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    PracticeFit™ Programme

    Income, Finance & Service Design

    Most GP practices are leaving money on the table — not through carelessness, but through small accumulated gaps. This 16-week programme closes them systematically and leaves you with recovered income, controlled costs and a financial governance structure that runs without us.

    Most practices are leaving money on the table.

    Not through carelessness — through the accumulation of small gaps: an enhanced service not claimed, a QOF code not applied, a service running at a loss nobody has measured. Add a staffing cost ratio above 80% and a forecast that exists only in the accountant's head, and the practice feels financially precarious even when the income line looks adequate.

    This is not a finance course. It is a programme of work that leaves your practice with recovered income, controlled costs, a functioning financial governance structure, and services designed around what the contract will actually fund.

    Who this programme is for

    • GP practices with QOF or enhanced service performance below local or national average
    • Practices where staffing costs exceed or are approaching 80% of total expenditure
    • Practices that have not reviewed their full income position in the last six months
    • PCNs or federations with variation in financial performance across member practices
    • Any practice where partners do not have a shared, current view of the financial position

    What the programme delivers

    Four outputs your practice will own

    Income Audit & Recovery Plan

    A structured review of every income stream the practice is eligible for, with quantified gaps and a 90-day implementation plan.

    • Core contract & capitation — list accuracy, temporary residents, dispensing
    • Enhanced services — sign-up, delivery evidence, claiming accuracy
    • QOF — trajectory, exception reporting, coding gaps, achievable uplift
    • DES, IIF and locally commissioned services — eligibility & delivery
    • ARRS utilisation against entitlement and non-GMS income review

    Staffing Cost & Workforce Modelling

    Where staffing costs exceed 80% of expenditure, a structured review with scenario options for partner discussion.

    • Current staffing cost ratio and trajectory
    • Role-by-role cost and productivity analysis
    • ARRS cost offset against direct employment
    • Skill mix optimisation opportunities
    • Phased reduction options that protect service and CQC standing

    Financial Governance Framework

    A practical structure for ongoing financial oversight — implemented and in use by the end of the programme.

    • Monthly finance reporting template — income, expenditure, variance, forward view
    • Partner finance meeting agenda and standing items
    • 12-month rolling forecast model (Excel, practice-specific)
    • Contingency planning framework for funding reduction or restructuring

    Service Design Review

    A review of services delivered against what the contract and system will actually fund.

    • Mapping of current services against funding streams
    • Services delivered at a net cost without strategic justification
    • Opportunities for redesign, renegotiation or ARRS substitution
    • PCN service alignment — what the PCN funds vs what the practice absorbs
    • Where relevant, a business case for renegotiation with the ICB or PCN

    Programme structure

    16 weeks, four phases, practice-owned at the end

    Phase 1Weeks 1–3

    Diagnostic

    Income stream audit across all funding sources, staffing cost analysis, review of current financial reporting, partner interviews, and service mapping against funding streams.

    Deliverable: Diagnostic Report — quantified income gaps, cost position, governance assessment, service design anomalies.

    Phase 2Weeks 4–5

    Planning

    Income recovery plan drafted with partners, workforce cost model developed where relevant, governance framework designed, service design recommendations drafted.

    Deliverable: Programme Plan — agreed priorities, actions, owners and 90-day milestones.

    Phase 3Weeks 6–12

    Implementation

    Income recovery actions implemented — claims corrected, sign-ups completed, coding addressed. First monthly finance meeting facilitated. Workforce decisions taken. Service design changes initiated.

    Deliverable: Implementation Progress Report at Week 12 — actions completed, income recovered to date, governance structure in place.

    Phase 4Weeks 13–16

    Embed & Evidence

    Financial governance running independently with practice leads, forecast model owned by the practice, outstanding income recovery actions tracked to completion.

    Deliverable: Programme Close Report — income recovered, cost position change, governance summary, recommendations for ongoing monitoring.

    What PracticeFit™ does — and what the practice does

    We support, we don't replace. Financial discipline only sticks if the partnership owns it.

    PracticeFit™
    The practice
    Conducts the income audit
    Provides access to CQRS, financial records and contract schedules
    Builds the financial models
    Names a finance lead (typically practice or business manager)
    Designs the governance framework
    Commits partners to a monthly finance meeting
    Facilitates partner financial discussions
    Makes decisions on workforce cost and service design
    Produces all reports and templates
    Implements agreed actions with PracticeFit™ support

    Measures of success

    How we'll know it has worked

    • Quantified income recovered or secured within the programme period
    • Staffing cost ratio at or below 80% — or a credible trajectory toward it
    • Monthly finance meeting in place and running by end of programme
    • 12-month financial forecast in place and owned by the practice
    • All eligible enhanced services signed up and actively claimed
    • QOF trajectory improved against baseline

    Investment

    Priced by scope and practice size

    Available as a standalone engagement or as part of the PracticeFit™ Accelerator — the full eight-domain improvement programme.

    Confidential discovery call. No obligation. We'll confirm fit before either side commits.

    At a glance

    Duration
    16 weeks
    Format
    Remote, partner-facing
    Audience
    Partners + finance lead
    Outputs
    Income plan · Workforce model · Governance pack · Service map

    Enquire about Income, Finance & Service Design

    Tell us a little about your practice. We'll be in touch within two working days to arrange a confidential discovery call.

    No payment now. We'll confirm scope and pricing before anything is committed.

    Bundled options

    Handle it end-to-end, not in five different places

    Most practices run QOF, PCN DES, surveys and wellbeing as four separate jobs. We pull them into one delivery rhythm with shared reporting and named owners.

    Operations Core

    QOF + PCN DES, run as one programme.

    • QOF assurance: registers, recall, year-end run-in
    • PCN DES: IIF, capacity & access, enhanced access
    • Single quarterly delivery rhythm with named owners
    • One reporting pack — partners, PCN and ICB-ready

    Best for: Practices losing time across two contracts that should be one workflow.

    Most chosen

    Operations + Insight

    Add staff and patient surveys to the contract delivery.

    • Everything in Operations Core
    • Annual staff survey + quarterly pulse
    • FFT narrative reporting and GPPS commentary
    • Live action log and CQC well-led evidence pack

    Best for: Practices that want contract delivery and well-led evidence in one rhythm.

    Whole-Practice Accelerator

    All four programmes, sequenced over 12 months.

    • CQC, Patient Access, Wellbeing and Strategic Planning
    • QOF, PCN DES, surveys and patient comms — done for you
    • Quarterly board-ready report across all domains
    • Dedicated programme lead + named associate

    Best for: Partnerships that want one supplier, one rhythm and one accountable lead.

    Not sure which bundle fits?

    A 30-minute discovery call is enough to map your contracts, pressures and reporting load — and recommend the right scope.