many of the main parties highlighting
increased healthcare spending as a key
pillar of their manifestos. Even the media is
criticising GPs a little less than usual, perhaps
as they realise that the rising numbers we are
seeing in general practice eclipse those that
have long been publicised in urgent care.
However, despite the upturn in short-term
confidence, looking further ahead there
remains a significant level of concern.
We remain grounded by the vision of
spiralling patient expectations, greater
complexity, stricter regulation, financial
pressures and a looming recruitment crisis.
Going forward, there is an acknowledgement
that increased use of skill mix, technology and
integration of services is necessary, as well as a
change in the way services are commissioned.
With the five year Forward View, we will trend
towards a capitated year of care model, with
risk and reward shared across sectors. This will
hopefully move the system to appreciate the
role of the expert generalists more. We may
also see the start of experimental accountable
care organisations with GP groups employing
specialists or hospitals taking over practices,
which could result in a more permissive
environment of local services configuration
through co-commissioning.
On the whole, while GPs are receptive
to positive changes, we know we stand at
a crossroads. We cannot continue doing
it the way we have always done it, but we
don’t quite know what to do next either.
GP RESULTS
QUESTION TWO
Do you consider the reforms underway in primary care as a threat or opportunity for your business?
No impact
7%
A small opportunity
29%
A major threat
30%
6%
A major opportunity
29%
A small threat
QUESTION THREE
What describes your personal
plans for the next five years?
QUESTION FOUR
In five years’ time what percentage of your
practice’s income do you expect to be from
services subject to a tendering/bidding process?
Partner and
happy to stay
as I am
Retiring / leaving
Looking
for a partner
position
None
21-30%
17%
22%
Over 30%
9%
13%
15%
29%
17%
Salaried GP/
Locum and
happy to stay
that way
28%
Partner and
want to grow
the practice
11-20%
23%
27%
1-10%
8
PHARMACIST RESULTS
PHARMACIST RESULTS
HITEN RAWAL
CEO of Wellbrooke Products Limited
It’s good to see that the confidence of
pharmacists appears to be increasing once
again, and with the sector likely to remain
steady for the coming year, I am hopeful that
this will continue into the next survey period.
The main development for pharmacists
sees a change in reimbursement, with an
extra 12p to be provided per item dispensed,
and a reduction in the practice payment. With
most pharmacies having a settled customer
base, and therefore a fairly static number of
prescriptions, this change means that the
acquirement of new units is set to be the
most effective way of growing both volume and
profits. However, it could also present certain
challenges to those serving communities
in low-population villages and towns, who
will be pressured into providing the vital
service with potentially a reduced income.
On the whole, the reaction to reform is
mixed, with 46 per cent of respondents seeing it
as a positive opportunity, while 44 per cent view
it as a threat. It would seem that while optimism
is rising, pharmacists are reserving some degree
of caution as to the exact nature of the
sector’s future.
Going forward, integrated services will
shape the future of healthcare, with the onus
on pharmacies to offer a greater provision of
primary care services. This is helping to drive
the growth plans of pharmacists although,
for many, there is still a question mark over
exactly what model they are going to grow into.
While it’s positive to see rises in confidence
across the board, there remain certain
challenges ahead, with many questions
remaining unanswered when it comes
to the future of the health industry.
It’s no surprise to see that the confidence
of pharmacists and dentists is higher than that
of their GP counterparts, although this can be
explained in part by the fact that they both have
their contracts tied down for the immediate
future, whereas GP practices are yet to learn
of any changes which may be on the horizon.
Of course, since this survey was carried
out, the Government has announced plans to
commit extra funding of up to £2billion within
the healthcare sector, and this could provide a
further boost as we look ahead to the next wave
of the survey.
PHARMACISTS’ CONFIDENCE INDEX
Short-term
46%
of pharmacists view the reforms
in primary care as a positive
opportunity for their business.
QUESTION ONE
What are your current plans for
bidding to win/retain services?
