Practice Diagnostic. Really Understanding your Practice

We help Practices with their resilience and ambitions by providing an independent and in depth analysis of their strengths, stresses and strains.


A GP Practice based in the South West of England requested support for an assessment to find out what was really underlying their problems and causing falling income, increasing workload, recruitment issues and increased stress.

The practice served a patient population of 7,500 and were under pressure in ways they have not had to deal with in the past. Some individuals were finding it increasingly challenging to continue to deliver the quality of patient care that they would like.


The Situation

  • As a dual-practice site, several staff felt that the main site were unable to cope with the volume of work, with the branch site often feeling underused.
  • There had been a fall in income
  • Resignation of staff and partners was common.
  • Our analysis of the financial reports revealed overall profitability was down year on year, now down to 75% net intended income and the income/profit ratio was running at 0.32. Staff costs were higher than benchmark.
  • Planning for the future was not evident from our assessment. There was no evidence of succession planning to replace the partners who had resigned.
  • This lead to the lack of any perceived commitment to the Practice, and no appetite for developing a vision and plan for the Practice that would be attractive for prospective partners.
  • Our findings suggested that communication between staff is effective and there was little evidence of disharmony. This was pleasing news to the partners and led to an immediate “feel-good” factor, and a desire to lead some improvements in other areas.
  • Recall systems, repeat prescribing and the patient appointment system were all discussed by staff as areas that they felt could be improved. Two partners volunteered to work with the practice manager and the lead practice nurse on these areas.

The Solution

To gain this detailed level of understanding Xytal asks the Practice to send over key preparatory work such as accounts, lists of personnel, any complaints analysis and sickness record.

The visiting team, two or more senior consultants, review this material, observe the practice for 2 days and conduct a series of interviews.

The Xytal team observe the domains of:

  • People
  • Processes
  • Premises
  • Finances
  • Futureproofing

The review is followed up within 2 working weeks by a written report. The report is presented in a manner that clearly identifies the underlying causes, making the crafting of a recovery plan straightforward.

Graphic The practice served a patient population of 7,500
Graphic Xytal observed the practice for 2 days
What our clients say
  • "The PGP process has been great for making us listen to each other and we’ve discovered things we weren’t expecting and made changes already."
  • “People feel more involved, feel the benefit of improvements.”