POSTGRADUATE DIPLOMA IN GENERAL PRACTICE

MODULAR ASSIGNMENT NO: 2

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COVER SHEET

TOPIC: PRACTICE MANAGEMENT

(Complete for each modular assignment)

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FPD Student number: FPD035067

Date of submission: 17/12/2023

Course name: PG DIP IN GENERAL PRACTICE Area: _________________________

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NAME & SURNAME SIGNATURE DATE

OMOTAYO J ONYEMARI OJ 17/12/2023

Now attach your answer sheet to this cover sheet. Remember:

1. Answer every question.
2. Modular assignments should not exceed the word count as indicated.
3. Your name and surname must appear on every page.

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 TABLE OF CONTENT

Cover Page…………………………………………………………………………………………………………………..……….1
Table of Contents…………………………………………………………………………………………….…………………..2
Introduction…………………………………………………………………………………………………………….…….…….3
Executive Summary………………………………………………………………………………………….………..………..4
Mission Statement……………………………………………………………………………………………….………..……5
Vision Statement……………………………………………………………………………………………………….………..5
Values…………………………………………………………………………………………………………………………..…….6
Strategic Plan……………………………………………………………………………………………………………….….…7
South African Health Care Environment……………………………………………………………..…………..…9
Action Plan………………………………………………………………………………………………………………...…..…11
Process of Strategic Control…….………………………………………………………………………………………..14
Test for Strategy in Business Planning...………………………………………………………………….…………16
Business Plan..……………………………………………………………………………………………………….…………17
Conclusion…………………………………………………………………………………………………………….…………18
References…………………………………………………………………………………………………………………..….19

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DEVELOP A COMPREHENSIVE BUSINESS STRATEGY WHICH WOULD SET YOUR PRACTICE
APART FROM THOSE OF YOUR COMPETITORS, BY INCORPORATING THE VARIOUS
PRINCIPLES OF BUSINESS PLANNING, THE BUSINESS ENVIRONMENT AND SA HEALTH CARE
ENVIRONMENT.

INTRODUCTION

The future of health care in South Africa is being shaped by the emerging trends of disease
burden and economic recession following covid-19 pandemic. The uncertainties, which
governed the lives of the south African people and health care professionals during the
pandemic has changed the mindset of the citizens and the practice of medicine, giving rise
to such trends as remote work [from home], virtual medical consultations, new technology
and equipment for diagnostic purposes especially in private hospitals, just to name a few.

On the other hand, government facilities, despite increase in expenditure, seem to have an
increased level of scarce resources [manpower and equipment], post-covid pandemic,
leading to an inability to alleviate the problem of the disease burden in government
hospitals and clinics [www.profile.co.za: Health care in South Africa 2020/2021 STILL. L].

The new NHI bill is geared towards bridging the gap between the government and private
sector, while providing universal access to quality health care for all South Africans and to
reduce the cost of medical expenditure [FPD study guide]. Below is a business strategy to
enrol a business practice as an NHI facility and make formal submission to the department of
health.

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EXECUTIVE SUMMARY

Our goal as a practice is to establish a world class facility that caters to patient’s needs
holistically, while managing their acute ailments, chronic illnesses at an affordable cost.
People of all gender, children and adults, as well as the elderly are welcome. Our services,
while mainly orthodox, will soon include rehabilitative and aesthetic sections.
The health of our community is important to us. Thus, we will be offering health screening of
prostrate, cervical, breast cancer, hypertension, diabetes and HIV screening quarterly to the
appropriate age groups. The Family medical centre Uitenhage’s doors are open to all the
year round. ‘Welcome’.

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MISSION STATEMENT

We are a family medical centre that provides holistic care and excellent services for all
people, children and adults, male and female, as well as people of all colours, race and
gender. Irrespective of the time and day, all are welcome.

VISION STATEMENT

Our goal is to be a world class centre with state of the arts equipment and facility to
diagnose and manage chronic diseases as well as offer basic surgical treatment that
improves health outcomes of patients. General annual health check-ups [hypertension and
diabetes] for all patient, quarterly prostrate, cervical and breast cancer and HIV screening
exercise.

Chronic disease support groups, rehabilitation [for alcohol, smoking, physiotherapy] and
aesthetic services are scheduled to commence soon. Collaboration with other allied health
care professionals such as dieticians, physiotherapists, orthotics, psychologists etc will also
commence soon, for improved service delivery to patients [ insured and uninsured].

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VALUES

Affordable service.

Confidentiality.