Long-term
Combined
0
-10
Have contracts
but don’t want
more
Don’t want to take
on additional services
-20
8%
9%
-30
Don’t have
contracts
but intend
to bid soon
-40
12%
22%
-50
58%
-60
Have contracts and
want more
-70
-80
-90
Wave 1
Autumn 2011
Wave 2
Spring 2012
Wave 3
Autumn 2012
Wave 4
Spring 2013
Wave 5
Spring 2014
Wave 6
Spring 2015
9
KEVIN NICHOLS
Managing Director,
The Pharmacy Consultancy
Pharmacy is on the up in terms of both
short and long-term confidence, and this
can be attributed to robust prices within the
sector, together with a new settlement for
pharmacy contracts which mean that ‘claw
back’ by the Government isn’t as onerous as
it has been previously.
Amid this positive outlook, the sector needs
to be aware of the importance of providing
more services, in-line with the growing need
to increase their offering beyond their
traditional role of dispensing medicines.
With strains on GPs’ surgeries on the increase,
it is inevitable that there will be an increasing
need for pharmacies to step up and take
responsibility for certain primary healthcare
services, which patients may in the past have
been offered by doctors.
As this issue comes increasingly to the fore,
pharmacists must consider the need to engage
with all service commissioners, local authorities
and procurement partnerships, to ensure they
are offering the correct breadth of services. It is
important to tailor these offerings to the needs
of the local community, which the pharmacy
serves. For example, if obesity is a problem,
the community would benefit from a weight
management service, whilst smoking cessation
provision could be more suitable in other areas.
One of the main differences between this
wave of the survey and the results we saw
last year is that the number of pharmacists
looking to expand through the acquirement of
additional units has increased by 14 per cent
to 39 per cent. This can be partly explained by
the settled nature of the pharmacy contract,
following the removal of most exempt contracts.
This adds certainty to the financial planning
process for the entrepreneurial pharmacist and
acquiring additional pharmacies is an effective
way of growing the business. Therefore, access
to bank funding becomes an even more
important part of this process.
I feel that this level of optimism should be
maintained going into the next survey period,
with the industry now settled for the coming
12 months at least. The only potential caveat
to that is the possibility of a new Government
in May, which could alter the landscape for
healthcare generally, including pharmacists,
in, as yet, undetermined ways.
PHARMACIST RESULTS
QUESTION TWO
Do you consider the reforms underway in primary care as a threat or an opportunity for
your business?
No impact
11%
A small opportunity
30%
A major threat
20%
16%
24%
A major opportunity
A small threat
QUESTION THREE
Which of the following statements is closest
to your current plans for the next five years?
No plans / not
thought about it
Carry on as I am
Retire / Get out
7%
QUESTION FOUR
In five years, do you expect the ratio of your
NHS turnover (excl. wholesaling and OTC)
between Services and PPD income to:
Remain the same
4% 11%
Increase
significantly
13%
25%
Reduce slightly
17%
Grow – buy
additional
units
39%
39%
Grow the
businesss
where I am
4%
Reduce
significantly
41%
Increase slightly
10
DENTIST RESULTS
DENTIST RESULTS
GRAHAM REW
Specialist Dental Accountant at Hazlewoods
The results from this survey show a
clear trend for strong confidence within
the healthcare sector, and this largely
mirrors the improvements which we have
seen within the general UK economy.
With falling unemployment, together with
predictions of three per cent growth, the UK
currently ranks as having one of the fastest
growing major economies in the world, and
this is fostering a more optimistic outlook and a
greater buoyancy within the healthcare sector.
Dentists in particular have seen an
improvement in the profitability of practices
over the past 12 months, and it is pleasing
to see that the majority of practice owners
are expecting to see this continue for the
foreseeable future. However, this good news
is tempered somewhat by the fact that, despite
being profitable at present, the majority of
dentists expect to see financial pressures
increase over the next five years.
For those looking to grow, the survey
shows that the majority of dentists are looking
to expand their business by making changes
to their existing practices, but there remains a
number of entrepreneurial practice owners who
are looking to acquire further units. Therefore,
demand for practices is expected to remain
high, and simple economics would suggest that
the high goodwill values that we are seeing
at the moment will potentially remain in place
for the future.
