In this month’s edition of Stay Connected, our Head of Accountancy has taken the work out of the Government’s mini budget and gives you the salient details of how it will affect you and your practice.
When was the last time you analysed your patient journey or even how your business functions in general? This month we look at how you can best do this to ensure your practice thrives!
We have examined how you can streamline and improve your patient journey to make onboarding new patients easier and ensure that they return to your practice long-term, helping boost patient retention and increase profits.
Our specialists have examined how strategic reviews can benefit your practice, helping you identify your strengths and weaknesses. Conducting a well-rounded evaluation across all elements of your business can help you adapt and grow and remove any issues before they become detrimental.
And finally, we know that NHS wait times are encouraging people to turn to private medical care. We have looked at 5 things private practices should consider to meet the needs of self-pay patients to help grow your practice and ensure their needs can be met.
It’s been more than two months since the introduction of reforms to the IR35 rules and in that time, thousands of contractors have required contractual assessment and review.
JSA Group’s assessment platform, IR35 Complete™, has been used to assess contractors with over 750 hiring organisations across numerous industry sectors since the reforms were implemented. Naturally, this scale of deployment leads to a healthy data set, offering interesting insight about what’s happening in the marketplace.
To date, 18.9% of the off-payroll status determination assessments carried out through IR35 Complete™ have identified that the hiring organisation is in fact not responsible for producing an assessment due to them qualifying for the “small company exemption”. In such scenarios, the IR35 assessment responsibility continues to sit with the worker themselves. The IR35 Complete™ assessment process specifically screens hiring organisations based on their size to ensure that supply chains don’t become polluted with invalid Status Determination Statements produced by exempted hirers.
“Inside” IR35 determinations account for just 28.2% of determinations made. This is interesting because of pre-April concerns that many more contractors were going to be officially classified as “inside” IR35. Of course, there is still some application of blanket “inside” IR35 decisions which isn’t reflected in this figure, but we believe this statistic speaks volumes about the value of carrying out genuine assessments. When roles are properly assessed, instances of “inside” IR35 are much less common, indicating the unfairness of large-scale blanket “inside” IR35 determinations.
“Outside” IR35 determinations show up in 52.8% of cases. When we consider that in practice this number can most likely be combined with the 18.9% of cases where the worker remains responsible for their own IR35 determination, that effectively means that in nearly three quarters of cases, there is no change of IR35 status disruption injected into the supply chain; it’s effectively “business as usual”.
All of this underlines the need for quality, timely and accurate IR35 assessments.
Article originally posted on theglobalrecruiter.com, August 2021
Designated have been voted Best Medical Services Provider in the UK in the Healthcare & Pharmaceuticals Awards!
Global Health & Pharma hosts the annual Healthcare & Pharmaceutical Awards to honour the innovation, determination and outstanding levels of care demonstrated by those who place patient wellbeing at the forefront of their practice.
Global Health & Pharma Magazine (GHP) was initially launched to act as an information-sharing platform for those in the healthcare and pharmaceutical industries.
Designated Medical are delighted to have been awarded ‘Best Medical Services Provider in the UK’
GHP have a dedicated research team to gather independent information which is then assessed
The research team casts their final judgment based on various criteria such as great contribution to the global healthcare or pharmaceutical industries, longevity, diversification, sustained or continued growth, significant innovations, feedback from patients and customers.
Thank you Global Health and Pharma for the award!
If you are considering taking on a Medical PA, please don’t hesitate to contact our professional and friendly team for a no-obligation chat.
Burnout is defined as physical or mental collapse caused by overwork or stress. As it turns out, there are ways to identify the early warning signs of burnout. And, there are many simple practices you can put in place immediately to prevent burnout from becoming an occupational hazard.
This summer Simone Biles, probably one of the best gymnasts we have ever seen pulled out of the Tokyo Olympics to focus on her mental health and just last month, Naomi Osaka stepped away from the French Open and Wimbledeon for the same reason. It is clear there has been a momentous shift in the acceptance of mental health, no doubt due to the awareness that has been raised over the past few years and in particular in the midst of the pandemic.
13 Early Signs of Burnout
High levels of stress or anxiety. Feeling frequently on edge, with adrenaline constantly coursing through your body.
