James Gransby, executive board member of the Association of Independent Specialist Medical Accountants, said: “Traditional GP practices are under threat from ‘last man standing’ syndrome because older partners are retiring and younger doctors are unwilling to take on the financial burden of partnership.” He continued: “To survive practices will need to adapt to working at scale, rather than as isolated units. The number of mergers and super partnerships being formed is a direct result of funding being directed towards these new scaled models, while traditional GP practices will continue to see their financial sustainability falter.”

ENDS

A record number of delegates attended the 22nd annual conference of the Association of Independent Specialist Medical Accountants (AISMA) last week. 210 accountants gathered in Daventry to hear an authoritative panel of speakers share opinions and expert knowledge about the current state of UK primary care.

Keynote speaker Dr Arvind Madan, Director of Primary Care, NHS England, opened the conference with an address on current issues in general practice, focusing on the progress of the General Practice Forward View.

The Pulse General Practitioner of the Year Dr Jonathan Cope told the conference how he and his colleagues developed the successful Beacon Medical Group super partnership in Devon, with a candid appraisal of the pitfalls and opportunities they experienced during the process.

Dr Paul Wilding, GP partner at the Slaithwaite Health Centre in West Yorkshire, gave an account of how, when his practice was under threat of closure due to a 44% budget cut following a PMS review, patients and the local community rallied to defend the practice and see off the cuts.

Other speakers during the two-day conference included Professor Rob Darracott, who spoke about how pharmacists can work with general practice to bring benefits to both; and Ben Gowland of Ockham Healthcare, who discussed the threats and opportunities for GP practices from working at scale.

The two-day conference programme provided several technical financial training sessions for delegates on topics including premises, pensions, Making Tax Digital and off-payroll workers’ legislation.

Andrew Pow, AISMA Executive Board member and joint conference organiser, said: “At a time of significant change in general practice, the conference allowed AISMA members to get together, keep updated with current issues and share ideas from around the UK so that we are all better placed to advice our clients through possible changes.”

NHS England is investigating concerns raised by GPs about recent QOF calculations and aspiration payments. On Friday last week the CQRS Project team at NHS England wrote to GP practices in England telling them that it has identified discrepancies with some prevalence calculations which could impact on some practices’ achievement and as a result on final payment and aspiration.

Andrew Pow, executive board member of the Association of Independent Specialist Medical Accountants, said: “This is yet further evidence of increasing problems in the GP payment system which is letting practices down across the country.”

Mr Pow and his AISMA colleagues are advising practices to compare their QOF data with last year’s figures to anticipate whether they will be affected by the problems.

While NHS England has assured practices that they will all receive aspiration payments on time, it is advising practices and local commissioners to temporarily stop any QOF approval processes.

Practice managers must balance the earnings expectations of their GP partners with the money available in the practice bank account. AISMA accountant Chris Howe offers tips on how to manage this sometimes tricky dilemma. Click here to download and read the full article.

There’s more work ahead for practices hiring locums as new rules mean locum GPs operating through a limited company may face an extra tax charge. AISMA accountant James Gransby analyses the impact of new IR35 legislation which comes into effect in April 2017. Visit the Pulse website to read the article in full.

AISMA accountant Luke Bennett explains why practice managers need to take action now to plan for bigger tax bills for some of their GP partners in January 2018 when the impact of changes to the pension annual allowance will be felt for the first time. Read the article in the March issue of Practice Management or click here to download the full article

‎James Gransby, a member of the AISMA Executive Board and head of healthcare at MHA MacIntyre Hudson, said: “For GPs partners already under financial pressure from high rates of tax and suffering from attacks on their pensions in recent years, the news that their main rate of class 4 national insurance contributions will rise by 2% over the next two years from 9% to 11% will be a bitter pill to swallow. Not least because this all but wipes out the promised income increases recently announced in the 2017/18 GP contract review.”

He added: “‎For locums the fall in the tax free dividend allowance from £5,000 to £2,000 per year from April 2018 will be a blow for those operating through a limited company and follows hot on the heels of a 7.5% increase to dividend rates that they are already reeling from. The tax cost of this change for a husband and wife owning shares in a limited company who are both higher rate taxpayers will be £1,950 per year, and more for additional rate taxpayers.”

GP practices could be caught up in new tax legislation aimed at stopping contractors using companies to pay lower tax and national insurance contributions, medical accountants have warned. Read AISMA chairman Bob Senior comments on the Pulse website. Click here to read the full article.

Accountants are currently receiving a ‘mailbox full’ message when they attempt to submit pension certificates via the online system provided by primary care support provider Capita. The deadline set by Capita for the receipt of certificates is Tuesday 28 February. This is to ensure certificates are processed by the end of the tax year on 5 April.

Andrew Pow, speaking on behalf of the Association of Independent Specialist Medical Accountants (AISMA), said: “AISMA members across England are reporting issues with Capita’s system. At this stage the only solution is for the certificates to be submitted by courier or recorded delivery. It’s very frustrating and to have the system fail just before the submission deadline is unacceptable.”

AISMA members are reporting that they are unable to establish which certificates have been safely received through the online system and which have failed to arrive.

Estimates of pensionable pay for 2017/18 also have to be submitted via the same online system by the same deadline. Mr Pow said: “If Capita doesn’t pick up these estimates then pension contributions for the next financial year will be calculated on the wrong basis. For many GPs this will mean contributions will be too low and there will be a massive adjustment to pay when balancing payments are due. Equally, other GPs will be paying too much and practice cashflow could be affected.”

The national shortage of GPs will lead to flatlining take-home pay for many GP partners from April, accountants have warned. In a Pulse article headlined ‘GP partners will struggle to increase take-home pay by 1%, predict accountants‘ several AISMA members offer their views on why a pay increase for GP partners as a result of the 2017/18 GP contract changes is unlikely.