How to Get the Best from Your Heartbeat Monitor

Your Heartbeat Monitor report is one of your most effective tools for understanding your operation. It displays figures from your most important operational reports, allowing you to quickly understand where you are performing well and where additional attention may be needed.

Your report sets out your most recent full month of results with comparison data showing the average of your previous three months and 15 top performing operations with their figures adjusted to your patient numbers. 

These comparisons therefore give you an indication of your operating trends and how you compare to other similar sized operations.  And if there is an area which you would like to see in more detail, then the detailed report supporting the results can be viewed by clicking on the report name on the left side of the report.

We recommend reviewing this report at the beginning of every month. Even a 15 minute review should be sufficient to understand operations and indicate whether or not a more detailed review is needed.

For user assistance, refer to the Heartbeat Monitor Indicators Help Guide, explaining report indicators for a more informed analysis.

The top section of your report covers General Purchases. This section shows the total of all purchases costs excluding NHS Reimbursables (mainly medicines) and medical equipment. Purchases are broken down into medical costs, and office costs covering stationery, IT and cleaning.

In reviewing your results keep in mind that most surgeries maintain a consistent level of activity throughout the year, with exceptions during holiday periods. Thus, you should see a steady level of results with slight variations during the holiday periods in December and the spring, the two times in the year when longer holiday periods, and surgery closings, are more common. 

If you do find you have had a jump in costs in a month, keep in mind that it could be special purchases, such as a renovation and restocking of a new treatment room. But if you are not aware of any special changes in activity, then clicking on the detailed report name on the left side column should give you an indication of the reason for the change in expenditures.

Saving Success

The third line in this section reveals how the total of your purchases compare with the best prices paid by other surgeries. It is shown as a percentage of success. 

Often a target of 95% is set, however there may be valid reasons for not achieving the best. Certain brands may be preferred over other more inexpensive options.  This is especially common in the purchase of furniture and equipment. For example, a particular style, colour or material may be needed for furniture to fit in with existing layouts, or extra functionality may be needed to attach a piece of equipment to a wall. Extra features may therefore result in the cost being higher than the best, resulting in a lower saving success %.

In order to understand your saving success rates in detail you can click on the Saving Success name on the left of the report.  This will take you to your Saving Monitor report, which can also be found in the Purchases NavBar area at the top of your online account.

There is a help link in the Saving Monitor Page Guide, found at the top right of the Saving Monitor page, which explains how to work with this report. 

Very briefly, the Saving Monitor report displays two tables below a graph, with the left table showing your most recent full month of purchases and the right table your results for the past 12 months. The tables are displayed by cost category, and by clicking on either the Success column or Alt Saving column figures you are able to see the details behind the saving figures. 

The details show you the potential savings you might achieve by buying an alternative option. Clicking  the + sign on the left of the item description will display a complete list of the saving options starting with the greatest saving option at the top. Clicking on one of the options will then show details such as brand, supplier, NHS Reimbursement rate and so on. 

Of note, the options shown are across all pack sizes, not just the pack size of the item purchased.

This section guides you through your monthly NHS Reimbursable claims, comparing them to other surgeries in the Model Surgery column. It helps identify the need for further investigation into your claims for the month.

Income potential 

Income Potential results are derived by recalculating your purchase costs using the NHS Reimbursement Rates to provide an estimate of the income expected from the NHS Reimbursable items. 

It's important to note that the current income figure is determined based on the goods' received date, which may not precisely reflect revenues earned in the same month due to potential time lags between purchase receipt and usage.

The figures in your three-month column will provide a more reliable indication of revenues as the purchases have been averaged over three months. If you are using the Real-Time Inventory area then the Stock Usage report in the inventory area may give you a more accurate understanding of actual costs.

When reviewing both the Previous Three Months and Current Month columns in comparison to the Model Surgery column, your patient demographics may explain the reason for a larger variation.  For example, if your patients are more elderly than the average, you may purchase more cancer medicines which have a higher reimbursement rate.  Or if you have a large student population, they may not be in need of higher cost reimbursement medicines resulting in lower Reimbursement Income. 

If you are still unsure, check with the surgery team that patient scripts are not being issued for administered items. Otherwise you may find that the local pharmacy is being paid a dispensing fee for your hard work.

Costs

The Costs line shows the costs incurred to generate the Income Potential results discussed above.

If costs are above the income, then there are some helpful reports to highlight how changes could be made. For example, the NHS Claimables Personal Catalogue Audit Report, found in the NHS Reimbursables section on the left of your homepage, will show you all items in Personal Catalogues waiting to be purchased that are not claimable and may result in a claims loss. In addition, it might be helpful to review the Personal Catalogues of those handling reimbursable orders, checking for stars (*) in the NHS Rate column. These stars indicate items that might be purchased at a higher profit level thereby avoid a loss or low profit.  And a discussion with the nursing/clinical team may also help highlight changes that can be made to improve profitability.

Please note that some items, such as sutures and some drugs, may not be reimbursable as the cost is reimbursed through a minor ops contract.

Saving success  

This line, akin to Saving Success in General Purchases, provides insight into items you might be purchasing at rates below the best available profit.

Non-Reimbursable Claimables

Items purchased that are not claimable, but may have a potential claimable alternative, are listed below this line. A maximum of five items is displayed, and for further details, including additional items not shown, clicking on the row name on the left opens the full report listing all potentially claimable items.

Note: While Model Surgery comparison figures are adjusted to match your surgery size based on patient numbers, it's essential to acknowledge potential differences in demographic makeup between your patient population and that of the Model Surgery. Please exercise caution however in interpreting the figures as Model Surgery figures are averaged across a diverse range of surgeries.  However they still can provide an important comparison indicator.

This section serves as an indicator of purchasing efficiency. The figures reveal the number of purchase orders issued in the month, along with the average value of each order, compared to your previous three months and the Model Surgery.

A consistently high number of purchase orders can be a concern, suggesting just-in-time ordering, unplanned purchases, or emergency buying. This often occurs when a staff member goes on holiday, when new staff members handle ordering or when a time-critical role, like a nurse with patient demands, adopts a just-in-time retail ordering approach. Suppliers favor this approach due to delivery charges on low order values, boosting their profits.

A large number of purchase orders typically indicates poor organisation and planning, with multiple orders placed from the same supplier, sometimes on the same or consecutive days. This results in staff being diverted from other tasks to manage orders, receive and store goods, and handle multiple delivery notes, which adds unnecessary time inefficiencies and financial costs.

In contrast, a well-organized operation issues purchase orders once or twice a month to each supplier, limiting them to primary and secondary suppliers in each product category. Ideally, one order per month is issued for office products, one or two for medical consumables, general medicines, cancer medicines, uniforms, IT, and cleaning supplies. Despite sounding challenging, well-organized surgeries successfully operate on this basis.

Purchase Orders Incurring a Delivery Charge

If delivery charges are incurred during the month, the number of occurrences is displayed in this section. Clicking on the row name redirects you to the My Purchase History report, where you can identify which orders incurred delivery charges. Look for a little red truck symbol, which indicates a delivery charge. Hovering over the red truck reveals the charge amount and the minimum order value required to avoid it.

For deeper insights, you can alter the My Purchase History report view by selecting the Transactions tab at the top of the table. This allows you to understand what other items were purchased on different orders around the same day. In this way you can see if it might have been possible to shift a purchase incurring a charge to another order or supplier.