My partners have left me in the lurch

My partners have left me in the lurch

Our Managing Director Jane Braithwaite has been tackling difficult questions arising from discussions in the digital issues of Independent Practitioner Today. This month she responds to a consultant’s ‘bombshell’.

‘I work in a group with two other partners who have both dropped the bombshell that they are aiming to retire next April. I want to keep my practice going for some years. How do I manage this situation?’

Hearing that the other partners in your group are about to retire with relatively little warning can be anxiety-inducing, to say the least.

You might think that your business is about to disappear or that your income is going to significantly decrease. But with a little planning and careful discussions with your partners, this does not have to be the case.

I can also tell you how to manage partners leaving your group through retirement, with ways to facilitate the transition, and how the group could continue to thrive after they have left.

Look to the start of the group

When the group was formed, hopefully contracts and agreements were drawn up. Buried deep in there should be the mechanism for a partner to voluntarily leave the group.

The contract should spell out how much notice the partner should give, what rights they have to any profit in the group at the time of leaving and any obligations of the group to the partner after they have left.

Of prime importance from a clinical standpoint is deciding who is going to look after the exiting partner’s patients and how to facilitate a clear and comprehensive handover.

Financial obligations can be difficult to disentangle, with the issue of ongoing profits derived from patients that the leaving partner acquired being particularly thorny. Hopefully, this should all be spelled out in the agreement signed on formation of the group.

Things become much trickier if there was no founding agreement, or the agreement does not cover the retirement of partners.

This situation can only be resolved by careful negotiation between the remaining partner and those who are leaving.

What should this plan involve?

It is very unlikely that you would be able to convince your partners not to retire, and you probably shouldn’t try. What is important is that you come to a plan that works for you, for them and for the group and its patients.

In the meetings that you need to call to sort this out, it is important that everyone is open and honest about what they want to get from the process, with their objectives and priorities clearly stated.

You may think that your partners want to ensure that they get the maximum value for their ‘share’ of the group, but they may be more interested in an orderly transition and the stability of the group than maximising their personal profit.

The outcome that you need to get from your meetings is a written agreement on how your partners will exit the group. This will protect both your interest and theirs and allow an orderly process for their retirement.

You do not need to shut the group down, but it is unlikely that it will be able to continue in exactly the same way with only one third of the partners left.

Having a plan in place will allow you to prepare for the transition and allow you to make changes to the form and function of the group as you see fit.

What options are there to change the practice?

Before leaping to a decision, it is worth thinking about what form you would like the group to have. Consider how the group was before the partners retired. Were you happy with the structure?

One option might be for you to take over the entire practice by yourself. The advantages of this are that you would have sole control over the direction of the practice and all the rewards of this hard work would be yours.

On the other hand, if the workload was previously shared between three colleagues, you may find that it is not manageable by yourself.

If you do decide to take over your partner’s shares of the group, you will need to decide how you ‘inherit’ their patients.

It is important from a clinical standpoint that the patients experience continuity of care as they transition from one clinician to another.

Compensation payment

Your partners may want some form of compensation for passing their patients to you. This could take the form of a one-off payment or an on-going reward dependent on the revenue that the patient brings to the group.

The nature of this financial return should hopefully be spelled out in the contracts that you signed when the group was formed. If this is not covered in any agreement, then it will need to be negotiated as part of the exit process of your partners.

If you feel that the workload is not manageable alone and you wish to keep the current number of patients, then you will have to look for other partners to join the group.

While the complexities of recruitment to join a group practice are beyond the scope of this article, there are a few things that are important.

Rather than just co-opting the first consultant that you can find, consider what skills and knowledge would complement your own. Is there particular training or background that may help the group expand revenues and offer new services in the future?

Take time to make sure that all the legal work is completed correctly, with the help of an expert. Ensure that those who join sign a contract, so that everyone is aware of their new responsibilities to the group.

Employ staff

If you feel that some of the workload could be managed without the direct input of a consultant, you may be able to employ staff such as nurses to undertake clinical tasks on your behalf. This can help make sure that your limited time is used for activities that only you can perform.

