With increasing pressure on practice budgets, we all need to look at areas we can save money.
There are lots of ways to save – here are my top six tips.
Under the new contract, faxes are to be removed by April 2020 anyway, which is great news for confidentiality, but also great news for your paper, toner, and electricity budget. The sooner you do it, the sooner you will generate savings.
When we got rid of our fax machine, we set up a generic email address in the practice and wrote to all the departments and organisations with whom we have a professional relationship, giving them the email address and asking for theirs, and responded to any incoming faxes with the same letter, giving them a date the fax would be unplugged.
After that date, we kept the machine running and still received the odd fax. If it was patient-critical, we telephoned the sender. After a few weeks we were able to switch if off, and we haven’t looked back since. We were the first in our CCG to do this, so it was it was hard work getting the email addresses set up in the hospitals, but our CCG Quality Improvement team were very supportive.
What did we save?
Replacing fax machine when it breaks: £150 every 2 years
Toner: About £100 a year
Paper: £50 a year
Time: Half an hour of admin time each week, clearing paper blockages, restocking, sending
Other advantages: Confidentiality improved, audit trails improved, no paper wasted on junk faxes
Practices can make considerable savings by sending letters using a franking machine or a mailing service.
Franking – a machine that franks your post, rather than using a stamp. This works out cheaper than using stamps. You have to factor in the cost of the franking machine (consider a reconditioned machine to help keep the cost down), the ink, and the time to frank, but each individual letter is cheaper. As of 25 March 2019, a first class stamp is 70p, but to frank it costs 64p.
Mailing service – where you send letters from your computer system, either by uploading the letter and address database, or by installing a print driver. A mailing service like Docmail costs 57.6p for a second class letter including print, paper, envelope and postage (compared with 61p just for the stamp). The mailing service is particularly good when you are sending batches of the same letter to different patients, as the biggest cost is the staff time.
What did we save?
We bought a reconditioned franking machine for £200 that we anticipate will last for five years. Ink costs £40 a cartridge, which lasts about six months. You need labels for thick letters, but we don’t use these much. Currently we are sending around 100 second class and 10 first class letters a week. In stamps this would have been costing about £65 a week, but we have been spending £35 a week by franking, saving £1,500 in a year.
Taking off £120 costs (ink and one-fifth of the cost of the machine), you are still £1,380 better off a year.
Other advantages: You can put senders details on the frank, meaning the letter can be returned if not delivered.
Note, you have to pay a rate change reset fee when Royal Mail changes prices, usually around £50.
You can save even more by communicating with patients by sending a text for recall campaigns (for example, MJog is great for this), or for a one-off message, such as: ‘The GP would like you to make an appointment to discuss your test results’ (Chain SMS by Accurx is great for this – and it’s free). So it’s certainly worth looking at the letters that are going out, and considering if they can go by SMS, or even email.
There are some disadvantages when using an SMS service – not everyone has a mobile, the information is less rich than a letter (unless you can use a service like MJogs’s Smart messaging where the information is unlimited) and there is a danger that patient’s mobile number is out of date. However, as long as you have a robust protocol, the cost savings can be considerable. If you were to change from recalling your patients for their chronic disease annual review by letter to text, you could save £1,000s of stamps each year.
There are also good savings in staff time by sending a text rather than making a phone call. For example, we now text patients using Accurx ChainSMS to let them know their blood results and in, and the GP would like the patient to make a telephone appointment to discuss them. This saves the problem of not being able to get hold of patients – they ring us at their convenience to book the telephone appointment.
Firstly, if your practice is buying drums, you may find you don’t actually need to – these may be provided under the CCG / CSU IT service. You are not usually allowed to keep a spare drum in stock, though, which means that if one fails your printer will be out of action until the new one is delivered. So you may still want to keep one in stock out of your own budget.
Secondly, you may be overspending on printer toner. To start with, make sure you’re getting every last drop out of your toner. When the warning light comes on, take it out of the machine, give it a gentle shake and keep on using it until it stops working.
Then check what type of toner cartridge you’re buying, as there are usually a number of options: original; compatible; reconditioned; and refilled. Whichever you choose, read up on the pros and cons and what you could be responsible for if a toner malfunction rendered the printer unusable. Most compatible suppliers offer a guarantee that they will replace the printer if their cartridge causes the printer to break. But in all my time as a practice manager, I’ve never known a problem with a compatible. Original cartridges are about twice the price of compatibles, and reconditioned and refilled even cheaper. I go for compatibles and recycle them afterwards.
Also, try to buy high-capacity toners. For example, a standard Brother TN3330 toner cartridge gives around 3,000 pages and costs about £70. The high-capacity alternative, TN3380, gives around 8,000 pages and costs about £100. So you are looking at a cost saving of around £85 per 8,000 pages if you go for a high-capacity instead of normal-yield toner – and it’s much better for the environment.
Potential savings
We use around 40 high-yield cartridges a year (we have 24 printers) and I have calculated we save around £1,800 a year by using compatible, high-yield cartridges. On top of this, we would use around 15 drums in a year: by ordering them from the CSU we are saving around £1,000.
Even better than saving money on printing expenses is just reducing the amount you print in the first place. There are a number of ways you can do this. Consider duplex printing (you can alter your printer settings so they use both side of the paper for printing, saving on paper – great for letters).
Look at your work processes – do you really need to print the full summary of the patient record to take on a visit (often 12+ pages), or will the brief summary (usually 1-2 pages) do instead?
Do your staff files or employee handbooks really need to be in a paper file? Electronic files are searchable, auditable and much more secure.
In particular, look at your prescription processes. Move patients across to EPS where you can so you’re not printing their FP10 and all the associated repeat ordering forms.
Also consider using your photocopier – the chances are you can use it as a network printer. Printing on a photocopier is generally about one tenth of the cost per sheet, so if you are having to print large volumes (for example on patient deductions), the cost can soon mount up.
What did we save?
This is a tricky one to put a price on as there of lots of little changes that add up to the saving. As an estimate, it’s around £500 a year, most of it achieved by printing on the photocopier.
My final tip is to look at your suppliers. New companies will often tempt you with initially discounted prices or special offers, but over time these costs creep up, or there are hidden charges like delivery. There are a number of platforms that integrate the majority of your suppliers into one platform. We use Surgery Network, for example. They charge a monthly fee, and for that you can be assured you are getting the best prices on your consumables (both stationery and treatment room). There are loads of other advantages too. They will help source flu vaccines when you run out; give you information on PPA claims and NHS reimbursement prices; be a central store of your order history / purchase orders in case you need to make an insurance claim; and even help you with your stock checks at year end. You might save £3 on a toner cartridge, £1 on a box of couch roll, 20p on a packet of pens, and 2p on disposable toothed forceps – without having to constantly compare prices to make sure you’re getting the best deal.
What did we save?
We have been with Surgery Network a number of years now, but the first year we moved across, our spend dropped by £1,300 a year. After taking into account subscription fees, we were saving £880 a year.
All in all, these tips save our practice over £5,000 a year.
Jennie Dock is Practice Manager at Hedge End Medical Centre, in Hampshire, which has a list size of just over 15,000 patients
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