Managing growth at Granta Medical Practices

On the face of it, the NHS would seem to have little in common with retail giant John Lewis. But for Tim Harrison, CEO at Granta Medical Practices, there are interesting similarities: both inspire strong affection and advocacy from their end users and employees, while staff are also recognised as an integral part of the business model for each organisation.

He is well placed to draw these parallels, having joined Granta from John Lewis three years ago. Perhaps surprisingly, the switch from retail has been a very natural step, with his previous experience giving him a valuable combination of skills for his role as CEO at the medical practice.

His commercial background was an essential requirement, as Granta is run as a business.

“In the old days, partners were asked to make all the business decisions,” says Tim.

Now, he and a management team take care of the day-to-day operations, allowing the partners to focus on their duties as GPs.

He’s also found other benefits from his time in the retail sector:

“The environment is very dynamic. You need to be adapting every year.”

That ability to adapt has proved important, translating into change management aspects of his role at Granta. This is something he sees as a key necessity for the NHS overall, if the organisation is to meet current and future challenges. Delivering this change, though, is perhaps the biggest challenge. 

“Everyone in the NHS has been trained a long time in a defined way of working. Everybody is very professional but those ways of working are embedded,” he explains. “But when we start to make changes, people see the benefits and you then get the advocates for this. Culturally, you need to keep very enthusiastic about the changes being made.”

A different model

These changes affect all areas of the NHS, ranging from the sudden necessity to alter procedures during the pandemic, to finding ways to manage chronic health conditions, such as diabetes and COPD. There are also changes to working patterns, with more emphasis on flexibility.  

“Sometimes it just needs a small touch on the tiller to make a huge change to the overall trajectory,” says Tim.

At Granta, it’s about “unlocking the benefits” for everyone. Alongside growing the business, that means better forecasting and planning to provide proactive health care:

“Productivity is key. Patients want to know they can see their GP or a nurse.”

Granta offers GP services from its six sites, serving around 57,000 registered patients, mainly across South Cambridgeshire. It also operates a few select contracts, including support for the East of England Ambulance Service.

A single practice, Granta is also a single Primary Care Network (PCN) in its own right. This is a variation on the usual PCN model, which generally brings together a number of separate practices.

Established in 2019, PCNs are designed to encourage greater collaboration and co-ordination of care. However, as the practices within the network are autonomous, this calls for a degree of conversation and negotiation.

“The beauty of our model is I don’t need to have those negotiations, which makes it much easier,” says Tim. He is able to judge how best to allocate resources across Granta's different sites.  

Insight into the business

When it came to finding the right accountants, Tim was “looking for something a bit different.” It was important they could “play a dual role”, handling both the partners’ interests as well as the business’ needs.

Simpkins Edwards was recommended to them by another medical practice, based in Taunton.

“They were waxing lyrical about their accountants, which nobody ever does!” says Tim.

He met with partners at the firm, Seb Beard and Mark Simic, and was immediately put at ease:

“What struck me was the way they handled our conversation. The enthusiasm they had about what they did was infectious.”

Simpkins Edwards work directly with the Financial Director at Granta, supporting the general accounting and reporting requirements. They also provide insight into the business, which Tim finds particularly valuable.  

“They’re really good at using graphics to lay out the data, showing trends over time,” he says. “Pulling out the management information is really powerful for us – that ability to show both the what and the why.”

Alongside this, he appreciates the strong working relationship they have developed over the last twelve months: “They know the partners and we enjoy working with them; they have the same core ethics as us.”

While previous experiences with accountancy firms have felt very “functional and transactional”, Tim has found Simpkins Edwards to be genuinely interested in the business.

“It’s always about the personalities and the people,” he says. “They make it feel personal. We’ve never had that before.”