If you do not currently employ clinical staff, careful advice is needed to ensure that you are providing a service that is safe and well-supervised, with on-going training and professional development.

If your partners announce they are going to retire, it is important not to panic. While it may feel like you are about to lose the business that you worked so hard for, this is not the case.

There are a number of ways that a group could continue, either in its current form or by altering its structure.

Change can be uncomfortable, but it is inevitable. This may give you the opportunity to push the group in new directions, with great personal and professional rewards.

We have a team dedicated to marketing private medical practice and have a wealth of experience for you to tap into.  Call us today 020 7952 1008 or via send us an email at

Managing Director Jane Braithwaite regularly writes for the Independent Practitioner Today, with this article first being published here.



Should I invest in marketing?

Should I invest in marketing?

How does any business owner decide how much money to invest in marketing? Should the marketing budget be based on a percentage of income? Or is it best to identify the projects for the year and the cost of each one to build up the overall budget? Originally published in Independent Practitioner Today, Jane Braithwaite gives her views. 

If a business invests £1 in marketing and generates £5 of income there is an argument to spend as much as possible on marketing to generate the highest income. Most businesses need to be more mindful of cash flow and are not able to deliver exponential growth to justify that level of marketing spend. 

When making any business decision it is wise to look at what other companies are doing to learn from their experience. The Gartner report titled ‘The state of the marketing budget 2021’ provides some insights into post-covid trends about marketing expenditure.  

Gartner reports that marketing spending as a percentage of income is at the lowest point in history. In 2020, marketing spending as a percentage of income was reported to be an average of 11%. In 2021 this reduced drastically to 6.4%. Before 2020 the percentage had typically sat between 10% to 12%. 

We can assume that in the coming years, as business confidence returns, we will see this percentage increase again to pre-covid levels. 

Stunts creativity  

In many small to medium businesses, decisions on marketing budgets are made on a project-by-project basis. This creates a short-term approach and stunts the creativity of the marketing manager or team.  

I am totally against micromanagement, as I firmly believe individuals can contribute more when they are given responsibility and accountability and allocating the marketing budget in this way does not encourage either.  

Setting a budget, ideally for the next 12-month period allows you to work with your marketing team to make sensible, long-term decisions.  

If you are new to the concept of marketing your business, then setting a budget for the whole year may seem too large a step. In that case, start with a budget you feel comfortable with and invest wisely. Measure the success of your campaigns and invest more in those that are most successful.  

Before allocating any of your budget, you must set out your objectives for your marketing activities. What do you want to achieve, when do you want to achieve it, and how will you measure success? Success can be so subjective in marketing, so it is critical in any plan to define your SMART objectives. So your business goals must be Specific, Measurable, Achievable, Relevant and Time-bound. 

Work with your team 

The subjective and individual nature of your objectives means that there is no boilerplate plan for marketing your business. This is why you must work with your team to set out how your marketing will help achieve your vision for the business. 

Your marketing budget is not going to be infinite, so it must be carefully allocated to projects and campaigns that are likely to bring revenue to your business. There may be larger projects, for example, a new website or a large event, which will take up a large proportion of your overall budget.  

Allocation of budget to these ‘big-ticket’ items needs to be done with care to avoid using all your resources up too early in your financial cycle. 

One of the decisions you will need to make is how often to review your marketing results. The risk from checking too often is that you may feel the effects are taking too long.  

Make adjustments 

On the other hand, if you only look at the outcome of your efforts once a year, you will be unable to make adjustments to projects that are underperforming or to double down on your successes.  

One possible approach is to sit down with your marketing team and have a full review of your activities and results every quarter. This way you can start to see which of your activities are having the right effect, and which are having no effect at all. This will allow you to make alterations to your approach if required, or to cut projects when needed. 

The essence of good marketing is measuring the outcome of your campaigns so that you can calculate your return on investment; in essence, how much ‘bang for your buck’ you are getting. 