Lack of engagement. You don’t feel motivated at work. You have difficulty focusing or exhibit a short attention span.
Increased cynicism. Feelings of resentment or disconnection. You may notice yourself being more negative and cynical. Feeling cranky and defensive or snapping at people easily. Youdon’tmake time to talk on the phone or connect with the people who matter most to you. If you’re feeling a lot of resentment towards others, chances are it’s because you’re not getting your needs met and you’re on the path to burnout.
Distracted eating. You eat your meals in front of a computer, television or while on the go (in the car, standing up, etc.)
Not getting enough sleep. The suggested minimum amount of sleep is seven to eight hours each night, if you’re getting less than this, you risk some level of burnout.
Low energy and exhaustion. You’re tired. Not just sleepy tired, but emotionally fatigued. You may feel exhausted by the end of the day, with no energy left to exercise or even engage with others, you just want to crash and watch television or zone out in some other way.
Never enough time. You feel as though you’re always in a hurry and never have enough time for all the things you’re trying to accomplish each day.
Excessive worrying, high level of self-criticism. Your mind cycles through the same worry-filled thoughts again and again and you can’t seem to stop. The critical voice in your head is very loud, telling you constantly to do more, work harder, and no matter what you accomplish, you’re still not doing enough. There is no self-compassionate voice to balance out the critical voice, or if there is, it is very weak and you can barely hear it.
Physical illness. Initially, the physical symptoms can be subtle. You may experience headaches, a persistent cold, have a stomach bug or an upset stomach frequently, or a weak immune system in general. If early signs are ignored, your body may hit a wall and receive a more serious diagnosis.
Numb feelings. Increase in addictive behaviour. Initially, this can show up as an excessive dependence on caffeine and/or sugar to stay alert and boost energy when feeling low. As things progress, increased dependence on drugs, alcohol, eating comfort foods or watching more television than usual can be signs you are burning out and using these coping mechanisms to avoid acknowledging how you really feel.
Inefficacy. Experiencing diminished personal accomplishment, a perceived decline of incompetence or productivity, and expending energy at work without seeing any results.
– Vacation. You can’t remember the last time you took a single day off just to relax and do nothing. Or perhaps you haven’t had a vacation in over six or even twelve months.
– Recharge throughout the day. You may have a tendency to push through your work without taking a break. It’s one thing to be in the zone, but if you notice you’re not getting up to get a glass of water, stretch your legs, go on a walk or call a friend at least once every 90-120 minutes, you could be putting unnecessary stress on your body.
– Weekly Rituals. You haven’t made time for a rejuvenating activity in the last week (massage or any pampering treatment, a bath, cooking or reading a book simply for pleasure, going on a hike, etc.).
Not enough exercise. You aren’t making as much time to exercise or move your body as you would like.
What are some practical, simple & cost-free things to do?
First, go through the list above and circle your top three symptoms.
Next, ask yourself “Hmmm, what do I need?” for each of these areas. For example, if you’re eating at your desk five days a week, what you need could be to connect with friends or colleagues over lunch more often, or to exercise during your lunch break. If you haven’t taken a vacation in over a year, what you need could be to schedule a vacation.
Once you determine what you need, come up with an action step for each of these three areas. An action step has a “What” and a “By When.” For example, Action Step: I will plan a vacation and book the tickets by next Thursday at 4pm.
Setting concrete goals is one of the best ways to ensure you’ll make a change.
Avoiding burnout starts by putting some of these preventative measures in place.
If you want even more accountability, you can recruit an anti-burnout partner. Tell this person what your action steps are and ask him or her to hold you accountable by checking in to make sure you’ve followed through.
Getting support and setting clear action steps will help you implement these simple practices with greater ease.
Hire a Designated Virtual Personal Assistant (Medical Secretary) and delegate some tasks to ease the burden. Our virtual personal assistant team will work with you towards the same goal and help to ease the pressure.
How to set up your PHIN profile. A step-by-step guide.
Last month we posted an article in relation to PHIN, and the importance of having a profile and keeping it up to date.
We sat down with Jonathan Evans Communications and External Affairs Manager, Private Healthcare Information Network(PHIN), to ask him why private practitioners should be part of their network.
For those of you who may not be familiar with PHIN, it is an independent, government-mandated source of information about private healthcare. The principle behind the network is to ‘empower patients to make better-informed choices when choosing private treatment.’
