Managing Finance and Operations in Private Healthcare Sector

This report discusses the regulatory measures, associated risks, and compliances that New Life Private Healthcare seeks to follow while expanding their operations in Norfolk or Suffolk. It also includes a cost-benefit analysis to determine the financial viability of the proposal.

Running head: MANAGING FINANCE AND OPERATIONS
MANAGING FINANCE AND OPERATIONS
Name of the Student
Name of the University
Author Note

1MANAGING FINANCE AND OPERATIONS
Executive Summary
The aim of this report is to identify th various regulationary burdens ,associated risks amd the
various compliances that New Life Private healthcare seek to follow while expanding their
operations in either Norfolk or Suffolk.The various compliances seek to put a challenge on the
operations of ye nursing care which the compay strive to overcome.A detailed cost benefit
analysis seeks to determine which locatinis suitable for its operations. The NPV criterion is also
found out to determine the financial viability of such proposal.A detailed analysis strives to find
out the workings of the private healthcare sector in UK and how best it can implement the
necessary regulations .

2MANAGING FINANCE AND OPERATIONS
Table of Contents
Introduction......................................................................................................................................3
Operational and regulatory measures..............................................................................................5
Regulationary burdens.....................................................................................................................6
Measure Performance......................................................................................................................7
Performance service measures.........................................................................................................9
Associated risks and their management...........................................................................................9
Manage reputational risk...............................................................................................................10
Income statement projections........................................................................................................12
NPV and Breakeven calculations.................................................................................................14
Technical analysis......................................................................................................................17
Critical analysis.........................................................................................................................18
Recommendations..........................................................................................................................20
Conclusion.....................................................................................................................................23
References......................................................................................................................................25

3MANAGING FINANCE AND OPERATIONS
Introduction
New life Private Healthcare is a private incorporated company which has recently made
great strides in the world of health care and has won a number of primary health care delivery
contracts across the UK.They have made a good market position in the healthcare industry and
are looking to challenge the market leader, Virgin Healthcare in all elements of the
market(Brown and Duguid 2017).
They are looking to expand their operation in Norfolk and Suffolk , having chosen both
of these places as possible destinations to expand their business. The property in Norfolk is under
a 25 year lease and the property in Suffolk has a property value of $120,000,000.A financial
review of both these proposals, under both NPV and payback period is evaluated to find out
which proposal is better. An income summary is also prepared to find out the financial viability
of the company.The analysis has been discussed subsequently in the following sections.
Nursing home care possesses the third largest segment in the health care industry. There
has been a growing demand for private healthcare with the increase in longevity and shifting
demographic, social patterns in the family.There is a growing need for long term care beds .This
presents the regulators with a very good opportunity to make sure that the long term future
needs of the enterprise are met.The policymakers have a clear influence on the potentially
emerging scenario of the healthcare industry(Hunter.and Murray 2015).This investment proposal
will help bring in more revenue for New Life Private Healthcare and help them in gaining more
market share.Being a new business , it has to comply with some regulations relating to
environment, tax and corporate governance(Wang et al .2015). It also has to bear the cost of
reputation, which is important in order to protect their brand value or goodwill(Lunt et al.2015).

4MANAGING FINANCE AND OPERATIONS
It needs to keep some of the associated risks and operational measures required by the company
to function effectively. Further there is a measurement of performance levels by which the
standard of performance is measured.There has been a growing trend of nursing home residents
in the private sector.Almost 76 % of all nursing home residents are now under private care(Lunt
et al.2015).The growing demand for beds have spiraled the need for private nursing home
centres and its rising demand has sparked the investment of private nursing home In the UK.
New Life Healthcare is a major proponent of the private nursing home facility in England and is
a major benefiter of that rise in demand(Bell et al. 2015).

