Client: South Coast Medical Group
Date: July 2019 – March 2020
Challenges faced by the client: South Coast Medical Group (SCMG) is an award-winning primary care provider, comprising six GP surgeries, serving a registered population of over 34k patients. The SCMG surgeries also constitute a single Primary Care Network. SCMG runs a range of services, alongside traditional GP clinics. These include Ultrasound and Echocardiogram services, a mental health nurse and a social worker. They are funded through a combination of additional income streams and surpluses generated from across the Group. SCMG provides these additional services because it is passionate about providing high quality patient care.
The existing delivery model for SCMG was not sustainable in the long term, as it relied on the continued operational and financial commitment of the sole Senior Partner. This posed significant risk to the resilience of services, particularly as the partner was approaching retirement and his personal financial circumstances were changing. SCMG also needed to shift to a more sustainable model that could secure continued use of the estate, and provided a greater degree of long-term certainty.
Support offered: Mutual Ventures undertook an options appraisal, which identified a Community Interest Company (CIC) Limited by Shares as the preferred option. The options appraisal was co-created with the client, and key stakeholders, including the Clinical Commissioning Group and Local Authority, using assessment criteria (desirability, viability and feasibility), allowing identification of a shortlist of options and then selection of a preferred delivery model option.
In partnership with Bevan Brittan, Mutual Ventures then produced a business case, including the strategic case, financial rationale, operational structure and identification of remaining technical issues. It also outlined the roadmap for implementation, including timescales and key risks. The business case built on the options appraisal, and included detailed analysis of the preferred options, particularly around the technical considerations, such as contracting, staff transfer and pensions, and in-depth financial modelling. Mutual Ventures ensured that social purpose was embedded and a focus on innovative approaches to care delivered across the Primary Care Network was maintained throughout.
Outcome achieved: The client was able to begin implementation of a Community Interest Company (CIC) Limited by Shares, which offered the following key advantages:
Social purpose was ‘locked in’ and dividends were limited, protecting added social value in the long term
GMS/PMS contracts could be novated to a company limited by shares (including where it is registered as a CIC), subject to CCG consent and compliance with the applicable rules on shareholding
The model was financially sustainable, subject to securing adequate initial financing
A CIC provided opportunity for community involvement in governance
The limit on dividends could provide more opportunity for sustained investment internally in innovation and workforce
There was the potential to seek grants from charitable sources and lever in third party investment from social investors