If you have not yet read our first article ‘Is your PHIN profile accurate’ we recommend doing so before continuing with this article.
When we posted the article we received many messages about the set-up process so thought it would be worth creating a follow up to take you through it step-by-step.
The CMA Order 2014 requires private healthcare facilities in the UK to submit private activity data to PHIN. Consultants are invited to review and verify the data submitted by facilities about their practice via the PHIN Consultant Portal.
Following some helpful feedback from consultants, PHIN has made some changes to the Portal, making the login journey easier. To access the new Portal you will need to activate your account, even if you have logged in before. An email will be sent to your GMC registered email address inviting you to activate your Portal account.
To demonstrate activating your account before signing in, there are steps below to help.
The first step is to visit the Portal:
https://portal.phin.org.uk/ and click ‘activate your account’ under the sign-in button.
Follow the steps on the screen to activate your account.
To confirm you are the owner of the email address that you are using, request a security code by entering the email address you have registered with the GMC and select ‘Request security code’. This will arrive in your inbox shortly.
The security code you receive will be sent from a Microsoft account on behalf of PHIN. You will need to use the 6 digit code to verify that you are the owner of the email address.
Enter the security code and click ‘submit code’.
Your email address will then be successfully verified and you will be asked to create a new password.
Please follow the on-screen guidance to create your password and include both upper and lower case letters, digits and symbols to generate a strong password.
Once you’ve created a new password, click ‘Create’. You should then be able to log in to the PHIN Portal.
So there you have it. Your step by step process to accessing and setting up your PHIN profile. PHIN is a legal requirement for all consultants in the UK, but we asked Jonathan what else would he add to the standard information available on PHIN, especially to new consultants entering private healthcare. He told us:
‘Engaging with PHIN is really important. Not only is it a legal requirement to engage with PHIN to submit fee information but reviewing your data and signing it off for publication is crucial and, when consultants have done that, many of them tell us that it is a very valuable resource.
Following the Paterson Inquiry and greater collaboration between the NHS and private sector through the Covid-19 pandemic, there is a big push for greater transparency, and it is unlikely that private healthcare will ever go back to the days of old. People considering private treatment are consumers and they act like consumers.
Greater transparency about what work consultants and hospitals undertake, and the outcomes (i.e. the benefit to patients), is now an expectation.
PHIN is not only a great place to market yourself, but it is also a place where you can view your whole practice data. This can help with whole practice appraisal and revalidation, but many consultants also find this helpful for understanding the care they provide in relation to others.’
Our team at Designated Medical are available to support you with delivering the PHIN criteria. Please don’t hesitate to get in contact with your Medical PA or Designated team to find out more: email@example.com
Planning to leave the NHS? For the huge number of doctors who say they are contemplating a move,Jane Braithwaite shares details of the support available that can offer a route to an alternative career path.
The last year has been a struggle for everyone in some respect, but for those working in the NHS the pressure of dealing with Covid-19 has been immense.
We all vividly remember the battle to provide everyone in the health service with adequate PPE, so they felt some level of protection, closely followed by harrowing images of faces battered and bruised by long periods of wearing masks.
Those working in primary care had to adapt to deliver a Covid-safe environment for patients and transform the provision of most services using technology to provide virtual consultations.
As vaccines became available, GP practices and hospitals have worked something close to a miracle to ensure they can be administered throughout the population rapidly.
We have recently seen a new campaign entitled ‘If I die, it will be your fault’, launched by the Institute of General Practice Management to call for an end to abuse from patients following their latest report, which concludes that most GP receptionists face unprecedented levels of abuse at work.
And now the same NHS staff face the challenge of dealing with long waiting lists of patients whose treatment has been delayed by Covid.
A report earlier this summer from the BMA delivers a stark and worrying insight into how doctors are feeling right now, and the evidence is clear that many of them are unhappy and are considering leaving the NHS in the next year.
It said: ‘Thousands of exhausted doctors in the UK have told the BMA they are considering leaving the NHS in the next year, as many continue to battle stress and burnout without adequate respite from the exhaustion caused by the demands of the pandemic.’