Looking at the wider picture, it’s clear
that uncertainty surrounding the NHS
continues. The new contract is yet to arrive,
and while pilot schemes have been completed,
there are now promises of further prototypes
which will prolong this feeling of unease
among many dentists. This, inevitably, can
lead to a lack of confidence that the contract
will be adequately funded, and I believe we
can expect mixed and NHS practices to boost
their revenues by providing further private
treatments, capitalising on an increased public
appetite for spending.
DENTISTS’ CONFIDENCE INDEX
64%
of dentists expect their business profits
to increase in the next 12 months.
QUESTION ONE
Which of the following statements is closest
to your current plans for the next five years?
Short-term
Long-term
Combined
50
No plans / not
thought about it
40
Carry on
as I am
Retire / get out
30
20
5%
9%
10%
Grow – buy
additional
units
10
17%
20%
0
-10
49%
-20
-40
Grow the business
where I am
-50
-60
-70
-80
Wave 1
Autumn 2011
Wave 2
Spring 2012
Wave 3
Autumn 2012
Wave 4
Spring 2013
Wave 5
Spring 2014
Wave 6
Spring 2015
11
JAS MATHAROO
Director, Nice Teeth Limited
This is the sixth successive survey that has
indicated that dentistry is the most optimistic
sector, demonstrated by an apparent keen
appetite for growth throughout the profession.
The results of the Index show that almost
half of those surveyed are looking to grow
their business at its current site, with a further
20 per cent looking to expand through the
acquirement of additional units.
This degree of entrepreneurialism throughout
the profession is indicative of the burgeoning
economic recovery, and the fact that dentistry
is a sector that can benefit from commercial
spending more than others within the primary
care space.
Therefore, it’s little surprise to see a greater
appetite to take on private work as opposed
to NHS led contracts. More than a quarter of
those surveyed have already gone private, with
an equal number happy to offer a mix of private
and NHS treatments, and a further 29 per cent of
those offering a mixed service with the intention
of increasing their private provision.
Of the 16 per cent of respondents who offer
only NHS services, three quarters are looking
to introduce private treatments within their
surgeries, further indicating the increased
trend to offer these services.
The thinking behind these results becomes a
little clearer when you consider that 79 per cent
of dentists have expressed their doubts that the
proposed new NHS contract for dentists will be
adequately funded.
On the whole, though, this is another
promising set of results, indicating a certain
bullishness among dentists to maximise their
profitability amid an improving financial climate,
and I would expect this optimism to continue to
grow over the coming survey period.
DENTIST RESULTS
QUESTION TWO
On the NHS v Private issue, which best describes your current status and thinking?
No plans/not thought about it
NHS but want more Private
3%
Already fully Private
12%
NHS and plan
to stay as I am
26%
4%
29%
26%
Mixed but want
more Private
Mixed and plan to stay
as I am
QUESTION THREE
Even if you have a Private Practice how
confident are you that the proposed new NHS
dental contract will be adequately funded?
Very confident
Not at all
confident
QUESTION FOUR
The latest statistics show NHS dentists are
more profitable than Private; do you expect
this to be the case in five years’ time?
Fairly confident
3%
12%
18%
32%
Definitely
Definitely not
8%
30%
50%
47%
Probably not
Not very
confident
Probably
12
INTRODUCING NEW COSMETIC DENTAL CHOICES TO THE LOCAL COMMUNITY
INTRODUCING NEW COSMETIC DENTAL
CHOICES TO THE LOCAL COMMUNITY
7,000
Cwmbran Dental Spa now serves
7,000 patients in Croesyceiliog,
offering cosmetic treatments such
as teeth whitening.
Dr Sharlene Parmar-Anwar bought the practice
in 2012 with help from Lloyds Bank, six years
after she graduated from Cardiff University
Dental School. Two years on, Cwmbran Dental
Spa now serves 7,000 patients – an increase
of 10 per cent since she took over.
To build on this success, Sharlene
secured a further six-figure loan from the
bank, which enabled her to add new cosmetic
services, such as teeth whitening, to meet rising
client demand. She also used the funding
to refurbish the clinic, enabling patients
to receive treatment in a bright and
modern practice.
