AISMA in the news

AISMA members regularly write in the specialist GP and practice management publications, offering expert advice to doctors on the key issues of the day.

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Practice Index: 24-hour retirement for GP partners

August 14, 2020

24-hour retirement allows doctors to draw their NHS pension and then return to work. Writing for Practice Index, AISMA accountant James Gransby explains what this means for GP partners. Go to the Practice Index website to read the full article.

AISMA response to HM Treasury pension consultation

July 17, 2020

Commenting on yesterday’s announcement by HM Treasury of a consultation to seek views on proposals relating to the 2015 public service pension scheme reforms, Deborah Wood, chairman of the Association of Independent Specialist Medical Accountants (AISMA) said: “This is a positive development for doctors who are members of the 2015 NHS Pension Scheme. It follows a Court of Appeal judgment in December 2018 which ruled that the transitional protection arrangements under the scheme for doctors closer to retirement directly discriminate against some younger pension scheme members.

“The government is seeking views on two proposals outlined in the consultation. For doctors the permutations are numerous, with consequences for revised tax calculations on pension growth. We will be responding to the consultation in due course, once our pension experts have undertaken a thorough analysis of the proposals outlined.”

The consultation closes on 11 October. Documentation can be found here:

AISMA elects new chair

May 18, 2020

Deborah Wood has been elected chairman of the Association of Independent Specialist Medical Accountants (AISMA). She takes over from Bob Senior, who has led the Association since 2010, following his retirement earlier this year.

Ms Wood is a partner at MHA Moore and Smalley, an accountancy firm based in the North West, where she leads the specialist healthcare services department. James Gransby, a partner at the Bromley office of RSM UK Tax and Accounting, becomes AISMA’s vice chairman.

Paying tribute to Mr Senior, Ms Wood, who is a founder member of AISMA, said: “Through his leadership, Bob has been an excellent ambassador for AISMA and leaves the organisation in great shape. As chairman my aim is to continue developing the excellent relationships we have built with the BMA, HMRC, NHS Pensions, NHSE/I, and their respective bodies and representatives in Scotland, Wales and Northern Ireland.

“AISMA, which celebrates its 25th anniversary this year, represents the views of the thousands of GP practices advised by the Association’s network of members, who are all highly knowledgeable specialist accountants with much to contribute to ensure the long-term sustainability of general practice.”



Claiming for additional costs during Covid-19

May 11, 2020

To assist practices in claiming additional costs during the COVID-19 emergency, the BMA, in conjunction with AISMA, has prepared a template reimbursement claim form.

This can be used to claim the costs from Easter weekend, and any other additional costs that might arise which are agreed to be reimbursable.

The form covers both staff and non-staff costs and provides costings based on the national agreed reimbursements for Easter weekend. These are able to be amended if a local arrangement was more favourable.

Follow the link to download the form, which includes guidance for completion.

Pulse: NHS England advises GP practices not to furlough staff

May 4, 2020

An article published on the website reports advice from NHS England that GP practices should not use the government scheme to furlough staff. Deborah Wood, AISMA vice-chairman, talking to Pulse, said: “I am anticipating that NHS England / Improvement will recognise that there is an issue regarding additional costs for cover with regard to self-isolation and shielding, and will deal with this by way of additional reimbursement funding.

“Practices should therefore discuss this with their CCGs, and only consider the furlough scheme for staff who are funded from private income sources that have temporarily ceased.”

Follow the link to read the article in full.

AISMA responds to 2020 Budget announcement

March 11, 2020

Responding to the 2020 Budget presented by the Chancellor of the Exchequer today, Andrew Pow, executive board member of the Association of Independent Specialist Medical Accountants (AISMA) and partner, Mazars UK, said: “We welcome the news that the annual allowance threshold for the NHS Pension Scheme will be increased by £90,000 for the 2020/21 tax year. This means that any doctors earning up to £200,000 will now get the full annual allowance of £40,000.

“While this will not remove higher earners with growth above £40,000 from having a tax charge, it will mean most doctors will not have their annual allowance tapered down. It will be important that NHS pension records are kept up to date so that higher earning doctors can assess their tax position.

“The Chancellor also  announced that entrepreneurs’ relief on business capital gains will be reduced to £1 million from £10 million. This keeps the allowance in place for most GPs selling shares in their premises.

“The earlier announcement today of a reduction in interest rates by 0.5% will benefit doctors who have variable rate loans on their surgery borrowing.”


Updated GP contract – AISMA verdict: PCNs win but core contract loses out

February 7, 2020

Response to update to the GP contract agreement 2020/21 – 2023/24
Published by the BMA on 6 February 2020

Speaking on behalf of the Association of Independent Specialist Medical Accountants, Andrew Pow, partner at Mazars UK, said: “It is positive that NHS England has responded to the concerns raised around PCNs, particularly the removal of the requirement for practices to fund 30% of the cost of new roles and the assurances given around the risk of future employment liability. It is encouraging that PCNs can now actively chose to engage with community partners to employ staff on their behalf.

