Business, Practice management

Mid-term business plan reviews – are you on track?

As 2019 draws to a close, now is the ideal time to analyse your practice’s goals and performance. Karen Crouch explains what needs to be done to guarantee a successful start to 2020.

It’s once again the time of year when we wish all readers a joyful and safe Christmas holiday season to be followed by a happy and prosperous New Year.

It is also an ideal time to dwell on the past six months’ performance against set targets by conducting a mid-term review of your goals for financial year 2019-2020. This is to determine whether any aspect deserves adjustment, upward or downward, in order to meet targets for the end of the financial year.

Large companies go a step further by undertaking QBRs – Quarterly Business Reviews – to track progress on targets and objectives, whether financial, operational (including personnel and personal matters) or client related.

Reviews should address both key elements of the annual business plan:

  • Tactical: ‘business as usual’, day-to-day management framework by which the practice continues to build on identified strengths and avoid negative performances, and
  • Strategic: growth aspirations aimed at optimising new opportunities so that short- and long-term goals are aligned and achievable.

As a valuable starting point, it is necessary to appreciate the fine differences between the practice’s business plan and strategic plan. The business plan is an annual compilation of goals and key performance indicators (KPIs) that includes achievable results, but also ‘stretch’ targets to encourage optimum performance.  It is usually created just prior to each financial year after consultation with key staff and in recognition of the prevailing business environment.

By contrast, the strategic plan is a longer-term projection, say 3 – 5 years, of realistically ‘where you want to be’, not ‘where you would like to be’. Many practices do not have or maintain a strategic plan and instead rely on a best efforts business plan.

For those that do maintain a strategic plan, regular tracking of the business plan against longer-term aspirations is essential to ensure future developments, opportunities and competitive advantages are grasped. For practices that do not maintain a strategic plan, monitoring and reviewing the business plan becomes even more important.

Plan well

Business plan review activities should typically include:

Expenses: budgets on a line-by-line basis (such as wages, insurance). Are they progressing to forecast trends, allowing for cyclical peaks? If the run rates (monthly averages) are higher than set targets, should adjustments to spending practices be considered?

Income: revenues projected for the year, based on practitioner numbers, working hours, charging rates and estimated number of consultations. Are they progressing to set targets? Any shortfall or excess should be carefully analysed as this particular element is vital to achieving a viable practice. Are there new or emerging community or patient demands that should be accommodated? Are there opportunities to differentiate the practice from others by the introduction of a new service?

Non financial: a vital aspect for practices to excel in is patient care. Are service levels (patient satisfaction surveys, wait times) being consistently met? It may be necessary to adjust, or introduce new day-to-day procedures, clinical or administrative, to ensure compliance with changing business imperatives, competition, or external factors like regulatory changes.

Human Resources: this vital element of any business should cover plans to develop staff and practitioners, as well as achieve ‘employer of choice’ status. Is it time to undertake appraisals of staff so they have timely feedback on their performance, encourage good work and address any less-than-satisfactory behaviour?

Marketing/Advertising: are selected advertising channels delivering value for money? How is the success rate of campaigns or individual advertisements being measured? Is it time to review your marketing activity, create greater exposure opportunities or consider a new drive?

Monitoring and Measuring: thoroughness of the overall budgeting system is paramount to tracking progress. Are the employed mechanisms accurate and consistently applied? Are KPIs (such as patient satisfaction and patient numbers) being consistently met, or were they too ambitious and require adjustment?

Obvious conclusions are that a ‘better-than-budget’ performance is a practical way to identify the practice’s strengths and continue doing more of it. While a ‘poorer-than-budget’ outcome is certainly an alert message, it should also present an opportunity to analyse problems and remedy them.

Finally, as part of the measurement and monitoring process, it is advisable to review business plans at least each quarter to ensure end-of-year tactical and strategic goals, including profit targets, will be met. Additionally, practice owners and business planners should remain abreast of developments in the political, regulatory, cultural, social or economic environment which may have potential impacts on practice operations.

From the team at HPC, we wish you a very safe and merry Christmas and a happy 2020.

Karen Crouch is Managing Director of Health Practice Creations Group, a company that assists with practice set ups, administrative, legal, business and financial management. Contact Karen on Email: or visit

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