When AISMA members met for their annual conference this year we were treated to talks covering commissioning, practice management, tax, pensions and all matters financial for GPs.
Author: Andrew Pow*, AISMA committee member.
The event highlighted more than ever the huge range of issues in general practice now as well as the diversification we are starting to see as the devolved nations approach issues differently.
Demand on general practice has been higher than ever but that is not being met with an increase in resource at practice level to deal with it.
Below inflation contract rises will leave practices struggling.
Staff recruitment and retention is no longer just a GP issue. It now covers all staff levels because the NHS has failed to match pay increments seen in other sectors of the economy.
But unlike airline companies, GPs cannot cancel services when staff numbers fall.
Primary Care Network (PCN) investment continues to increase in England but dissatisfaction with these groups is growing as they begin to deviate from the original intention. VAT is a significant risk for many PCNs.
If organisations do not get their compliance in order then there will be tax problems. Our legal colleagues at the conference pointed to other risks inherent within PCNs and we all concluded that a more robust framework is now needed.
In the background we had the Fuller report, setting out a stocktake of general practice in England. It puts PCNs and not practices at the heart of the new primary care framework as part of the new Integrated Care Systems.
The next two years will be challenging to see how general practice reacts.
In Scotland we still await development with contracts for general practice. It is a case of wait and see and in Northern Ireland too, as a continued political impasse means everything is put on hold. Arguably only Wales currently has a clearer future.
Pension issues continue to be a problem. Our conference heard from PCSE about updates to its online system – but significant frustrations remain for both practices and accountants.
A recent response by Health Minister Edward Argar in Parliament confirmed that up to 20,000 GPs currently do not have their pension records updated.
This is a problem for doctors looking to retire soon and for a substantial number of others waiting for information on their pension growth so their pension annual allowance tax charges can be assessed.
Another immediate concern also relates to the inflation impact on the pensions annual allowance for GPs. The legislation as it stands was not written in the context of the sharply rising inflation we now have.
GPs who have never been impacted by this tax charge before could well get caught by it in 2022-23. AISMA drew this to the attention of HM Treasury in a letter sent on 25 May 2022. The Treasury’s response, received on 4 July, did not address all the points raised by AISMA. It is disappointing that the government is failing to look at this important issue with reference to its impact on the workforce.
With significant challenges now it is important for practices to look at how they operate. We heard at the conference about how practice systems can be altered to meet demand using digital access for patients, telephone triage and changes in the standard working day to help staff work more flexibly.
We also heard from GPs and pensions experts about how doctors need to educate themselves about finance – not to replace advisors but to take control of their own position.
Dispensing claims experts revealed how to improve financial returns from drugs income while lawyers, bank and property experts demonstrated how they can help deal with the current problems of general practice.
2022 is perhaps the most challenging period ever for general practice. But AISMA accountants are well placed to assist their clients in managing the issues that lie ahead.
This article first appeared in the Summer 2022 issue of AISMA Doctor Newsline.