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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Response to BMA ‘perfect pensions storm’ letter to the Chancellor of the Exchequer

April 25, 2019

The Association wrote to the Treasury in 2016 to highlight the significant issues surrounding the recruitment and retention of senior health professionals within the NHS, driven in part by the changes to the taxation of pension savings introduced in the 2015 Summer Budget.

Since then, AISMA has written a series of letters to the Secretary of State for Health and Social Care and the Chancellor of the Exchequer reiterating these concerns.

AISMA’s latest letter to the Chancellor, sent last week, asked the government to urgently review the pensions savings regime with reference to the Annual Allowance, and set out three suggestions:

1 – Changes could take the form of raising the Annual Allowance threshold to a position where it removes the majority of key NHS workers from this charge. This can be justified on the basis that pension growth for higher earners is now effectively capped by the reduced Lifetime Allowance. The Lifetime Allowance rules lead to a tax charge where benefits exceed the maximum allowed. This allowance has reduced over the years and therefore automatically caps tax relief on larger pensions. At the very least the tapering rules need an overhaul as they are causing “cliff edges” where additional tax is higher than earnings

2 – The Government could consider further changes to the NHS pension scheme to allow qualified GPs and hospital consultants to cap their pensionable earnings to give them back control over the pension growth they have in any one year. This is more difficult to achieve without a significant overhaul of the pension scheme. Simply allowing the option to say reduce contributions and benefits to 50% as proposed in the latest GP contract will in our view not have the desired impact. Changes need to be more radical than this.

3 – Allow the measurement of the Annual Allowance to be linked directly to combined employee and employer contributions, rather than on the benefit accrual method that HMRC adopt, on the basis that Public Sector schemes now have to be self-funding. This would reduce the burden of administration on the NHS pension scheme and allow tax payers to complete tax returns more accurately. This is the simplest option which would achieve quick results and allows professionals to better control their growth.

State-backed indemnity ‘won’t bring major GP pay rise’ in 2019/20

March 27, 2019 reports today on the new state-backed indemnity scheme. “Significant savings under state-backed indemnity ‘will not deliver massive pay rises’ to GPs as £60m is stripped from core pay, and staff and inflationary costs eat into savings, accountants have warned.” Click on the link to read comments from AISMA Executive Board member Andrew Pow.

DHSC response to pension scheme consultation

March 5, 2019

Commenting on the publication of the Department of Health and Social Care’s NHS pensions scheme consultation response, Deborah Wood, Vice Chairman, the Association of Independent Specialist Medical Accountants, said:

“Despite the widely-held concerns raised during the consultation about the financial impact of the 6.3% increase in employer pension contributions, the increased rate of 20.6%, plus a 0.08% administration charge, will be implemented from 1 April 2019.

“For 2019/20 a transitional approach is being applied so that 6.3% will be paid directly by NHS England to the pension scheme. Therefore, from a cashflow point of view there will be no immediate effect on GP practices. In 2020/21 GP practices will pay the full 20.68% but should have received funding to cover the extra cost.

“However, the tax impact on individual GPs, who are deemed to pay their own employer contribution for tax purposes, needs to be understood. If HMRC takes into account the additional 6.3% when determining exposure to the pension annual allowance and subsequent tax charges, then even more GPs could find themselves affected by annual allowance tax charges on a regular basis.

“It will be essential for GP practices to see a clear correlation in their funding allocations for the additional 6.3% being added to their budgets out of which they will then have to make the additional employer contributions on a regular monthly basis from April 2020 onwards.”

Read a full report by Nick Bostock at

What should your accountant do for you?

February 21, 2019

In the first of a new series of articles for GP practice management information hub Practice Index, AISMA board member James Gransby, a partner at MHA MacIntyre Hudson Maidstone, explains what your accountant should do for you – without being asked! From commenting on new developments that will affect your practice, to financial benchmarking and spotting any missed claims, the article is a useful checklist when comparing the service your own accountant is providing.  Visit the Practice Index website to read the article in full.

Global sum increase is a ‘step in the right direction’, say medical accountants

February 21, 2019

AISMA Chairman Bob Senior and board member Andrew Pow give their response to Pulse following the 92p increase in the global sum. ‘Although 92p does not sound like a big deal, the increase should be seen in the context of the changes to indemnity and the addition of the £1.76 per patient for joining a network.’ Click here to read the article in full.

AISMA responds to GP contract agreement for 2019/20

January 31, 2019

Commenting on the GP contract agreement for 2019/20, Andrew Pow, board member of the Association of Independent Specialist Medical Accountants, said:

‘There is much to be welcomed in the new contract with almost £1bn extra in core funding for practices in England across five years. There are, however, some issues that we are viewing more cautiously, notably the new state-backed indemnity scheme.

‘The indemnity scheme will be funded by a one-off permanent deduction from the global sum and will cover all GPs and staff, including locum doctors. Since locums will no longer need to pay for their own indemnity cover they have been asked to consider their rates. If locum rates do not reflect the new indemnity arrangement GP partners will be pick up the cost twice; once through the reduction in the global sum and again through the locum fee. AISMA raised this during discussions with NHS England and the BMA. Urgent guidance is required on setting responsible locum fees.

‘Also needed will be guidance on the legal and pension structures of Primary Care Networks so that it is clear where responsibility for contracting and employment rests.’


Andrew Pow is available for further comments on 07957 585808

NHS pension scheme consultation: AISMA response

January 28, 2019

Members of AISMA have a deep knowledge of the NHS Pension scheme, specifically relating to the taxation of pension savings. AISMA’s view is that the proposed changes to scheme regulations 2019 as outlined in the consultation document are likely to result in more members of the pension scheme ceasing contributions which could cause the scheme to have further funding issues and a knock-on effect to how the Government affords the obligations payable to existing members in retirement. The reasons for this are complex and highlighted in the Association’s response.

Click here to read the full response.

Death announced of John Dean, former AISMA chair

January 25, 2019

Members of the Association of Independent Specialist Medical Accountants are sad to hear of the death of John Dean, one of the Association’s founder members. A well-known writer and lecturer, Mr Dean was the author of one of the first books to be written about the financial management of GP practices.

Seeing the need for a network of specialist medical accountants to help GPs and other doctors to manage their finances, he was a driving force in the forming of the Association and became its first Chairman in 1995.

The AISMA Executive Board would like to offer their sympathies, on behalf of all AISMA members, to Mr Dean’s family and friends.

Proposed increase in NHS pension scheme contribution rate for employers

December 19, 2018

Responding to the proposed increase in the NHS pension contribution rate for employers, announced yesterday by the Department of Health and Social Care, Andrew Pow, representing the Association of Independent Specialist Medical Accountants, said: “The current rate for employer contributions is 14.38%. An increase to 20.6% will represent an additional £4,665 for GP partners with pensionable earnings of £75,000, £6,220 for those earning £100,000 and an additional £7,775 for GPs with pensionable earnings of £125,000, as well as increased costs in employing staff. This will have a severe impact on practice finances unless additional funding is available. To make it even worse, individual higher earning GPs in the 2015 pension scheme could also see an increase in their annual allowance tax charge.”

A consultation was announced  on18 December 2018, and can be seen on the at: ‘our consultations’). It will run until Monday 28 January.

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