very hard question need help

features November 8, 2004

A good business plan can pnt yonr practice in tiie driving seat WriUng a business plan is iiecoming an important skiii in tiie new worid of GiVIS2 - Dr Miciiaei ingram and practice manager Ken Spooner gnide you flirougii tiie basics

Cost of 24 weeks treatment'

Tetralysal 300 I42.7ti f4 66% saving

Minocin MR

* Compared to Minocin MR jn mild to moderate inflammatory acne

TETRALYSAL 300 Prescribing information Presenuiion: Capsule containing lymecycline 408mg (equivalent to 3O0m9 tetracycline base), indications: Acne and treatment of infections caused by tetracycline-sensitive organisms. Dosage and administration: Adults and children over the age of ] 2 years - One capsule daily for at least 8 weeks for the treatment of acne. For other infections, usual dose is 1 capsule b.d. Contra-indication5: Renal insufficiency. Hypersensitfvity. Children under 12 years. Pregnancy and lactation. Warnings and precautions: Prolonged use of broad spectrum antibiotics may result in the appearance of resistant organisms and superinfection. Exercise care in hepatic impairment. Tetracyclines may rarely cause photosensitivity. May cause exacerbation of systemic lupus erythematosus. Can cause weak neuromuscular blockade so use with caution in Myasthenia Crauis. Interactions: The absorption of tetracycltnes may be affected by the simultaneous administration of calcium, aluminium, magnesium, bismuth and zinc salts, antacids, bismuth containirtg ulcer-healing drugs, iron preparations and quinapril. These products should not be taken within two hours before or after taking Tetralysal 300. Absorption of Tetralysal 300 is not significantly impaired by moderate amounts of milk. Tetracyclines may increase the effects of anticoagulants. Concomitant use of diuretics should be avoided. Concurrent use of tetfacyclines and oral contraceptives has been associated with a few cases of pregnancy or breakthrough bleeding (not reported for Tetraiysal 300). Undesirable effects: Rarely anaphylaxis

Tetralysal lymecycline ' # # • •

& dysphagia. Nausea, vomiting, diarrhoea. A few cases of oesophagitts, oesophageal ulceration and pancreatitis have been reported. Overgrowth of nonsusceptible organisms may cause candidiasis, pseudomembranous colitis (Clostridium difficile overgrowth), glossitis, stomatitis, vaginitis, or staphylococcal enterocolitis. Transient increases in liver function rests, hepatitis, jaundice and hepatic failure have been reported rarely. Bulging fontaneiles in infants and benign intracranial hypertension in juveniles and aduks have been reported. Presenting features were headache and visual disturbances including blurring of vision, scotomata and diplopia. Permanent visual loss has been reported. Skin rashes, photosensitivity, erythematous, and maculo-papular rashes, pruritis, bullous dermatoses, exfoliative dermatitis. Teeth discoloration - usually only obvious after repeated doses. MANumber: PL IOS90/0019. Package quantities and cost: Available in packs of 28 capsules £7.16 and packs of S6 capsules £14.26. Legal category: POM. Date of preparation: March 2004. Fuil prescribing information is availabie from the marketing authorisation bolder: Calderma (UK) Limited, Calderma House, Church Lane, Kings Langley, Herts. WD4 8JP. Telephone: 01923 291033. Fax: 01923 291060. Tetralysal and Calderma ^ H are registered trademarks of Calderma (UK) Ltd. GAIDERMA WM Reference: I, MIMS June 2004, 56 pack size, HNHHJ K.rii:,uu" | 3 TfT/l 05/0604 Bfl

I he new GMS contract may well have its I advantages and disadvantages but there is ^ ^ ^ one theme that seems to be running

I through it., namely that the pro\ ision of I primary care services is no longer tlie

^ p j exclusive right of GPs. A competitive environment will start to emerge where practices will find that to retain contracts and, more importantly, income for services tliey will have to bid again.st other providers.

Though there are many inherent advantages that GPs will bring with them into this new order, there is one major area where inexperience could cause problems in the bidding process and that is the writing and submission of a business plan.

Private providers are skilled at writing convincing, soimd business plans that impress and persuade PCTs, especially when compared with some of the poorly written unconvincing efforts submitted by some practices.

Practices will need to acquire skills of content and presentation of these plans if they are to thrive in the new competitive world.

A few guiding principles, coupled with thorough preparation, can produce a high-quality document that will boost the fortunes and prospects of practices in convincing the PCTs that they are worthy of investment resources and selection for service provision.

What exactly is the plan? What are you setting out to achieve and w hat are your aims in submitting the plan? These need to be defined to give the plan focus and incorporated in the opening of the plan or even its title.

Start off with an executive suinmary This should contain: • Details of what you are actually asking for or proposing. • Business reasons for this. For example, these can highlight that the new service will be better, have a shorter waiting time, cost less or offer increased patient services. • Outline of the costs involved. • The risks that need to be considered. The summary should be concise and compact.

Look at the guidelines that have been given. Most requests for business plans fi-om the PCT will be relating to the provision of services or bidding for extra resources, and guidelines for these will be supplied. These guidelines are the nub of the issue and they need to be incorporated Rilly in any plan.

The flindamentals of exam technique is to answer tlie question asked; however much you write, if it is not relevant to the question you will get no marks. The same applies in a business plan; it can contain the most well-argued proposals but if it does not focus on the issues contained in the guidelines it will be a waste of effort.

Better still, use the guidelines as headings to make sure that all points have been considered and dealt with.