5MANAGING FINANCE AND OPERATIONS
Operational and regulatory measures
The regulatory measures make sure that the operations and the products offered by the
company are meeting both national and international standards , thereby making sure that the
company New Life Private Healthcare is better equipped to understand what is required by the
prospective customers(Pan et al. 2015). Regulatory measures benefit from a wealth of
professional expertise.
Compliance with regulations help the business to grow in the following ways:
 Avoidance of expensive corrective costs and uncontrolled risks.
 The business comes under a layer of protection and with the help of this its reputation
can be enhanced.
 Supervisory establishments mark their inadequate funds on businesses that disobey the
rules, thereby making sure that there is an equal measure of commercial business and
encouraging a reasonable and benign return to the business(Langabeer and Helton 2015).
The OECD have pigeonholed the major focus of regulations to three areas :
a) Parameters of employment over the recruitment and removal of employees and adhering to
the health and safety standards including the providing of facilities to handicapped and
disabled people, reporting of employee data, social security information and pension rights
also including other benefits like maternity leave and sick leave(Torchia, Calabrò and
Morner 2015).

6MANAGING FINANCE AND OPERATIONS
b) environmental regulations that consist of things like licensing, product quality standard ,
environmental scanning and reporting , pollution regulator , product guidelines , record
keeping and maintaining the daily basis of administration requirements connected to the
surroundings, environmental laws and taxes(Devaux 2015).
c) Tax guidelines that cover business taxes, corporate taxes etc..
Regulationary burdens
The main costs associated with this are compliance costs, administrative costs and
regulatory costs. Compliance costs include the costs that are borne by the people who play tax or
by third parties while complying the requirements of the taxation system over and above the tax
liability itself (Marshall et al .2015). Administrative costs are the costs incurred by the official
personnel during administration in the process of taxation. The sum of compliance costs and
administrative costs are referred to as operating costs(Runciman, Merry and Walton 2017).
The Better Regulation Task Force has embraced the word “compliance cost” that consists
of the combination of both periodic and non periodic costs The RTF uses these costs as direct
costs of regulations. Periodic cost include further continuing costs for entrprises as a
consequence of staff cost regulations and time, consumable materials and inspection
costs(Muennig and Bounthavong 2016).Non periodic cost include costs such as one time
investing costs of plant and machinery, buildings and trainings.
The Cabinet Office makes a guidance on the achievement of Regulatory Impact
Assessments that needs to make a difference between policy and implementation costs. Policy
costs are those costs which can be directly attributable to the goal of polocies involved and the

7MANAGING FINANCE AND OPERATIONS
implementation cost signify the costs associated with the implementation of regulation(Anderson
2014).
The values of procedures can be calculated using two approaches
 Making people consider what they are willing to spend for regulationary changes.
 Deducing observed performance for amount truly rewarded by individual for
regulationary changes.
In addition to the regulationary burdens , there are other key issues affecting the UK healthcare
sector like the rise of operarting costs, cutbacks to local authority funding and more recently the
introduction of both the NLW and the work place pension, nursing shortage and Brexit are some
key issues plaguing the UK healthcare sector. There is an incessant burden for governments to
slash budgets for private nursing care which cuts back private funding as well(Xue et al.2017).A
removal of local funding led nursing homes to look for altenative source of private funding.The
government’s social care council tax principle allows councils to increase council tax in the areas
by 2 percent per annum to fund private health care(Morgan, Ensor and Waters 2016).Also in
light of the recent treatment shortage, drvien by reducing UK student nursing places, reduced
spending of government , immigration issues places more barriers to complement the use of
workforce through the use of more affluent workforce.The CQC determines the ratings for
carehomes and if a care home fails to report minimum industry standards the CQC has the
power to rescind their license and suspend their operations(Smee 2016).
Measure Performance
A growth business needs to be managed with care to make sure that the new investment
proposal makes sure of the decisions and expansion plans. Putting performance measurement