“There is now a clear active agenda to encourage resources to flow into primary care, although concerns remain around the availability of staff to take up new roles, particularly in areas that have struggled to recruit.”

Mr Pow continued: “It is encouraging to see financial support for new doctors taking up partnerships, although the new contract does not address the current retention issue. From April 2020 seniority income will cease and it is disappointing that there is no replacement of incentives for partners to remain as partners. Many partners will question the Locum Support Scheme as they already feel the balance in favour of being a locum over a partner is too strong.”

According to Mr Pow, the digital-first service initiative is positive, with many areas now adopting these services to improve patient access. “It is not entirely clear what funding will attach to this, but if it is funded in a similar way to PCN staff then it should be helpful”, he said.

While there is good news around premises investment, Mr Pow said issues remain about premises costs in leased premises which remain unresolved.

Mr Pow warned that, against a backdrop of constructive initiatives and support, there is very little additional funding going into the core GMS/PMS contracts, which will be expected to pick up the costs involved with improved employment provisions for staff. “Many practices are now beginning to feel the impact of the increases in the minimum wage flowing through all staff levels”, he said. “A rise in the global sum to £93.46 – an increase of £3.58 on the face of it – looks positive. However, practices will have lost all MPIG and seniority funding from April 2020 and have staff pay increases and new employment conditions to absorb. In many cases this may deliver a profit reduction year-on-year.”


AISMA responds to draft network specifications

January 15, 2020

The Association of Independent Specialist Medical Accountants (AISMA) has published its response to the draft service specifications for primary care networks (PCNs).

The response focuses on the financial implications of the specifications, which relate largely to service delivery.

Specific points raised by AISMA include how and when money from the Investment and Impact Fund will be made available and how practices will agree to split the ongoing employment costs for additional roles to be recruited. Only 70% of these costs will be reimbursed. Other questions include how the significant project management time involved in the ongoing development of service delivery will be funded.

Other points in the AISMA response consider VAT on supply of staff working across the networks; employment contracts and how they relate to NHS Pension scheme membership; sub-contracting and the off payroll IR35 regulations; and existing work commissioned by local CCGs.

Click here to download the response


Response from NHS England received 20 January:

Dear colleagues,

Many thanks for your considered response to our engagement on the draft Network DES service specifications. Please take this email as acknowledgement of receipt of your comments.

We would like to thank the large numbers of GPs, local medical committees (LMCs) and others who took the time to read and respond to the drafts. This is particularly true as the engagement period was necessarily shorter than planned, driven on one side by the timing of the general election and on the other by the need to give GPs good notice of their new contracts for April 2020.

This is the first time that we have shared draft GP contract materials for open engagement. Whatever the views of respondents about the specifications, we view such widespread engagement in a debate about how primary care networks (PCNs) develop as a positive change and a learning opportunity.

Having invited your feedback, we want to be absolutely clear that we have heard the views expressed. We will now carefully consider how to respond adequately, balancing the ambition to improve services for patients across England and the need to stabilise general practice, with what can realistically be delivered by PCNs in 2020/21.

A final version of the GP contract for 2020/21, informed by this engagement, will now be agreed as soon as possible through negotiations with the BMA GPC.

Yours faithfully,

Primary Care Strategy and NHS Contracts Group
NHS England and NHS Improvement


Action on 2019/20 pension tax impacts

November 22, 2019

NHS England has announced the action to be taken on 2019/20 pension tax impacts:

Responding to the announcement, Andrew Pow, executive board member of the Association of Independent Specialist Medical Accountants (AISMA), said:

“This announcement may go some way to persuading NHS doctors to work the shifts needed to meet demand over the winter. However, it is important that doctors understand that the proposals relate only to their 2019/20 tax payments. Those with large annual allowance tax charges for 2018/19 will still need to pay these in January 2020.

“It is uncertain if the payment of the 2019/20 tax on retirement may lead to a benefit in kind income tax charge. While positive news at first glance, the announcement contains significant uncertainties, including the potential for some form of down the line tax charge, which may not lead to the change in behaviour that is intended.

“Doctors who have already opted out of the NHS Pension Scheme to avoid the annual allowance tax charges should talk to a specialist financial adviser as soon as possible to consider the pros and cons of re-joining the scheme.”

Read how reported the announcement:

BMA demands legal guarantee over pension tax offer as accountants flag ‘uncertainties’

Years of service charge disputes ‘have undermined GP funding and recruitment’

November 21, 2019

AISMA accountant Andrew Pow tells that long-running disputes over service charges have cost GP practices in NHS-owned premises ‘huge amounts’ of time and money and left them unable to recruit or plan ahead. Read the full article.

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