The dental surgery is now serving a
larger proportion of the local area, easing
the pressure on other local health services,
and the investment has created further
employment opportunities and increased
the clinic’s capacity for treatments.
Sharlene said: “The refurbishment means
that we are now in a better position to provide
services for the local community and have
the best modern facilities in place to ensure
patients receive quality care in an inviting
and relaxing space.
“The funding and support we received
from Lloyds Bank was vital to make our
refurbishment and treatment plans a reality,
and the bank’s specialist team of healthcare
relationship managers played a fundamental
role throughout the whole process.”
Suzanne Rees, Relationship Manager
at Lloyds Bank Commercial Banking, said:
“As is reflected in the latest Index findings,
we’ve seen that confidence amongst dentists
in the long-term remains steady, whilst in the
short-term it is soaring.
“The refurbishment of Cwmbran Dental
Spa and the investment in new services is
evidence that dentists are continually looking
for new ways to enhance their offering for
patients, making long-term investments to
ensure a positive and successful future.
The practice can now serve the ever growing
demand for new treatments and is an asset
to the local community.”
13
BENEFITS OF INTEGRATED HEALTHCARE SERVICES UNDER ONE ROOF
BENEFITS OF INTEGRATED HEALTHCARE
SERVICES UNDER ONE ROOF
Heswall Medical Centre and Pensby Surgery in
Wirral merged and relocated to form Heswall
and Pensby Group Practice, with the support
of a seven figure loan from Lloyds Bank
Commercial Banking.
After securing the funding package from
Lloyds Bank to join under one roof at a newly
renovated site, Heswall Medical Centre and
Pensby Surgery now operate as Heswall and
Pensby Group Practice, and offer a wider range
of services for over 12,400 patients.
The practice operates from a purpose-built
building with a specialist minor operations room
and dedicated areas for visiting physiotherapists
and counsellors to work from.
Recognising the changing landscape of the
healthcare sector, the partners of the former
Heswall Medical Centre and Pensby Surgery
saw an opportunity to expand the services on
offer to patients by joining together to facilitate
all healthcare amenities from one full-service
medical centre.
Dr Sophia Nelson was instrumental in the
practice merger. She said: “We had been hoping
to modernise the centre for over fifteen years,
so to eventually see the new premises
completed was a very proud moment for
everyone involved. The new centre has the
capacity to offer a wider range of care options,
as well as providing room to keep expanding
over the next few years as our patient list size
increases further.”
She added: “The support we received
from Lloyds Bank was instrumental to the
project’s success. The bank immediately
understood what we were trying to achieve,
and they were always on hand to provide
pragmatic and honest guidance at every
stage of the development.”
Graham Scott, Senior Healthcare Banking
Consultant at Lloyds Bank Commercial Banking,
said: “When the partners approached us with
the plans we could immediately see how the
expansion would benefit patients and the wider
community. Combining the two surgeries in
one state-of-the-art centre meant that patients
would have access to a wider range of services
in a modern and spacious environment.
“In line with the latest Index findings,
which show that GP practices are
planning to grow, Heswall and Pensby Group
Practice is a great example of a local business
that has been formed by two practices looking
to capitalise on growth opportunities and
provide a better service for the local community.
“Our specialist Healthcare Banking teams
receive regular training to ensure that they
can help GP businesses achieve their growth
ambitions and are always on hand to provide
tailored support and advice to help them
achieve their goals.”
The merger enabled the practice
to operate from a purpose-built
building with a specialist minor
operations room and dedicated
areas for visiting physiotherapists
and counsellors to work from.
14
FUTURE PLANNING
FUTURE PLANNING
Adam Thompson
Director, Primary
Care Surveyors
While GPs’ short-term confidence reflects
that they remain not overly optimistic,
it is a significant improvement on the
pessimism we’ve seen in the last couple
of years. This can perhaps be explained
by a changing public attitude to primary
healthcare, driven by a more sympathetic
media narrative. Notably, the Royal College
of General Practitioners has raised the
profile of the important role GPs play in the
sector, and have brought many of the issues
surrounding it into the public conscience.