Integrity.

Compassion.

Empathy.

Teamwork.

Patient centeredness.

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STRATEGIC PLAN

In order to have a well-placed, satisfactory, smooth-running practice with a competitive

advantage [taking into account the NHI requirements], a well implemented strategic plan,
must be put in place. This would involve conducting a market or target audience survey. This
includes investigation on the people who will benefit from the services offered by the
practice, the type of neighbourhood, the economy of that geographic region or locality, the
neighbouring surgeries and their proximity to the proposed centre as well as the services the
surgeries offer.

A situational analysis would also be conducted, which involves assembling staff members to
brainstorm and gather information on the internal and external factors affecting the practice
and its future. The SWOT analysis would be utilized for this exercise. The SWOT analysis is
used to investigate the strengths, weaknesses, opportunity and threats affecting the existing
practice and its future innovations. It assists in identification of unforeseen problems in the
implementation of future goals.

Helpful Harmful
Strengths Weakness
Internal Origin Easy access to practice Limited operation time [not
location. 24-hour service].
Diverse services available. Non-multi-disciplinary.
Out-patient only services.
Multilingual staff.
Low-income neighbourhood.
Patient-centred facility.
No pharmacy department.
Flexible payment plan.
365-day accessibility.

Opportunities Threats
Recruitment of new staff. Other nearby surgeries.
External Origin Upskilling of staff. Local gangsterism and high
NHI funding. crime rate.
Networking with other Economic inflation.
allied health personnel. Current political instability
Purchase of a new building and policy changes.

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to expand services. Load shedding.
Getting a multi-disciplinary
team.
Purchase of up-to date
ultrasound scan machine,
ECG, and bedside testing
equipment.

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THE SOUTH AFRICAN HEALTH CARE ENVIRONMENT.

Having completed the SWOT analysis to identify internal and external factors that may
influence, the proposed strategic plan, a careful study of the current South African health
care environment is important, taking cognisance of the trends in disease burden post-covid
as well as economic resources available for health care following the pandemic.

South African heath care system in the post-covid era, has seen a new trend of diseases and
health care services, with the emergence of more cases of non-communicable diseases,
[diabetes, hypertension, obesity, respiratory diseases] and communicable ones [HIV,
Tuberculosis etc].

The above and maternal and child mortality make up the quadruple disease burden [Visser.C
;FPD tutorial session 05 Dec 2023]. The mortality rate has become higher in the above
vulnerable group due to trauma and violence on women and children. The economic and
political instability of the country as well as the constantly changing policies that the health
care service providers must adhere to, also has a role to play in driving the burden of disease
in south Africa. The NHI bill for instance has got most South African medical practitioners
uncertain of the future of their individual practices. Since this will be based on capitation,
the question arises of the long-term sustainability of this funding, and will private practices
be able to keep their gates open? The answer to these questions will probably develop in
the forthcoming months.

Again, for a long time, South African provinces have had unequal health care systems, with
some provinces having better health facility and resources than others. Of course,
urbanization has a role to play in this but, the diversity in some provinces is so obvious, that
it cannot be blamed on urbanization. A good example is the Eastern cape, which seems to
have one of the poorest health systems in South Africa. Here the government hospitals and
clinics, lack resources including manpower[staff], equipment, medications just to mention a
few. These facilities have been unable to provide adequate health care for the people in the
community. Most people must seek help from private practices having been disappointed by
government institutions. They prefer to save their money and grant funds to visit the private
practitioners where they can get appropriate help.

On the other hand, the private sector caters to the people, who can afford to pay for health
care services in the private surgeries or hospitals, that is insured patients[under medical aid
schemes] and uninsured ones[fee for service]. Unfortunately there is a larger population of
uninsured patients compared to insured ones due to the socio-economic status and
problems of the post-pandemic era. These group of uninsured patients have no choice but
to rely heavily on the public health system has become grossly inadequate with regards to

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management and scare resources. The NHI aims to bridge a gap between the public and
private sector, making sure that all South Africans have access to universal basic health care
through both government and private avenue at an affordable cost, though there are bound
to be, challenges from this in the ensuing months, considering the method of capitation
funding and the limited patient’s visit per year. However, it is still a positive step, in reducing
the country’s health care expenditure.

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ACTION PLAN.

