Is Your Practice Running Like a Business?

Gary Hughes
Jun 8
6 min read

By Gary Hughes - THC Associate Writer

Like most practices, you’re probably working incredibly hard to be a good practice delivering great patient outcomes.

But how much effort are you putting into making your practice a great business?

Teal and black title slide: Is Your Practice Running like a Business?

The need to be a strong business often makes GPs uncomfortable because some dislike the idea of general practice being described as a business. Yet GP practices are independent businesses contracted to provide NHS services.

Like it or not, every practice is both a healthcare provider and a business, and we need to be as comfortable talking about business performance as we do clinical performance.

Over nearly 20 years, I have worked with practices of all shapes and sizes. What I’ve consistently seen is that the practices facing the greatest challenges often show the same warning signs:

Leaders spending all their time firefighting.
Recruitment and retention getting harder.
Staff feeling stretched and demotivated.
Decisions taking too long or never being made.
Financial pressures becoming harder to manage.

The instinct is then to work harder, and drive everyone to do more with less. That is rarely the answer and often makes things worse. If these are familiar challenges for you, then the issue is the strength of your business itself.

One of the biggest misconceptions in primary care is that if you run a good practice, you will automatically run a good business. That is not true.

Running your practice as a good business will help you create a better practice. The reverse is not always the case.

Making your practice the best business it can be is not about putting profit before patients. It is about making your practice more resilient, better prepared for change and able to see opportunities. It is about creating a practice and a team capable of delivering excellent care for years to come.

What does a successful practice business look like?

I have found that the strongest practices invariably have seven key ingredients in place.

These ingredients work together, complementing and strengthening each other. Equally, when one becomes weak, it affects the others.

1. Vision

Strong businesses know where they are going. This does not need to be complicated, and often the best visions are the simplest; “Together we improve lives” is a memorable example from a practice I have worked with.

The key thing is that leaders live it. They use it to guide decision-making and improvement, and to inspire and develop others.

It’s an area that many practices struggle with, but if you’re getting it right, you should answer yes to the question:

Can your leadership team clearly describe your vision, and do they use it for decision making and to inspire others?

2. Financial Management

One of the common frustrations I hear from practices is that they don't feel in control of their finances. Usually that is not because the information doesn't exist, but because it isn't being turned into meaningful information that helps with planning, control, decision-making, and avoiding disagreements.

If you’re a strong business, then you understand your finances, talk about them regularly and use them to plan ahead, rather than waiting for the year-end accounts and looking backwards at what’s already happened.

Do you understand the financial position of the practice, and are you using financial information to guide planning and decision making?

3. Culture

Culture exists whether you do anything about it or not. The question is whether it is helping your practice succeed or holding it back.

Your culture will probably be defined by the worst behaviours you tolerate.

Strong businesses are intentional about culture. You need to have clear expectations on the way people treat each other and the standards that you accept within the practice.

You want to ensure everyone is role-modelling the positive behaviours to create a culture that will improve engagement, retention, teamwork and patient experience.

Are the behaviours, attitudes and values you see every day creating the culture you want for your practice?

4. Growth

General practice is moving faster than ever. Patient expectations, technology and the wider NHS are all changing. Standing still is rarely an option.

One of the biggest differences between successful practices and those that struggle is the willingness to embrace change. Strong businesses are prepared to try new things and look for better ways of working, making small, consistent improvements to gain an advantage.

They understand not everything will succeed, but they know doing nothing is an even bigger risk.

Are you actively looking for ways to improve and adapt, or are you relying on doing things the way they have always been done?

5. Governance

Governance is one of those areas that you feel is a burden and spend little time on. Actually, good governance will help your practice operate more effectively, and avoid problems that can cost significant time, money and energy.

Strong governance is part of how you work. Having clear responsibilities, managing risk, and using governance to support improvement rather than ticking a box to satisfy a requirement.

Good governance should not waste valuable time and slow you down. It will help you be more efficient and more resilient.

Is governance something you do to satisfy requirements, or is it helping you run a safer, stronger and more effective practice?

6. Measure

KPIs are probably your most important business information. Used properly, they help you understand how your business is performing, spot problems early on and guide your decision-making.

Strong businesses use a small number of meaningful measures to track what matters most. That might include patient satisfaction, access, workforce engagement, finances or progress against specific goals. The important thing is that the information is useful, monitored and reported consistently so it removes guesswork and reduces disagreements.

Your KPIs are vital to understand what is really happening in your practice.

Do you have meaningful measures that help you understand performance, identify problems and make better decisions?

7. Leadership

Leadership is the most important of the seven ingredients because it influences all the others. A strong, effective leader or leadership team will know what is needed and make it happen. Only strong leadership will ensure you have the conditions to succeed.

A common mistake in practice is to believe that leadership is the responsibility of the Partners and Practice Manager alone. It’s better to develop leadership throughout the practice and create a leadership team with the skills and influence needed for a successful business.

Do you have strong leaders throughout your practice who are driving improvement, developing others and helping the business succeed?

So, how much effort are you putting into making your practice a great business?

Most practices can answer that question easily when it comes to patient care, but when it comes to the business itself, then it's less clear.

One of the biggest misconceptions in primary care is that if you run a good practice, you automatically run a good business. As we've seen, that is not necessarily true.

The strongest practices pay attention to both. They take deliberate action to make the business better because they know that will help them have a great practice.

That’s why I developed the Business Strength Model. It provides a simple way of assessing the areas that have the greatest influence on the success of your business and helps identify where you can make it stronger.

Running your practice as a business is not about putting profit before patients. It is about creating a stronger, more resilient organisation that is better able to support patients, staff and partners.

If you want your practice to deliver the very best outcomes, then it needs to be the best business it can be.

About Gary Hughes, MBA, PGCMDE

Gary Hughes has spent nearly 20 years in primary care, leading, supporting and strengthening general practice as a Practice Manager, consultant, educator and facilitator. Through Leadership in Practice, he helps practices become stronger, more effective businesses.

Gary developed the Business Strength Model, a practical framework that enables practices to assess the strength of their business across seven key areas. He also designs and delivers workshops and education programmes, speaks at industry events, and hosts the Leadership in Practice podcast.

If you would like to understand the strength of your business and identify opportunities for improvement, contact Gary at gary@leadershipinpractice.co.uk to arrange a free Business Foundations Health Check.

About us

THC Primary Care is an award-winning healthcare consultancy specialising in Primary Care Network management and the creator of The Business of Healthcare. With over 20 years in the industry, we have supported more than 300 PCNs through interim management, training and consultancy.

Our expertise spans project management and business development across both primary and public sectors. Our work has been published in the London Journal of Primary Care, and we have authored over 250 blog posts sharing insights on primary care networks.