Tied to this is the concept of ‘lifetime value’ (LTV), which is the average revenue you will earn from a patient throughout the entire time they are with your practice.  

This figure will vary hugely between clinicians. Those that usually see a patient to treat a one-off problem will derive a very different lifetime value than those who treat patients with lifelong conditions.  

Your marketing team will help you review the data for your practice to work out the average LTV for your patients. If the amount you spend to acquire a patient is less than the LTV that the patient will bring, then you can begin to generate a profit. 

Return on investment 

If you spend £100 on marketing to attract two new patients to your practice and the lifetime value of each patient to your practice is £1,000, then your return on investment is excellent.  

There would be a strong argument that you should invest £1,000 in the same form of marketing and generate 20 new patients. You could invest more, of course, and soon the limiting factors will be your time and how many patients you can see each week.  

Marketing has the power to bring greater success to your business if done properly. With the help of your marketing team, you should set a sensible budget with specific goals, and a reasonable time span to take effect. Your success, or otherwise, should be measured against specific targets.  

Marketing is an investment in the future success of your business and should be viewed as a worthwhile expenditure to achieve your goals. 

If you have any specific questions that you would like answered in upcoming editions, please do feel free to get in touch 

Talk to us about how we can help with your marketing.  We have a team dedicated to marketing private medical practice and have a wealth of experience for you to tap into.  Call us today 020 7952 1008 or send us an email at



Definitive Guide to Attracting Patients

Definitive Guide to Attracting Patients

Attracting patients is a key concern for doctors starting out in private practice and for those with established practices who want to increase the frequency of their practice sessions.

How are you attracting patients?

Marketing is essential to the success of any business, including private medicine. While unfamiliar to many doctors, it does not have to be complex or time-consuming. So here are some effective strategies to help promote your business.


The most effective way to expand your practice is through word of mouth and via existing patients, friends and family. Are your patients familiar with the full range of services you offer? Are they aware you are actively aiming to expand your practice?

Contented patients will automatically act as ambassadors and refer you to their friends and colleagues. It is also a good strategy to maximise communication with your colleagues – including GPs and specialist consultants.

Traditional marketing methods

With current focus firmly on the innovative world of digital marketing, it is easy to overlook tried and tested methods of promoting your practice.

  • A brochure or simple flyer is a cost-effective marketing tool, which can be handed directly to patients and potential referees or simply displayed in your waiting room.
  • Articles in relevant publications will enhance your reputation.
  • Paper newsletters are another potent tool for marketing your practice; there are many available options once you start thinking creatively.

Check your online profile

Google your name and see what you find. Prospective patients will do this before they book their first appointment. It is vital to take control of your online presence.

Ideally, your website should be prioritised within any list of results. It is not necessary to pay for listings – there are numerous free directories featuring private doctors in London.

You should ensure your details are listed accurately and updated on each one of them. You may get mentioned on websites such as Mumsnet. While you cannot control this, you can engage with the process positively.


A website is an integral aspect of digital marketing and a powerful communication tool – allowing you to monitor, amend and update content as your practice develops. It is often the first port of call for potential patients and a vital component in promoting your unique expertise and services.

Fundamental technical components include:
  1. 24-hour email contact which is highly visible.
  2. well-designed, user-friendly interface.
  3. fully compatible with mobile device access.

Make it easy for potential patients visiting your site.  Ensure your phone number and email are highly visible and facilitate this with a one-click appointment process.


Blogs are a vital tool in promoting your business and communicating positively with patients. Frequent blogging is a highly effective way of reassuring prospective and existing patients and letting them know what to expect when they book an appointment. By citing existing patients’ positive experiences, using real examples, you can ensure readers will have highly positive expectations.

Social media

Use social media to your advantage as part of your digital marketing strategy. It is a highly-effective way of driving patients to your website prior to booking an appointment.

By posting content related to your personality and practice, you can strategically attract more patients. Twitter, Facebook and LinkedIn are all relevant in this field.