Following a close study of the South African health care system and a swot analysis with
recommendations to set up a standard NHI facility, the next course is to formulate an action
plan on how to successfully implement the standard practice, befitting of the NHI, while
rectifying the problems identified previously. Below is a grid showing the proposed action
plan, which takes into consideration, the key participators in bringing the plan on paper to
reality. It involves; the human resources of the practice, finances and budget planning [loan
acquisition from banks or shareholders], collaborators [medical aids, other practitioners],
vendors or suppliers, [ pharmaceutical and medical equipment supply companies],
marketing strategy and future standard of operations.

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 SMART APPROACH
ACTION PLAN

Room = FAMILY MEDICAL CENTER UITENHAGE Time Period = 1 year

Objective Tasks Success Criteria Time Resources

s (what you need to do to (How you will Frame (What or Who can
(List of achieve the goals) identify your (By help complete the
goals) success) when task)
you
need to
complet
e the
task)
Market  Identify the people  Identified
survey and community to number of 2  Public
be served by the prevalent months Relations
practice. diseases in personnel of
 Identify nearby the the practice.
competitors, their community
strengths and
weaknesses.  Number of
competitors
identified
and services
they render.
 Meetings with
Finance finance personnel  Budget plan 3  Accountant
and of the practice to formulation months of the
Budget get estimate of the practice
overall budget.  Bank
Manager
1. Staff remuneration  Shareholder
2. Day to day s
operation costs  Lawyers
3. Procurement of  Business
medication and Consultants
equipment  Medical aid
 Acquisition of  Signed representati
shareholders to agreement ves
finance expansion with
of practice. shareholders
 Application for loan .
at the bank
 Enrolment with
medical health  Loan
scheme approval by
the bank

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  Medical aids
scheme
enrolment.
 NHI funding
(in view)
 More staff
Staffing recruitments  The increase  Human
 Contracting of staff in total 1 month resource
 Remuneration number of department
 In - service training staff of the
 Upskilling of staff members practice
 Contracting of available to
other allied work.  Recruitment
professionals; agencies
physiotherapist,  Increase in
dietitian and skilled staff
orthotics. members

 Setting the  A 3 Human Resources

standard of presentation months Manager
Operatio operation (SOP) for of the SOP Clinical Manager
ns daily running of the to staff Business Consultant
practice. members. Builders
 Procurement of  Agreement Contractors
medication and with more
equipment. pharmaceuti
 Incentives for good cal
performance(annu companies
ally) for monthly
 Building of supply of
additional rooms medications.
for consultation.

 New
consulting
rooms
To circulate information on  An increase 3 Public relations team
product and services in the months Social media
Marketin offered by the practice to number of Flyers
g plan Uitenhage community. patients who Word of Mouth
come in for
consultation
daily

STRATEGIC CONTROL TECHNIQUES

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According to www.clearpoint strategy.com, there are four main strategy control processes.
These processes assist in achievement of set goals and in monitoring internal and external
factors that may pose a threat or grant opportunities to the practice. These include:

 The premise control which deals with assumptions which maybe environmental or
political. This type of control helps to look out for changes that may affect ready
formulated plans. Example of this is, assumption that the medical aid schemes will
continue to pay out charges to the surgery, but with the advent of NHI, this is not
certain. Hence the finance delegates of the strategic planning committee for the
practice will have to come up with methods to correct deviations in the planning
process.

 The implementation control has got two categories: Monitoring strategic thrusts or
projects and reviewing milestones.

A Monitoring strategic thrust is a way of assessing the smaller plans that together
make up the major planning, determining the success of the plan or loopholes, thereby
helping to decide early on if the current plan formulated should go ahead or be cancelled.
B Reviewing milestones involve analysis of the goals and objectives of the strategic
plan, determining how much has been achieved, otherwise, identifying the problem and
rectifying it. An example of this is assessing successful record of over 50 patients per day for
the practice following, the marketing strategy of sharing flyers to the different
neighbourhoods and streets in Uitenhage and social media advert. This assessment can be
done at intervals; quarterly or annually.

 Special alert control, planning for the unexpected while implementing the strategic
plan. Environmental conditions of a business are dynamic, either the internal or the
external part. A plan must be put in place to ensure the change or sudden event does
not derail successful implementation of the current plan and the maintenance of the
practice standards and viability in the ensuing years.

 Strategic surveillance control. This type of control techniques takes care of

overlooked factors. Example, new practices or pharmacies near the practice or a
problematic sewage system that is yet to be addressed by the municipality causing
pollution in the neighbourhood and posing a threat to influx of patients to the
practice. The strategic surveillance control must be ongoing from the conception of
the strategic plan to its implementation and the day-to-day operations of the practice
[Visser.C ; FPD tutorial 5th Dec,2023]

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All four control processes will be utilized in the expansion and renovation of the practice
Family medical centre Uitenhage. The processes will each be further subcategorized to
properly control areas of the practice standards such as; finances, human resources, quality
control, infection control etc.
Below is an illustration which shows the strategic control process in monitoring the success
of a sector of the practice.