8MANAGING FINANCE AND OPERATIONS
systems in track is an effective way of making sure that the concerned business is in line with its
overall objectives(Xue et al.2017).It gives dynamic information about what is happening in the
present and also delivers the point of origin for a system of setting targets that will most likely
implement growth plans. Performance measurement and setting target are critical to the process
of growth(Morgan, Ensor and Waters 2016).THE benefits of performance measurement are
knowing how the business is performing by considering the valuable information. A good
performance measurement will also figure out the performance changes.This enables us in a
better position to manage performance in advance(Smee 2016).
A good nursing facility is largely impervious to differences among the residents
populating different hospital beds.Such an indicator would vary with differnces in the quality of
care provided by the nursing home.Unfortunately for a variety of reasons such indicators are
limited in number in case of a nursing home(Yang and Zou 2014).There are often instaces of
mishaps like fire or medication errors due to insufficient data.Such instances limit the operational
performance of nursing home and capture the general constructs of nursing home quality(Bahri
et al.2015).
The performance measurement systems of nursing homes are almost universal. The vast
mainstream of these systems hope to rank instruction of all nursing homes based on numerical
quality measures. However, the aptitude of such systems is to ascertain homes opposing in
quality is hindered by the multi dimensional nature of nursing homes and their residents. As a
result, there remains a doubt of the capability of many nursing home performance systems to
help consumers discriminate among homes based on varying levels of quality(Smee 2016).For
consumers, performance measurement models pose a better solution at identifying problem
facilities than potentially good homes.

9MANAGING FINANCE AND OPERATIONS
Performance service measures
It is very important to get the performance measurement indicators right. The focus should be
on key business drivers .This business should focus on the following key drivers are:
 Staffing- There has been an unprecedented shortage of health care personnel in the last
few years. Considering this shortage, there will be a shift of health care personnel from a
private doctor to a more central base team care(Gao 2015).
 Acuity- Patient acuity, a performance measure that measures the intensity of nursing
personnel required while the total bed counts are declining. This rise in acuity indicates
that the patients live longer due to better health care services provided with a range of
moderate to severe health care conditions.( Yang and Zou 2014)
 Shift in revenue-Health care services need to step it up to provide a more aesthetically
pleasing service, instead of providing just the basic health care services. (Bahri et
al.2015)
 Patients as Consumers- Patients are service acquirers looking for service overs
status.the modern status of the patient is that of the customer. Their should be an urgent
retail care center in case of an emergency. The growth of retail clinic shows further
evidence that the customer wants options and more convenient options(Emberson,. and
Trautrims 2017).
Associated risks and their management
Some of the associated risks that need to be kept in mind while managing a nursing
home are:

10MANAGING FINANCE AND OPERATIONS
 Falls- A slip by any resident in the nursing home
 Nutrition- A basic provision of nutritious food and drink should be provided to the
residents.There should be an increased monitoring, including keeping tabs on individual
patients , especially to patients on critical conditions(Hirth and Huang 2015).
 Sanitation- Maintaining clean and well kept sanitary facilities and also making
provisions in order to contain infectious bacteria and germs.
 Medical care- There should be a proper management of medication and keeping a close
watch on drug related problems including over dosage and under dosage problems(Bos
and Harrington 2017).
 Employee liability- There should be a strict code for employee conduct to adhere to the
employees rulebook and keeping the patient safety standards in prime
condition(Konetzka, et al.2015).
Manage reputational risk
The company’s reputation is one of its biggest assets.it needs to be effectively managed ,
so that no other business can take misuse that reputation . So it becomes very important to
protect that risk(Huang and Hirth 2016). There are some things that the company can do to
protect its reputational risk. They include:
 Start monitoring reputational risk-To monitor reputational risk , the business need to be
proactive. The business should anticipate that there is a possibility of risk lurking around
in every corner. So, to prevent that from happening they should start mining the data they
have gathered from sources including data acquired through customer feedback, financial
statements and software audits etc(Grabowsk et al.2015).

11MANAGING FINANCE AND OPERATIONS
 Build reputational risk reporting to governance-The reputational risk should be combined
with the corporate governance report. Awareness of this type of risk will help in
curtailing risk management during the decision making process(Godin et al. 2015).
 Allocate resources- Most executives believe that their company is spending an adequate
sum of money on reputation management. However there are some respondents who
believe that the company is not spending enough on resource allocation. There should be
a separate budget that remains available for resource allocation (Rondas et al. 2015).
 Conduct a reputational risk audit-In other cases, the company can bring in a separate third
party to conduct a reputational risk audit, to assess the reputational risk that the company
could be in(Tao 2015).This audit will analyse both the internal and external data and
form an independent assessment and opinion as to the status of the reputational
risk(Cherry and Jacob 2016).