  • LinkedIn is primarily used to network with colleagues and patients;
  • Facebook to interact with patients and to perfect and control your public profile.

Speaking at conferences

Good speakers are continually in demand both nationally and globally. This could be an excellent opportunity to impart your expertise and expand your network.

  • Speaking commitments require careful planning, both leading up and afterwards.
  • Focused research to establish the right event, location and correspondence procedures would be logical first steps.
  • Allow plenty of time for this process.


With careful planning, a successful event can yield productive results and, ultimately, bring you more patients. It does not have to be ambitious in scale; a well-planned social gathering can be very relevant – if you get the initial focus right.

  • Think about your guest list, whether a small-scale occasion or a focused educational event with the aim of referring doctors.
  • Allow plenty of time to choose the right venue and location, appropriate catering and, crucially, allow sufficient notice for your guests to plan their attendance.

To summarise: authenticity is always a good strategy – use the marketing tools you feel most comfortable with – but do not be afraid to branch out.  Good luck.

Talk to us about how we can help attract new patients.  We have a team dedicated to marketing private medical practice and have a wealth of experience for you to tap into.  Call us today 020 7952 1008 or via send us an email at

Managing Director Jane Braithwaite regularly writes for the Independent Practitioner Today and her latest series entitled Private Practice Growth Guide is a must read for anyone looking to attract more patients and increase the frequency of practice sessions.



‘It’s good to talk’ to defuse disharmony

‘It’s good to talk’ to defuse disharmony

Our Managing Director writes about how to ease tensions within a private practice. First published in Independent Practitioner Today.

Tensions are not uncommon when consultants get together to form groups in private practice in the current financial climate. Our Troubleshooter Jane Braithwaite tackles an appeal for help. 

‘We have been working in a group for two years now and we are starting to experience tensions between us. How do we manage these tensions without breaking up the group?’ 

Running a busy private practice group can be rewarding but time-consuming at the best of times. If you are experiencing disagreements with the other members of your group, it can feel overwhelming.  

Tensions, disagreements or even arguments can be common, especially among the high-performing clinicians that make up your group. 

This article will look at how to approach your colleagues to diffuse this tension, how to reduce the chance of divisions going forward and what steps to take if you feel the situation is irretrievable and the group needs to be dissolved. 

There are a number of steps you can take to resolve this situation. 

Tensions are common  

The nature of a group can lead to building tensions. It is rare that everyone in the group has exactly the same goals, both professionally and personally.  

These slight differences in objective can lead to stress, which can manifest in many different ways. 

The reasons for these disputes vary from person to person and from group to group. They could be related to individual financial problems, the clinical direction that the group is moving in, the way work is allocated or how profit is distributed.  

Whatever the cause, it will be essential to see the problem from everyone’s point of view in order to come to an amicable solution. 

How to start the discussion 

The process of understanding the problems within the group and addressing them is key.  

One of the best methods is a meeting to talk through all the issues. Everyone must be present, because if someone feels excluded, it may lead to resentment and the underlying problems cannot get solved. 

At the outset, you should set the expectation that these meetings are the forum to talk through all the tensions, with no side discussions or confidential chats that do not involve all members of the group. 

This meeting aims to bring up all the problems that people feel are holding the group back, work together to find a solution and decide how it will be implemented. 

How to structure the discussion 

If you lead or manage the group, you may feel it is natural that you take charge of this meeting.  

Depending on what needs to be discussed or what the underlying issues are, the other members may find it more difficult to be open and honest if one person appears to have more sway than the rest. 

To ensure that there is no power imbalance in the discussions, you might find that having an independent person to chair the meeting can help things flow a bit better. They can help keep the meeting on topic and make certain that everyone is having their say. 

If you have significant problems within the group, it is likely that this meeting will involve a degree of confrontation.  

This is never a comfortable position to be in, both for yourself and others. Going into this meeting prepared, either by having thought through what needs to be said or bringing notes with you, will make sure that you can manage to get your point across. 

