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How We Work With GP Practices and Medical Professionals

We've developed a specialist knowledge of NHS professionals, especially Doctors and GP practices. Paul McGrath, our Accounts Manager, explains why practices approach us in the first place, and what they can expect when we work with them.

GP practices usually approach us for one of two reasons. Either the service they've been getting hasn't been as good as they would like, or they think they are overpaying for what they are getting.

Often it's the GP's Practice Manager who makes the initial approach to us, and after an initial conversation with us we will be invited to a partners meeting. This is our opportunity to investigate their practice setup, their ethos, values and goals. Like most partnerships, GP Practices can vary widely in the approach that they take, as well as their level of business and management expertise.

Having met the partners as group, we will then meet with each partner individually to discuss their own personal goals and values, and their long term aims. This is important because it helps us to understand each partner's own unique situation, and how this fits in to the practice as a whole.

We will prepare individual tax computations for each of the partners. GP's tend to have multiple streams of income, and it's important to understand what tax planning has been done, if any, before we can begin to recommend beneficial changes. It may be appropriate to consider limited company structures or other vehicles to channel these various income streams. The GP's future pension expectations and retirement plans are an important factor in these projections, so we make sure we have these details for each partner as well.

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This understanding can give rise to a range of recommended strategies. For example it may be appropriate to reduce the amount of chargeable work that falls under the pensionable element of a GP's earnings in favour of a limited company receipt. This can have implications for income tax and national insurance payments resulting in significant savings, whilst retaining the benefits and protections of the NHS pension and employment package.

The ability to defer tax events using a limited company offers the opportunity to take remuneration earned today at a more favourable time, making this a strategy that is of particular interest to GPs working in the years up to retirement.

We will also carry out a detailed analysis of the NHS income received by the practice to enable the partners to make decisions based on both clinical and financial grounds. Management accounts describing the current and potential financial benefits or drawbacks of changes of practice emphasis can be evaluated using model criteria.

All practices receive huge amounts of data each month from the NHS and elsewhere, but our experience has been that many practices don't make full use of this data which is often sitting in a box or is spread around different files or datasets inside the practice somewhere. This is a huge missed opportunity, and one that we want to make sure that partners are making full use of.

In our work we meet many GPs, and attitudes vary from person to person as well as from practice to practice. Some GPs are focused on delivering clinical priorities above all and have little interest in wading through spreadsheets, whilst others are very entrepreneurial and are vitally interested in maximising the profit and business potential of their practice. However all GPs are eager to know how they can become more efficient, deliver better and wider choices for their patients, and create more service opportunities.

What we've been able to do is to gather the data that is already sitting in the GP's offices and harness it into a set of templates that, in a visually appealing way, enables partners to get a grasp on the business that they run in a way that they often haven't experienced before. This can lead to some revelatory insights that can result in hugely significant changes in practice structures and areas of clinical focus.

Very much related to this is our analysis of individual partners tax accounts and personal goals, which I believe makes us quite unusual as an accountancy firm. It's also a real benefit in being able to call on specialist advice on investments and financial planning as well as legal implications for individuals legacy planning.

Undoubtedly the biggest area of interest for GPs is pension planning, and many remain unaware of the important interaction between the individual GP's remuneration structure and their retirement plans, and the various choices and strategies available to them. This is a hugely complex area and sound advice from a highly competent adviser is essential to make sure that partners are making the most from their options and avoiding the bear traps that can snare the unwary.

I've focused here on GPs but we have a lot of experience in working with a range of medical professionals and consultants, dentists, osteopaths and similar professionals, all of whom have their own specific ways of operating and practice objectives, but for whom we would follow a similar approach.

All of our clients are different and understanding these differences are the first and most important step in our process. I think we can confidently say that we have been able to help transform some of our clients businesses for the better, as well as deliver a lot more certainty and control to the individuals within them.

Almost all of our new relationships begin with a simple chat. If you like the sound of our approach, you're welcome to call me at any time, or drop me a line at and I'll get back to you.

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