Responses came from over 4,000 doctors and 31% of them stated they are more likely to take early retirement, which has more than doubled since the survey was done 12 months ago. Half of the respondents said they are more likely to work fewer hours and 25% more likely to take a career break.
The survey also suggests a strong desire by many to continue to work, but in a different environment. Twenty per cent of respondents are more likely to leave the NHS for another career, with 17% considering working in another country and 14% more likely to work as a locum.
If doctors follow through on these desires to retire, work fewer hours or leave the NHS for another career, huge resource gaps will develop in the NHS.
Of course, over time, the desire for some doctors to leave the NHS may decline and the NHS pension may be an important factor, but for those who are considering alternative careers, I wanted to investigate and share details of the support and the organisations available that can offer a route to an alternative career path.
Before considering the options, it is also helpful to understand the reasons why there is a desire to leave the NHS, as this gives useful insight into the objectives of doctors when seeking alternative careers.
We often assume, when it comes to career choice, that money is the greatest motivator for most individuals.
But the BMA survey showed that pay was quoted as the main reason for leaving the NHS by 29% of the respondents, while workload and personal well-being drew a much higher response.
Forty-four per cent of respondents looking to leave the NHS said that workload was a factor and 43% highlighted their own personal well-being.
So in looking for alternative careers, opportunities that offer a more manageable workload and a better work-life balance will be hugely appealing.
Of course, finances will be a significant factor for many and a great place to look for helpful information isMedics Money.
Medics money was founded by Dr Tommy Perkins and Dr Ed Cantelo to help doctors, dentists and other professionals make better financial decisions. Of particular note, Ed is a GP trainee and also a chartered accountant and tax adviser with nine years’ experience at accountancy firm PWC.
On its website, you will find a wealth of resources in the form of articles and eBooks, but its most valuable offering is a series of podcasts in which it covers a huge range of topics of relevance to the profession.
It’s latest offering, called ‘Episode 44 – The NHS pensions trap with salary sacrifice’, would be a good listen as would ‘Episode 25 – Using a limited company to save tax and invest to retire early.
One obvious option for doctors looking for a career outside the NHS is, of course, private practice, and with a greater desire for improved well-being and a more manageable workload, this is most definitely an option that may appeal to many.
The aim of Private Practice Pro is to help doctors launch, run and grow their own private medical practice. It is founded by Mr Giles Davies, consultant oncoplastic breast surgeon, and Tom Davies who is a lawyer and former chief investment officer of Seedrs.
Private Practice Prooffers a video-based course for doctors looking to set up in private practice with Giles acting as medical coach and Tom as a business coach.
The course is made up of over 55 on-demand videos complemented by 30 templates and guides and, for interested doctors, Private Practice Pro regularly runs webinars and small-group workshops.
For the more entrepreneurial doctors,Doctorpreneursis a global community of doctors, medical students and other interested individuals focusing on healthcare innovation and entrepreneurship.
In its most recent newsletter, it includes an inspiring interview with the chief executive and founder of Tympa Health, which is a London based start-up that has created the world’s first, all in one, hearing health assessment system.
It also includes details of job opportunities across a wide range of sectors. This is a good place to start to understand the type of job opportunities that are currently available and it is an exciting discovery.
It is free to join, and you simply sign up on its website.
My final suggestion isMedic Footprints, who provide ‘The world’s biggest gateway to alternative careers for doctors’.
This is again an organisation led by doctors, providing a wealth of information on their website regarding changing careers and connecting doctors with career coaches who can help manage the process.
Their job board presents several exciting opportunities including some overseas roles that will appeal to those doctors interested in working outside the UK.
You can join their community for free on their website or upgrade to their premium package for access to their series of webinars and a free CV review.
In my search for supportive organisations for doctors when looking for a career change, I also discovered that the NHS provides further information on its website.
Back in 2017, NHS England published a paper offering guidance for doctors looking to leave the NHS, which included a selection of organisations including Medic Footprints.
In an ideal world, we would all like doctors to enjoy their career within the NHS and to want to stay, but right now it seems the best approach may be to ensure that the wealth of talent is not lost and is engaged in other rewarding healthcare careers that ultimately benefit the UK population now and in the future.
In my role as MD at Designated Medical, I work with many doctors pursuing either a full- or part-time career in private practice and I would be happy to help anyone who would like to know more about getting started.