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Income statement projections
Annual Budget of New Life Private Healthcare for the year ended
Annual Budget
£
Staff 5,720,000
Maintenance 500,000
Operational cost 1,000,000
Equip Lease 500,000
Depreciation £12000000/20
years 600,000
8,320,000
Mark UP
0.1
0 832,000
Target Revenue 9,152,000
Price at 100% Occ 501.48
Based upon 80% 626.85
Potential price per bed day to achieve group margins
Maximum Bed
days 50.00 365.00 18,250
Reduced
occupancy 80.00%
bed days 14,600

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Working Notes 1
Target revenue- cost + mark up= 8320,000* 110 %= 9152000
Pricing at 100 percent occupancy-9152000
Mazimum bed days- 365*50=18250

14MANAGING FINANCE AND OPERATIONS
NPV and Breakeven calculations
Npv calculation for buying decision
Total cash ouflow for buy- 12000000
Inflow- Target revenue* 80%= 7321600
Operating costs- Total costs- Depreciation= 8320,000-60000=7720000
Investment
Appraisal
Y0 Y1 Y2 y3 y4 y5
Capital -12,000,000 8,000,000
Capital Cont 0.00
Income
7,321,60
0
7,321,60
0
7,321,60
0
7,321,60
0 7,321,600
Operating costs
-
7,720,00
0
-
7,720,00
0
-
7,720,00
0
-
7,720,00
0
-
7,720,000
NC
F -12,000,000 -398,400 -398,400 -398,400 -398,400 7,601,600
DF
1.0
7 1.00 0.935 0.873 0.816 0.763 0.713
DCF -12,000,000 -372,336 -347,978 -325,213 -303,937 5,419,836
NP
V
-
7,929,629.2
2

15MANAGING FINANCE AND OPERATIONS
Commercial Plus Social Services
£
Income beds
Commercial 30 15,044
Social No discount 10 5,015
Social with discount 10 3,510
Income per day 23,570
Income pa 8,602,880
Commercial plus NHS
Income
bed
s £
Commercial 40 20,059
20,059.0
0
NHS Discount 10 3,510 3,510.00
Income per day 23,570
23,569.0
0
Commercial plus social services
Commercial income- 501.48 *30=15044
Social No discount- 501.48* 10=5015
Social with discount-5015* 70%=3510
Commercial plus NHS
Commercial income-501.48*40=200059

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NHS discount= 5015* 70%=3510
contribution analysis
sale price per unit- $552
sales volume per
period 18,250
total sale price
$10,067,20
0
variable costs
Staffing costs 5,720,000
total variable costs 5,720,000
Fixed costs
building maintenance
costs 500000
other operations cost 1000000
total fixed costs 1500000
contribution- $4,347,200
Breakeven analysis
contribution per unit $238
fixed costs 1500000
breakeven point(units) 6297
Working Notes
Contribution per unit- Contribution/ no of unit sold= 238
Breakeven point( in units)- fixed cost/ contribution per unit= 6297
The workings for breakeven analysis have been done in the excel sheet.

17MANAGING FINANCE AND OPERATIONS
Technical analysis
The initial outlay to buy the property in Suffolk is $ 12,000,000. This is a one time
investment. The savings in operating costs amount to $ 100,000, for every year for the next 20
years. That is the amount of cash inflow . The lease in Norfolk is under a 25 year lease,
renewable after 5 years , $ 500000 with an expectation that these costs will increase by 10
percent. As per the NPV criteria, the excess of cash inflow over cash outflow represents a
positive cash flow. However as per the above calculations, in case of buying property in Suffolk
there is a negative NPV.Since the NPV is negative hence its payback period cannot completed.
Payback period is the amount of time needed to recoup the original investment.Since the actual
investment is not recouped , as reflected by the negative NPV hence the question of payback
period does not arise.In case of the leasing property in Norfolk, after making requiring
adjustments in cost savings and increase in leasing cost sof 10 Percent every five years the NPV
is negative as well. However the negative is less than that of buying property in Suffolk.
Hence ,being minimum of the two negatives the least criteria as per the NOV criterion is
accepted.However the lease option, despite being financially viable does not get selected because
Suffolk has collaborators with local health and social care partnerships.There is no payback
period for the same reason mentioned above in case of buying property.The NPV here is
negative as well.
The costs involved in collaboration with both NHS and Social Services remain same
including providing discounts of 30 % for 10 beds each.As per the breakeven analyis we see that
the company achieve s a breakeven point in terms of 6297 beds per year. This is the situation

