How to plan a new clinic building
Troubleshooters
With increasing numbers of consultants considering how to turn their dreams for a private practice clinic into reality, our troubleshooters Sue O’Gorman and Hannah Browning give some warnings – and encouragement
QI am thinking about setting up a new clinic with a few consultant colleagues, but we don’t know where to start. What areas would we need to think about and how would we go about it?
AMore and more consultants are making the move to setting up their own independent clinics and facilities. The idea of practising in a way that is driven by the clinician rather than the hospital is very appealing to many.
However, this is not an easy route. Setting up a healthcare facility takes huge amounts of time, effort, expertise, energy and more money than you realise.
This type of project will be all- consuming for many months, even if you have a team of expert support. Be realistic with yourself whether you have the time and bandwidth, especially if you have a busy NHS and/or private practice.
There will be points in the project when you may need to be onsite or make several decisions quickly; therefore, if your availability is limited, this could impact the delivery and could add additional cost.
Despite these warnings, consultants do set up clinics. It certainly is possible and they can be very successful.
Where to start?
Understanding the type of facility you are looking to create is a good starting point. This is particularly relevant if there are a number of consultants coming together. You all need to be on the same page with a very clear vision and end goal.
All the questions below will help you to understand the type of building you need in terms of space and layout, the potential investment for equipment, staffing requirements and the regulatory requirements with the Care Quality Commission:
What types of specialties would you like to perform?
Roughly how many consultants/clinicians will be using the facility?
What diagnostic procedures will you need access to?
Will you perform minor procedures and what types of potential equipment are needed?
Will any surgery be performed? If so, what procedures?
If surgery is going to be on site, what sort of recovery is needed?
Will you see and treat children?
The specialties
Depending on the group of consultants, you may have a single-specialty focus or a diversity across a range of specialties.
There is also an option that you start with fewer services with a plan to grow and develop more over time. If this is the case, do keep this in mind at the initial stages, as you will need to understand where the growth can happen within the physical location.
Having just one service line to set up will be simpler than multiple specialties and it will enable you to focus on the ultimate pathway for this patient group.
Consultants and clinicians
Understanding who will be using your facility is important. Are you just creating a clinic for the partners or will other consultants be able to see patients?
Unless you have a large group of busy consultants setting up the clinic, it is unlikely that you will be able to generate enough revenue to offset the costs with your group alone. Understanding the process for enabling consultants to join and having a robust practising privileges process will be required.
There will also be a balance between having enough consultants with clinics to build revenue and not too many on your practising privileges that you are not able to safely manage your consultant body.
In an ideal world, you need consultants with regular clinics so that they become familiar with the clinic, staff and your ways of working.
Diagnostics
Not all diagnostics need to be available on site. Most providers won’t have the budget or space for an MRI scanner, for example. You do, however, need to think about your patient pathways and where patients may be able to access the diagnostics you don’t provide.
Are there certain diagnostics that are critical to your pathway? If the pathway becomes too disjointed, then your service may not be viable.
Diagnostics all come with their own regulatory requirements, especially if you are using radiation. Also, think about who will report the scans and the systems you will need to process and store images.
Minor ops
As healthcare progresses, there are a greater number of procedures able to be performed in a walk-in-walk-out setting. This will extend the revenue opportunities for clinics.
Look within the specialties as to what is safe and appropriate to perform in outpatients.
From a facility perspective, you will need a room with the required air changes, a sink, washable floor and walls and so on.
Surgery
If you are looking at performing surgery, this will take your venture from a clinic set-up to an acute surgical provider.
There are a number of regulations about the correct and safe set-up of a theatre and expert support should be sought to get these aspects right.
A new build will have some different requirements to an existing building, so it is important you understand what regulations are relevant to your project.
Having surgery within the facility can, however, dramatically change the revenue potential, so it is worth considering.
Children
There is demand for the provision of children’s services in private healthcare. This is due to a number of providers reducing or removing these services over the last few years.
The regulatory requirements for treating children are much more complex than adults. As a clinic, you will not receive any more money from an insurer for treating a child, but you will have higher staffing costs and risk.
If you would like to see children, you will need dedicated areas within the clinic and to recruit a paediatric nurse.
These questions are just a few to consider as part of your initial discussions; however, it is just the tip of the iceberg. Getting the right experts on board at the start of the project will help you to navigate the complexities of setting up.
If you get the foundations of your new business right, then you will ultimately save yourself time and money later on.
Sue O’Gorman (left) is director of Medici Healthcare Consultancy. Email: sue@medicihealthcare-consultancy.co.uk.
Hannah Browning (right) is director of Beyond Excellence Healthcare Consultancy. Email: info@beyondexcellenceconsultancy.co.uk.
