Education And Debate


BMJ 1995; 311 doi: (Published 07 October 1995) Cite this as: BMJ 1995;311:938
  1. Andrew Millman,
  2. Nicholas Lee,
  3. Roy Sharma


    Many modern practice computer systems are equipped with a separate PC on which the practice manager can run various standard business programs. These workstations can be connected to the main system by using terminal emulation software that makes them behave like dumb terminals. This allows the practice manager to access the patient database as well. Good systems allow the manager to transfer data from the clinical system into the business programs for further analysis of activity and profitability. Many practices choose to put a laser printer in the practice manager's office so that professional looking letters, reports, notices, and leaflets can be produced.

    Business applications used in general practice

    • Word processor

    • Payroll program

    • Spreadsheet

    • Accounts package

    • Fundholding software

    • Online banking

    • Desktop publishing

    Managing the payroll

    All practice managers will be familiar with the problems of using paper based payroll systems. Tax and national insurance deductions have to be looked up in the correct tables, payslips have to be written out by hand, and returns to the inland revenue have to be calculated manually. The process is particularly laborious when a practice has more than about 10 employees and is liable to simple arithmetic errors.

    Computerised payroll systems greatly simplify the whole process and ensure a high degree of accuracy. In addition to automatically calculating tax and national insurance deductions, they are all capable of handling statutory sick pay and maternity leave payments. Furthermore, they print out tax returns approved by the inland revenue—P60s at the end of the year and P45s when employees leave. There are several excellent commercial systems, but practice managers often prefer to use systems written specifically for general practice (such as the Ferguson system) because they also produce the quarterly returns required by family health services authorities to calculate reimbursement of staff salaries.

    Ferguson GP software: a dedicated general practice payroll system.

    Monitoring cash flow

    All practices must …

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