Page 29 - P4304.1-V112_PS Magazine - August 25 (print) (1)

Cash flow
Another major consideration for any practice
looking to undertake an improvement project
is to monitor and manage cash-flow. Although
the mechanisms may vary from ICB to ICB,
when Malpas completed their scheme, there £200,000 Malpas Project Cash Flow (£000s)
£180,000
was always two valuation payments made £160,000
to the contractor, before any reimbursement £140,000
£120,000
was received from NHS England. This meant £100,000
that at one point, the Surgery had paid out £80,000
£330,000 before receiving anything in return. £60,000
£40,000
Most practices do not have that kind of spare £20,000
money. Malpas didn’t, so financing options £0 VAL VAL VAL VAL VAL VAL VAL VAL VAL VAL VAL VAL VAL VAL VAL
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had to be explored. Total Cost £109 £46 £44 £98 £90 £155 £113 £144 £186 £144 £94 £110 £88 £133 £7,1
Top tip 7: Ask the ICB for pump priming
funds based on maximum forecast cashflow
deficit. Just remember it will need to be paid
back – set up a separate bank account for
the project.
The result
After 20 months of dirt and disruption,
the building work concluded fully in May
2024; and the 12-month defects are just
being completed across the site. The result
is impressive, both financially (significant
increase in property value and in notional rent)
and in terms of the space offered to patients
and staff.

There are now six additional consulting rooms,
a new meeting room, staff room,
sluice, several admin offices, an entirely
remodelled dispensary and a new dedicated
dispensary service area, as well as a fully
accessible building.

Top tip 8: Even once the programme of work
has finished, consider how else improvements
can be made. Malpas Surgery has added a
large solar PV scheme and currently 70%
of all electricity use in the building is solar
powered, with the excess going back
to the grid.

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P4304.1-V112_PS Magazine - August 25 (print).indd 29 16/07/2025 12:12:29
P4304.1-V112_PS Magazine - August 25 (print).indd 29
16/07/2025 12:12:29