The extra £2billion of funding announced
by the Government following the completion
of this survey period may have an effect on
the short-term confidence in coming months,
although it is tempered by a belief among some
that this may be a ‘sticking plaster’ solution that
does not address the longer-term concerns
about the infrastructure of the sector.
Going forward, the main challenges faced
by GPs will revolve around resource issues and
cost, with increased integration of services a
necessity. I believe that there may be more
‘filtering’ down of points of access to medical
services, with more primary care to be delivered
by pharmacists, and GPs increasingly being
able to specialise to ease some of the pressure
on secondary care and make quality care more
accessible. This will allow hospitals to become
‘centres of excellence’, dedicated to what are
deemed the more complex and essential
life-saving services.
These changes will mean that rather than
visiting their GP for any condition, patients
will instead come to a medical centre that
accommodates a range of healthcare services
and see the appropriate professional – whether
it’s a GP, a pharmacist, a nurse, or another type
of specialist.
One of the most interesting findings in this
survey is a slight inconsistency between those
who expect the NHS to improve, with 43 per
cent responding positively, and an identical
number with the opposing view. This could
potentially be explained by a feeling that
despite improvements in cancer detection
and treatment successes, this could be caused
by a narrowing focus away from non-life
threatening conditions.
While it would appear that almost 60 per cent
of GPs expect to remain in the profession in ten
years’ time, what isn’t specified is whether they
believe this will be within the NHS. Until we have
greater clarity on future strategy, this will be the
main question going forward.
59%
39%
Nearly three fifths of GPs consider the
reforms underway in primary care as a
threat to their business.
Over a third of GPs have no plans
to bid for additional services.
15
CLOSING THOUGHTS
CLOSING THOUGHTS
Lynne Abbess
Partner, Hempsons
There has been a key shift in the last survey
period which has coincided with a greater
understanding of the pressures GPs face, with
even the press, who have long been critical
of the industry, beginning to come onside.
This greater level of appreciation means that
doctors are not feeling as isolated as they
perhaps were previously, which has helped
to achieve the rise in short-term optimism
indicated by respondents.
Looking ahead to the coming 12 months,
the £2billion funding boost announced recently
by the Government may see confidence among
GPs continue to rise, although this will largely
depend on the conditions it will carry. The BMA
is lobbying for £1.2billion to be earmarked for
improvements to the real estate infrastructure,
with the aim of offering updated facilities for the
benefit of GPs, their staff and patients. However
at the same time, there are concerns about the
high levels of service charges carried by large
modern facilities, which could impact on the
benefits perceived through the opportunity
to work within them – potentially to the extent
these are perceived to outweigh the benefits
of any extra funding practices will receive, so
it will be important to exercise caution in the
short term.
72%
Nearly three quarters of all GPs, dentists and
pharmacists are happy in their profession.
With the NHS a hot topic of debate, it remains
to be seen what the future holds for GPs, with
the possibility of seven-day week care looming
large. There are some practices who may see
this proposal as an opportunity which they can
make profitable. However, there remains some
concern that it could be made mandatory,
leaving some surgeries struggling to recruit
the doctors and nurses needed to provide
this service.
Moving on, the confidence of dentists
remains high in the short-term, but low in the
long-term. This could partially be explained
by the proposed increase in registration fees,
which are currently being challenged through
judicial review, the result of which is expected
in the near future. However, with the worst of
the recession now hopefully past, the sector is
looking ahead to a more profitable future.
Finally, it’s good to see confidence rising so
well among pharmacists, who are enjoying the
opportunities that are coming their way as they
play an increasingly important role in adding
primary healthcare services to their traditional
role of dispensing medicine. The evidence that
pharmacists are beginning to form federations
to bid for contracts reflects the fact they are
stronger, and feeling optimistic, and this is
reflected in the report.
69%
More than two thirds of dentists
want to grow their business over
the next five years.
16
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Issue date: March 2015
LBHealthcareEdn6(0315)