Collaboration rather than merger: what can specialist accountants offer?

Much has been written on the financial benefits of practice or partnership merger, but there is rather less discussion about the benefits that may accrue from collaborative arrangements. Whilst these are necessarily ‘looser’ than legal merger, they are often more acceptable to practices who value their autonomy.

As integrated care is developed across the health service, all practices will inevitably work more closely with their neighbours. Indeed, the forthcoming guidance on Primary Care Networks provides a detailed template as to how such collaboration might be developed

Some accountants who specialise in primary care now have considerable experience of the various types of merger in general practice, but what value can we add to those considering a collaborative approach?

Many of the reported benefits of ‘at scale’ working can be derived through collaborative working, without the necessity of formal merger. Areas that can be worked on include:

  • Same day / urgent appointments
  • Extended access with each location taking turn to provide this for all of the hub practices
  • Consideration of a centralised telephone triage system
  • Sharing of specialist healthcare staff across locations
  • Utilising spare staff capacity
  • Utilising unused surgery space

Coordination of the work carried out together is often best guided by an Inter-practice Service Agreement. This ensures all parties are clear as to what the scope of the collaboration will be, and how it will work in practice. A properly written agreement will help avoid misunderstanding and build trust between colleagues, as well as ensuring the key elements are addressed and the benefits delivered.

In addition to providing financial advice, specialist accountants frequently act as business advisors, working alongside practices to support the ongoing development of the collaboration. This broader offer may include assistance with the following:

  1. VAT– review of the services being provided for potential VAT considerations and solutions
  2. Review of legal agreementsto identify tax planning opportunities and VAT problems
  3. Carry out a feasibility study reviewto identify differences in profitability and working practices with a sharing of results in order to benefit the practices involved
  4. Shared contracts of employments– consideration of benefits or requirement of these
  5. Back office functions– assistance with set up
  6. Advising on structure / framework– taking into account future merger options

Whilst merger can often generate the greatest efficiencies, many practices prefer to explore the benefit that collaboration can bring, at least for an initial period. During this time, mutual trust can be built up, and significant gains can be made if efforts are targeted towards the areas of greatest potential return.

Steve Cosford, Healthcare Director, MHA MacIntyre Hudson

This article was commissioned from MHA MacIntyre Hudson, who are a commercial partner of GP View.

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