18MANAGING FINANCE AND OPERATIONS
where the company makes neither a loss or a profit. In terms of the contribution analysis the
staffing costs have taken as variable costs because it will fluctuate with the increase in staffing
personnel while the building maintenance costs and other operating costs have been taken as
fixed costs. The contribution analysis suggests how the usage of each bed contributes towards
the recovery of fixed costs in the organization. It helps in assessing the profitability of each bed
that is serviced by the organization. This contribution analysis mainly helps in the case of pricing
per bed.
Critical analysis
The current financial proposal is made in agreement with valid United Kingdom
accounting standards.The specific accounting policies implemented have followed the historical
cost convention.It has also prepared its policies in reference to a going concern basis, which
assumes that the business will remain operable for an indefinite period of time(Mullins and
Forbes 2015). The leases have charged under straight line basis under the relevant accounting
standard(Dellefield et al.2015). The nursing care also recognises revenue as care is taken of non
-contracted beds and made accessible for contracted beds. Revenue is recognised at the moment
of unrestricted exchange of contracts(Bierbower et al.2016).This is discussed in terms of the
current financial proposal.
An alternative evaluation deems the usage of costs and revenues that should have been
considered. New Life Private Health care has omitted the use of several expenses which should
have been discussed , chief among them are the salary and wages of health care personnel..The
private nursing home, being a medical facility maintains a lot of pharmaceutical drugs and
medicines, the cost of which has not been mentioned. This is a necessary operating expense that
should have been included in the financial statement. The revenue should also incorporate other

19MANAGING FINANCE AND OPERATIONS
revenue in addition to hospital be revenue only.It should also incorporate other revenue sources
from the cost benefits provided by eventual collaboration with NHS and Social Service.The
discount of 30% for 10 beds each should also be incorporated in the financial statement as
discount allowed to the above organizations and hence will fall a part of operating expense.
There is also no available cash balance or bank balance. Without that information the data for
cash flow is not complete. A cash flow need to be prepared to find out the various sources and
applications of cash and how the cash is utilized in the business.There is also no provision of a
corporate tax rate. The rate of corporate taxation has not been provided in this instance.That
should be accounted for.Hence the newest proposal should incorporate all these things that have
been discussed, in order to give a more detailed light to the financial workings of this
company.The data provided in the current proposal is simply not clear enough to present a more
sound and reasonable financial and technical analysis.
,

20MANAGING FINANCE AND OPERATIONS
Recommendations
From the above analysis and analyzing the financial statements, especially the Income
and Expenditure Statement it is seen that if the company wishes to invest in the NHS and Social
Services, the two public collaborators the cost would be significantly reduced. Partnership
between NHS and New Life Private Healthcare could be very important breakthrough in making
upgradations towards service quality and productivity. It enhances effectiveness and operational
skills. Further NHS provides a range of benefits that can provide more engagement opportunities
like roundtable events , information exchange between NHS and New Life Private Healthcare
regarding product briefings , advertising opportunities for New Life etc. The following
recommendations need to be addressed to the board for making this investment proposal a
success:
 Partnering with NHS and Social Services is the right move because it provides not only
cost benefits but also other benefits as well.Major benefits include providing quality
health and nursing personnel, good quality pharmaceuticals and medicine equipment.
This brings in more investment opportunities and this affiliation with NHS and Social
Services will help the company positively by an upstanding reputation in the private
healthcare industry. This will also help the company in giving a clear message to its
competitors , especially to the dominant market leader. Virgin Healthcare.This will
signify major growth of the healthcare and make significant opportunities in teaming with
other public collaborators in the future.
 NHS England co sponsors clinical pharmacists that there are there in general practice to
support GP prescribing and optimize the usage of medicines. This will enable New Life