If no guidelines are given and you are writing the plan from scratch, then you will need to take a broad approach. Make sure the objectives of the

plan are clearly stated and then look carefully at all the parties likely to be affected and consider how they will view the proposed projects. Also ensure all the key players are mentioned and tlieir anticipated view s addressed,

If you are submitting your plan to the PCT make sure it reflects its issues and concerns. Who will be reading it.> What is their

function within the PCT and what is their political direction?

For example, if the PCT's main thrust is to tackle waiting lists, highlight those areas of your plan that can help it. PCTs will allocate resources into high priority areas, so illustrate how your proposal will help them meet those targets.

If you are trying to get finance for new premises, for example, show how the services that you will provide there will mean a reduction in demand for secondary care and thus ease waiting list pressure.

As well as personnel, look at performance targets. Many PCTs will be looking at their star ratings and anything you can highlight in your

You need content and presentation skills for the ne\v competitive worldtttt

November 8, 2004

and description of proposal

Executive summary A few sentences only summing up the case

Business objectives Describe what you are setting out to achieve and hew this will be done

Resources Look at the cost benefits and resource issues involved

Risks Highlight the risks involved in the project and how these oan be minimised or planned for

Where guidelines are pubiished these can be used as tities for sections instead of 3-5

proposals that arc likely to help tlicm achieve that will be of great interest to them.

In adopting this strategy remember those on the board might have different priorities. The finance director may be foeiising on the costs and savings oftcred wliile other members may be looking more towards a patient-oriented service or 3chie\ing the targets that have been set for them.

Highlight all the benefits II you are going to be able ro offer financial benefits to the PCT then say so and describe the way that your proposals viill achieve these. But if your proposal does not have obvious financial advantages then it is important to highlight the other benefits and be convincing in the argument tliat tliese extra benefits justify the financial resources \ou seek.

VVMake sure youfplan reflects the issues and concerns of the

Costs Wlien presendng costs these must be legidmate costs and must be both realistic and accurate. If it is difficult to be exact about dicse costs then say so, and explain what the various factors are that have to be taken into account.

Get your facts right Make sure you are certain of what you state and ensure you have done your homework properly. If you are inaccurate with the fects that you use you will sooner or later get found out and the whole plan will be discredited,

It is essendai to use the business plan as die foundation of the project, proposal and presentation. Wridng a plan is a developmental process. Start with a draft plan and dien re-read it.

Consider die quesdons that you would ask If you were reading the plan or on die panel assessing it and then formulate the answers to those questions. These can then be incorporated into the next working of the plan. Discuss the plaji looking for other questions that are likely to arise from it and how these can be addressed.

The end result of this process will be a business plan has been developed into a document that not only contains proposals but also seeks to answer the points most likely to be raised as a result of what is being suggested in the plan.

Business plans need a great deal of dme and effort to make diem effccdve.

They should relate your proposals to the main local issues and priorides of the PCT, demonstrate how resources will be used more effecdvely, and seek to identify and answer quesdotis that are likely to arise.

As with many areas of pracdce thorough preparadon is the key to success.

Michael Ingram isaGPin Radtett, Herts and Ken SDOOner is his practice manager

Prescribing Information; Unguentum M is an amoipliik toprcal preparation wild emollient properties, whicd contains the high (ipifl content ct an oiniment but also has the water mscible chaMctensties of a cream. Contains: Punded water, white solt paraffin, cetostearyi alcohol, polyscrbate 40, propylene gtycol, glycefoi (Tionostearate 40-55. liquid paraffin, rnedium- chain triglycerdes, S(xt»c acid, colloidal aiViydicus

silica, sodium hydroxide. Uses: Unguantum U has emolliem properties and is recotiimer>ded (or tfte symptomatFC treatment of dermatitis, nappy rasti. ichttiyosis, eczema, proiection of raw and abraded skin areas, pruriius and related skjn conditions where dry scaly skin is a problem, and as a pre-ba!hing emollient for dry/ eczematous skin, to alleviate drying effects II ts also used as 3 diluent for various topical corticostemid

formulatioos where a lowe* strength preparation Is r e q u i f E d and as a general base for eKtemporaneous dispensing Dosage and adrninistration: A ihin application of c e a m should be gently massaged mW the skin three limes daily or at appropriate intwvals When used as a protective cream Unguentum M should be applied spanngiy to the affected areas of Ihe skm beioFe, or immsdiately after, eiposije lo a potentially

harrTTful factor. Contia-indications, warnings etc: Unguenlum M should l o t be used m patients sensitive to any of the ingredients Undesirable effects: None known Package quantities: SOg and lOOg lubes SOOg tub ana ^OOmi pump pack Basic NHS cost: 50g C1 59. lOOg E3.13. 500g C9.55.200nil e6.19. l ^ calegCHV: GSL Poduct licence number PL 00327/0115. PtodDct licence holder. Crootes Heaircare Ud. Notmgrem NG2 3AA.

Unpronounceable You may have difficulties saying it, but for patients who need

an ointment yet prefer a cream, it's well worth the effort.

Unguentum M is a moisturising, lipid-based emollient with water-miscible characteristics which make it ambiphilic.

C KOIJKKS IIFALTHCAKE

CHCSK04-96-C Date of preparaiion: September 2004

Because of this it's easy to apply for the symptomatic relief of eczema, dermatitis and other conditions that can leave skin dry and scaly.

Unguentum M. Works like an ointment, feels like a cream. www.crool(es.co.uWhcpsefvices