Specialist PCN Accountants for Host Practices, Clinical Directors & Networks
A Primary Care Network sits in an awkward financial space. It is not quite a company, not quite a partnership, and yet it receives millions in ARRS reimbursement, core funding, capacity and access payments and enhanced service income that must be accounted for, allocated fairly between member practices and evidenced to the commissioner. Our PCN accountants build the reporting that keeps host practices safe, member practices confident and clinical directors out of the spreadsheet.
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We work with PCNs at every stage of maturity, from newly formed networks still using a host practice bank account to established networks operating through their own limited company or company limited by guarantee.
Clear separation of PCN funds from core practice income, ring-fenced reporting, and protection for the host practice against being taxed on money it merely holds.
Statutory accounts, corporation tax, VAT reviews, payroll for directly employed ARRS staff and clean intercompany recharges to member practices.
Accounting where staff and funding sit with a federation or a lead provider, with transparent allocation statements for every participating practice.
Management accounts, budget forecasting, ARRS headroom tracking and board-ready reporting so decisions are made on current numbers, not last quarter’s guesses.
Every service below is built around the way PCN money actually moves — monthly ARRS claims, quarterly reconciliations, workforce plans and member practice allocations — not around a generic small business template.
Annual accounts and income and expenditure statements by funding stream, with a full allocation schedule showing what each member practice has received and why.
Monthly tracking of ARRS reimbursement against actual employment costs, headroom monitoring and early warning where claims will exceed or undershoot the maxima.
RTI payroll for directly employed network staff, NHS pension and auto-enrolment handled correctly, plus advice on employed, seconded and subcontracted staffing models.
Whether to incorporate, how to hold funds, VAT treatment of staff supplies and recharges between practices, and the corporation tax consequences of each option.
Monthly or quarterly management information, cash-flow forecasts and variance analysis, presented so a board meeting takes minutes rather than hours.
Networks carry financial risks that no other NHS body quite shares: money held on behalf of others, staff employed by one practice for the benefit of several, and funding rules that change annually. These are the issues we fix:
PCN income mixed into core practice accounts at the host
ARRS claims that do not match actual employment costs
Member practices unsure what they are entitled to receive
VAT exposure on staff supplied between practices
Unclear liability if the network is unincorporated
Clinical director payments treated inconsistently
No management information until the year is already over
Network finances take specialist knowledge. We already understand the Network Contract DES, ARRS reimbursement mechanics and why host practices need their PCN money ring-fenced. Here is what you get:
PCN funds recorded as held on behalf of the network, so core practice profit and partner tax are never overstated.
Live monitoring of reimbursement against actual staff costs, so nothing is left unclaimed and nothing is overclaimed.
Clear allocation statements every practice can understand, which removes the single biggest source of friction between network members.
Practical guidance on incorporation, staff supply arrangements and the VAT consequences of how you share people between practices.
Reporting designed for clinical directors and business managers, not for accountants, delivered on a fixed timetable.
One agreed annual fee for the network, quoted up front, with unlimited telephone and email support included.
Clinical directors were appointed to improve care, not to reconcile reimbursement schedules. Our three-step process gets the network set up quickly and keeps the board informed all year:
We begin by getting to know your practice and understanding your unique needs. This step ensures we have a clear picture of your operations and your goals.
Based on our initial discussion, we create a personalised plan designed specifically for you. The aim is to keep everything organised and easy to follow. You can rest assured that your numbers are being handled with expert precision.
From there, we take care of the ongoing work and keep you updated with reports. You’ll always know what’s happening, and we’re always here to answer your questions, ensuring you have a clear picture of your financial health at all times.
Chartered, experienced and genuinely specialised in healthcare. Here is what working with us looks like in practice:
We use Xero, Quickbooks, Sage & many other online software.
Meet, call or email the same qualified accountant who knows your practice and your pension position.
Free telephone & email support
throughout the year.
Our team have over 100 years of combined experienced.
Never Miss any deadline with our automated email reminders.
We’re an ICAEW, ACCA & AAT accredited Firm.
Take a back seat and let our specialist healthcare accountants handle everything. Moving the network’s accounting to us is straightforward and does not disrupt your ARRS claims:
Reach out to us, and we’ll discuss your needs and how we can help your healthcare practice thrive.
We’ll send over a simple letter to formalise our partnership and get everything in motion.
If you're switching, we’ll take care of contacting your previous accountants to make the transition smooth.
From there, sit back and relax. We’ll manage your accounts, taxes, and everything in between, keeping your practice running smoothly.
Network funding received by a host practice is generally held on behalf of the network rather than earned by the practice. It should be recorded through a separate ledger or bank account and shown as a liability to the network to the extent it has not been spent, so that partner profit and tax are not inflated by money that was never theirs.
No. Many networks operate perfectly well through a host practice or a flat practice agreement. Incorporation becomes attractive where the network employs significant numbers of staff directly, wants to limit partner liability, or delivers services beyond the Network Contract DES. We model both options against your circumstances.
ARRS reimburses actual employment costs of eligible roles up to a maximum. The reimbursement should be matched against the corresponding salary, employer National Insurance and pension cost in the same period. Where claims and costs drift apart, either the network is out of pocket or a repayment is building up.
It can be. Medical services are usually exempt, but supplying staff is often a standard rated supply of staff rather than an exempt supply of healthcare. There are specific concessions and case law in this area, and the answer depends on your exact contractual arrangements, so it should be reviewed rather than assumed.
It depends on whether the clinical director is paid through a practice, employed directly by the network, or engaged through their own company. Each route has different income tax, National Insurance and pension consequences. We set out the options and document whichever one you adopt.
In an unincorporated network the participating practices, and ultimately their partners, generally carry the liability. That risk is one of the main reasons networks look at incorporation, and it is worth quantifying before the network takes on long-term staff commitments.
Yes. We prepare a clear statement for each practice showing funding received by the network, costs incurred, the allocation basis used and the amount attributable to that practice. This is usually the fastest way to end disputes between members.
Yes. We operate RTI payroll for network staff, apply the correct NHS pension tiers, deal with auto-enrolment for staff outside the scheme, and reconcile payroll cost to the ARRS claim every month.
Monthly is ideal for larger networks and quarterly is normally sufficient for smaller ones. The important thing is that the board sees ARRS headroom, staffing commitments and cash position early enough to act, rather than discovering a problem after the financial year has closed.
We quote one fixed annual fee based on the number of member practices, whether the network is incorporated and whether payroll and management accounts are included. The quote is provided before any work begins.
Yes, and often that is the cleanest arrangement. We can act for the network while each practice keeps its own accountant, sharing the allocation information both sides need.
Yes. We are based in Morden, South London and act for networks across England using secure cloud accounting, video meetings and electronic signatures.
Please double-check the figures before you act. The tax, NHS pension and accounting information on this page is general guidance for UK doctors and healthcare professionals, not personal advice. Tax rates, allowances, thresholds and NHS pension rules change regularly, including at each Budget and at the start of every tax year on 6 April. PCN DES specifications, ARRS reimbursement caps and network funding are revised every financial year. Always cross-check any rates or figures against HMRC, the NHS Business Services Authority and the latest Budget announcements, or speak to one of our qualified accountants before acting. CruseBurke cannot accept liability for decisions made solely on the basis of this page. Last reviewed: August 2026.