Psychologist Bruce Tuckman described the stages that teams go through when working on a project together. He named these stages ‘forming, storming, norming, performing’.  

The ‘storming’ stage is characterised by potential conflict between members as everyone tries to work out individual roles and pushes against boundaries. 

It may be that, as a group, you have entered the ‘storming’ stage, with its uncomfortable conflicts, and that you need to work through to reach ‘norming’, where everyone resolves their differences, and ‘performing’ where members work together to achieve the group’s goals. 

If you can push together through this difficult stage, you may find that you have bonded better as a team and can attain greater success in the future. 

How could the process go wrong? 

Any situation involving confrontation is fraught with pitfalls. 

If relationships within the group are already fractured, there may be considerable resistance to bringing about the meeting. Sometimes in these circumstances, there is one member of the group who can act as a ‘peacemaker’ and bring the others together. 

It can be tempting to phrase all communications about these meetings in hard-nosed business language. By humanising what you say and acknowledging your own and others’ discomfort with the situation, you might find that everyone can open up a bit more about the problems that they see. 

Some people may find this level of discomfort and confrontation intolerable and, rather than face the issues, may choose to leave the group. 

 If there is no way to bring about a meeting between members, then the business relationship, and thus the group itself, may not be salvageable. At this point, the advice of experts such as lawyers and accountants will become invaluable. 

How can we improve in the future? 

If you have managed to have these discussions, then you have taken a difficult but important step for your business. It would be a shame now to slip back into your old ways and find that the same problems and conflicts are continued. 

Look back at the contracts and agreements that you had drawn up when you formed the group. Do these still reflect the way the business is run? You may find that you have altered some of the roles, responsibilities and functions of group members and may wish to put this down in writing in new contracts. 

You will need an agreed structure for the future and this should be documented and signed by all members of the group.  

If necessary, you should seek advice about drafting these new contracts and agreements to make sure that everyone has clarity about what they can expect of others and what others will expect of them. 

Ongoing communication will be essential, perhaps in the form of a monthly group meeting. This will provide a forum for issues to be aired while they are still small and easily solvable and allow them to be dealt with before they become a threat to the group. 

What if the group cannot be salvaged? 

Sadly, it is not uncommon for dis­agreements to snowball, ending up with a break-up of the group.  

If your founding agreements included provisions for dissolving the group, then this process will be much easier. 

If the initial contracts did not cover this, then it will be necessary to negotiate with the other members of the group to find an amicable way to split the assets. This could be complicated and having the advice and input of experts as early as possible is advised. 

Managing conflicts, tensions and disagreements in a group can be difficult. If you can find a way to bring everyone together as a team, where each individual is empowered to raise problems, you may find that the resulting group functions much better than before. 

If you have any specific questions that you would like answered in upcoming editions, please do feel free to get in touch. or call 020 7952 1008


How can a strategic business review help your practice excel?

How can a strategic business review help your practice excel?

When you are running your own private practice, how do you take a step back? To stop and evaluate, and to listen and learn from your patients and team? 


Are the values and vision you hold dear, understood and communicated to all your stakeholders, referrers and patients? 


Doing this is hard within your own practice. Taking time away from the demands and stresses of “business as usual”, to pause and evaluate whether you are offering the best experience to your patients and your team is important but also challenging. So how do you achieve this? 


This is where a strategic business review comes into its own. Undertaking such a review will immediately help you to identify the strengths of your practice, and pinpoint the weaknesses, creating an opportunity to highlight and rectify any problems before they become ingrained. 


Most businesses conduct annual employee performance 360 reviews and find them extremely helpful with staff development and management, however, much greater value is to be had from running a whole business review, covering both your patient’s and employees’ experience of working with your practice. The process of looking at every aspect of your practice by reviewing each part of the structure from the top down, will reveal exactly how it is perceived, and identify any gap between your view of how you want to be perceived and reality. 


What is a business review? 

A business review evaluates key aspects within your practice that are the pillars of its success, through an in-depth audit and interviews with key stakeholders. 