21MANAGING FINANCE AND OPERATIONS
Private Healthcare to get better access to specialists that have a wealth of expertise in
dealing with critical illnesses.
 NHS involvement in working with New Life Healthcare is to consolidate pharmacy
infrastructure such as medicines stores across wide geographies to handout further
efficiencies and free up pharmacists time for clinical work.
 There should be a focus of quality of care so that the quality and safety standards can be
enhanced . Quality of care is monitored by the regulatory authorities. Safety standards
intend to improve particular areas of care like coronary, cancer, mental health ,
disabilities etc. This should be rigidly enforced in the organization as this will increase
quality and reduce service variation .
 Extra care should be taken to help the older people and disabled people. There should be
a provision of free influenza and pneumonia immunization for people above 65 years of
age . Action should be taken to better facilitate the oral health of senior citizens and
increase their access to dentistry. As for disabled people, there should be a special
allowance for them.This will be made available for disabled people and people who need
daily assistance in personal living.These allowanaces provide the extra financial support
that the extra costs are required for personal caring and daily activities, for example the
daily domestic activities like washing, dressing and bathing etc. It also includes the
supervision required to monitor disabled people and taking them from place to place.
 There should be a regulation of private sector healthcare as common standards should
prevail across both public and private sectors . Important areas in which regulations could
benefit patients include The company standards of public hospitals, and other corporate
governance measures, better availability of information for patients about costs and fees .

22MANAGING FINANCE AND OPERATIONS
 Advocating the need for innovations and controlling costs across specialists operating
privately and reimbursing them by a payment of a fee or service . this will bring in better
quality of medical care and be a major boost in bypassing the competition.
 Improving the bed occupancy rate by actively doing routine patient discharges, and
planned hospital admissions. Thereby managing the patient discharge time.Also
recruiting adequate staff , especially for housekeeping , maintenance and help desk will
improve bed occupancy rate. There should be an appropriate provision of surgeon or
physical scheduling to improve contingencies by allocating them on different times so
that there should not be a time when no physician or surgeon is not available.
 There should be a persistence of promoting a culture where the patient safety standards
are not brushed aside.There should be an increased commitment in achieving the
organizational objective sand protecting the safety standards of patients. Without
following the required protection standards, this company will not only diminish its own
reputation but also lose a significant chunk of its market position.

23MANAGING FINANCE AND OPERATIONS
Conclusion
From the above discussion it can be inferred that the Board has chosen the Norfolk
project proposal because of its cost savings and rejected the lease in Suffolk. The reduction in
cost savings facilitates performance driven benefits including benefits in customer satisfaction.,
return on investment etc. These benefits will help New Life Private in the long run. This report
provides a brief overview of private nursing care in UK through the private nursing centre New
Life Private Healthcare based in UK. There has been discussions involving the benefits of
partnership with NHS and Social Services, which have been discussed in detail.Public
collaborations meet the sufficient rise in demand of healthcare services. There is always room for
improvement in the quality of care and quality of medical personnel. The regulationary burdens
provide significant challenges for the company to overcome. The operational measures need to
be implemented and properly followed. The associated risks should be taken into consideration
ad adequate steps should be taken to make sure that this will not happen.The reputational risk,
one of the significant assets that could be misused by rivals needs to be protected adequately.
The impact of collaboration between private and public healthcare will go a long way in
estimating the rebranding of the company as a major force in the private nursing home centre.
The strategies executed under this collaboration should facilitate the strategies for divestment,
diversification and restructuring of the company.
The presented report thus attempts to understand the financial viability of the investment
proposal of NEWC life Healthcare and how it impacts its overall costs. After all calculation sad
findings, the results show there is a significant cost benefit while collaborating with NHS and
Social Services.In addition it also illustrates the various operational and regulatory measures

24MANAGING FINANCE AND OPERATIONS
about how the regulatory framework attempts to understand the various restrictions.It also
attempts to understand the current financial proposal and make a critical evaluation of
insufficiency of data to be incorporated as part of an alternative financial proposal. This includes
various costs and revenue sources which are deemed to be important in incorporating in the
current proposal but which has not been done.

25MANAGING FINANCE AND OPERATIONS
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