FAMILY MEDICAL CENTRE UITENHAGE STRATEGIC CONTROL PROCESS

WHAT HAS TO BE CONTROLLED----------- INFECTION

SET CONTROL STANDARDS----------------- Only 1% of wound dressing performed daily

Must be infected.

MEASURE PERFORMANCE------------------ 3 superficial wounds noted with poor healing and

infection after 2 subsequent alternate day wound-
dressing visits out of a total of 50 wound dressings.

COMPARE PERFORMANCE TO STANDARD----------6% wound infection noted out of 50

Wound dressings performed.

DETERMINE THE REASONS FOR THE DEVIATION-----[a fish bone analysis could be used to
Investigate this]
? contaminated dressing materials.
? poor nursing skills.

CORRECTIVE ACTION--------------------------- In service training of nursing staff on proper

Dressing.
Autoclaving of dressing materials.
Procurement of appropriate wound disinfectants
and dressing materials.
TEST FOR STRATEGY IN FAMILY MEDICAL CENTRE [FMC] UITENHAGE.

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Sorting for funds from the bank and shareholders would require being able to prove that the
business venture [FMC], proposed, is not a wasteful or unrealistic one. In order to convince
lenders on the authenticity of the business plan, it must pass the three test for strategy in
business planning.
 The realistic test: Family medical centre[fmc] passes this test as during the market
survey, it was determined that, most households had members who suffered from
one chronic disease or the other. This was inferred from the questionnaires
administered to 3 different household on each of 4 different streets near the
practice. As the management of chronic diseases is one of the goals of the practice,
FMC, passes the realistic test. The cost of service delivery to the community will also
be affordable.

 The competitive test: This the second test which the business plan must pass. It
shows what the practice will offer its target audience or community. FMC will be
conducting quarterly and annual healthcare screening test for the community, to
facilitate early diagnosis and management of chronic disease and to intimate
members of the community on, services offered by the practice, some of which other
nearby practices do not offer.

Certain bedside tests such as the Hb, total cholesterol, HbA1c, PSA, ECG, obstetric,
abdominal, and pelvic scans will also be offered. Corporate social responsibility,
example, feeding the community breakfast daily by creating a soup kitchen will stand
out to attract customers to the practice.

 The value test: This determines the probability of making profit from the strategic
plan or venture for example, Family medical centre Uitenhage will cater to different
age groups i.e. the elderly and children, men and women for management of
common ailment and chronic. This will encourage the lenders to loan money to the
practice as the probability of making profit from the business plan is high.

THE BUSINESS PLAN

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  Executive summary ; refer to page 4
 Target Market
Uitenhage Town
Chronic diseases
Competitors – Narshai Medical Centre, Primecure Centre
 Human Resources
HR Manager
Clinical Manager
Doctors
Nurses
Porter
Cleaners
Pharmacy technician
Ambulance driver
 Vendors/Supplies
Pharmaceutical companies
Medical equipment companies
 Marketing Plan
Flyers, social media, radio, word of mouth
 Operations
Formulation of a Standard of Operation with collaboration from senior staff members
 Financial Projections
R1.5 Million from bank loan and shareholders

CONCLUSION

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The successful establishment of a medical practice depends on the formulation and
implementation of a good strategic plan as well as monitoring and appropriate control
strategies.
In order to, bid for the NHI funding, the practice must have a competitive advantage in terms
of location and services offered. Family medical centre Uitenhage is a practice which intends
to expand its services to accommodate other allied health care professionals and to serve
the community at a cost affordable to them with the aim of bridging the gap between the
private and public sector.

References

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Louw, Venter et.al; 2019, Strategic Management Towards Sustainable Strategies in Southern
Africa fourth edition.
Lubanga. M.A 2019; The Effect of Strategic Control Processes on a Company’s Non-Financial
Performance. A Case of Nairobi Hospital.
Miro.com; July 11,2023, Strategic Management Process
Still.L 2020/21, Health Care in South Africa
Visser.C, 5th, Dec 2023 (FPD Tutorial)
www.clearpointstrategy.com ; April 19, 2023 (Strategic Control: Breaking down the Process
and Techniques)

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