The process is usually managed by an external partner, covering areas such as: 

Business objectives 

Vision, Mission and Values 

Service offering 

Key sectors, target patients 

New patient/referrers strategy 

Marketplace perception 

Your people – staff engagement 

Patient experience/journey 


The output of the review is a comprehensive report, providing evaluations and recommendations that engage your team, identify your ideal patients and referrers and ensures your brand messaging and values are woven throughout all of your practice communications and patient journey.  

One of the benefits gained by a business review is the feeling of inclusion amongst your employees while contributing to creating a more positive workplace. 


The report 

From the answers obtained in the interviews, the review of supporting documentation, clarifications and from research, an extensive report is produced, which addresses all of the areas above and summarises your successes and challenges in each area and provides recommendations to improve, including, but not limited to:  

Competitor analysis  

A review of your brand messaging and story and suggestions on your messaging going forward  

A full website audit  

A review of all your communications, social media, marketing collateral, pitch/presentation documents  

Development of user personas for your target patients and referrers  

A ‘secret shop’ to experience your patient journey  

Results from a staff engagement survey to inform Values and identify any areas for improvement  

The report concludes with recommendations for all of the key areas: – Business strategy, patient experience, your people, brand messaging and marketing strategy and activity.  

It will also provide a 3-month marketing plan that incorporates your Brand Strategy which can be implemented at your own pace.  


Tough read 

Any review you undertake can be a difficult read as it will enable you to uncover issues of which you were completely unaware. The process and findings can feel quite personal as your practice is your passion. The key is to thoroughly evaluate the results and make changes where necessary.  


A review can broaden your view of your practice, patients, referrers, workplace and employees and steer you away from assumptions. It will allow you to identify the improvement opportunities and create a strategy to implement them. 

The idea of any review can seem daunting, and the results can be brutal and difficult to accept, but it can be an especially useful way of identifying issues and weaknesses before they become a real problem affecting practice performance. When managed properly, the results can lead to changes that ingrain best practices within every layer and ensure that your employees and patients feel listened to and valued. The most important part of any business is the employees and ensuring they are all on board with the values and ethos of the business allows the company to develop and flourish in its given field.  


If you would like to find out more about our Designated Business Review, please do get in touch: 

Michelle Wheeler, Marketing Director 

2022’s mini budget update & what it means for you

2022’s mini budget update & what it means for you

Here at Designated, we aim to help our clients succeed and to support this we are committed to sharing our expertise and experience. This week our team of accountants are available to help you make sense of last week’s budget and how it may affect you and your practice.

If you’d like to have a more in-depth discussion with our finance team, get in touch with Vicky at: 

Here is a quick budget overview from Vicky: 

The mini budget has come as a surprise to some, and a real shock to others. Reading all the newspaper coverage can cloud the raw details of the Government’s announcement, so here they are, with no fluff and straight to the point!


  • AIA will remain at £1,000,000
  • IR35 rules will be reformed, and tax codes will be reviewed
  • Income tax rate of 45% to be abolished next year, and income tax (lower threshold) to be 19p in the £1 from April 2023.
  • End of the 45p tax rate, paid by those earning more than £150,000, from April 2023.
  • 1p cut to the basic rate of income tax brought forward by a year to April 2023
  • No stamp duty to be paid on property purchases up to £250,000 and up to £425,000 for first-time buyers
  • Scrapping of the bankers’ bonus cap in a bid to boost the city
  • Reintroduction of VAT-free shopping for overseas tourists
  • Businesses based in 38 new ‘investment zones’ will have taxes slashed and will benefit from the scrapping of planning rules
  • Alcohol duty frozen from next year (estimated to be worth 7p on a pint of beer and 38p on a bottle of wine)
  • National Insurance contributions increase of 1.2% to be cancelled from 6th November 22
  • Cancellation of next year’s planned rise in Corporation Tax, will now remain at 19%

Designated are always here to support you, across all our services. Get in touch with the team to start your conversation. 

Phone: 020 7952 1008 Email:

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