Measuring the Strength of Your Practice

By Gary Hughes - THC Associate Writer

How strong is your practice?

It's a simple question, but most practices don’t really know how to answer it. They don’t know how to measure the strength of a practice.

You might tell me your finances are in good shape, your patient satisfaction scores are high, or your CQC inspection went well. Equally, you might say recruitment is difficult, workload is increasing, and partners are struggling. All of those tell me something useful, but none of them tells me how strong your business really is.

In my previous blog, I wrote about the importance of running your practice as a business. One of the obvious questions that follows is, "How do you know whether you're succeeding?"

Most practices will have some measure of their performance. Successful ones go a step further and measure the strength of the business itself. They know if the foundations of the business are weak, problems will eventually appear somewhere else.

Over nearly 20 years working with practices and primary care businesses, I've found that the most successful practices have a much clearer understanding of the strength of their business. They use that understanding to guide decision-making, planning and improvement.

Looking beyond finance

When people hear the phrase "business strength", finance is usually the first thing that comes to mind. Financial performance is important, and every practice should understand its income, expenditure, profitability and cash position. If you’re not financially healthy, then it is much harder to invest, improve and plan for the future.

However, finance is only one measure of the strength of your business.

I've worked with practices that were financially successful but had poor leadership, a culture that tolerated damaging behaviours, and governance that created unnecessary risk and inefficiency. On the surface they looked successful, but the reality was a weaker picture.

I've also worked with businesses facing genuine financial pressures that were exceptionally strong because they had clear leadership, engaged teams, effective planning and continual improvement. They were far better placed to respond to future challenges because the foundations of the business were already strong.

Looking at finance alone doesn't tell you the whole story.

Measuring what really matters

If we want to understand the strength of a business, we need to look at the areas that have the greatest influence on its long-term success.

In the previous blog, I introduced what I believe are the seven key ingredients of a successful primary care business. We can use these to build a framework for measuring the strength of a business across seven indicators:  

• Strategy

• Leadership

• Finance

• People and Culture

• Compliance and Risk

• Patient Experience

• Innovation and Development

Each of these contributes to the overall strength of the business. More importantly, they are all connected.

Strong leadership helps create a positive culture. A positive culture improves staff engagement and retention. Better engagement often leads to improved patient experience, while good financial management creates opportunities to invest and improve. They are continually influencing one another.

When one area becomes stronger, others often improve alongside it. Equally, if one becomes weak, it usually has consequences elsewhere.

That is why measuring only one or two areas won’t give you an accurate picture of how your business is really performing

Bringing the information together

General practice is certainly not short of information.

Practices already have financial information, workforce data, patient feedback, complaints, and QOF data. The challenge is that these are often reviewed in isolation, sometimes by different teams, and rarely brought together to answer one important question.

How strong is our business?

It’s only once you begin looking at the information in a joined-up way that you can answer that question. Instead of only seeing an immediate problem you need to fix, you see the areas that are strong and, most importantly, the areas of the business you need to strengthen.

A measure that supports better decisions

One of the reasons I developed this way of measuring business strength was because I wanted a better way of guiding decision-making and improvement.

A measure of business strength helps with that. It highlights where the business is already strong, identifies where improvement is most needed and provides a simple way of tracking progress over time.

It also helps keep Partners and Managers engaged and focused on what really matters. Rather than relying on assumptions or individual opinions, decisions can be based on evidence, priorities are clearer, and plans become much more focused.

Measuring improvement

Every practice invests time, energy and money trying to improve. Whether it’s leadership development, new systems, workforce initiatives or service redesign, they all require significant effort. Yet it can be difficult to demonstrate the overall impact of that work.

If you measure the strength of your business consistently, you can see the difference those improvements are making. Just as importantly, you can identify where the intended impact wasn’t achieved and decide where your attention should move to next.

So, how strong is your practice?

Many practices can tell you how busy they are. Some can tell you how profitable they are, and others know their patient satisfaction scores or their CQC rating.

Far fewer can confidently tell you how strong their business is.

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 practice. It brings them together into a single score for each of the 7 areas, and one score for the overall strength of your business.

Measuring the strength of your business is not about creating another performance target or another report. The Business Strength Model uses existing and readily available data, making measuring and reporting a simple and essential activity.

The strongest practices don't leave success to chance. They understand their business, they measure it, and they continually work to make it stronger.

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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.

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