Specialist Accountants for GP Federations
A GP federation is a genuine trading business wearing an NHS badge. You bid for contracts, employ clinicians, subcontract to member practices, carry VAT risk on staff supply, and answer to shareholder practices who all want to know where the money went. Our accountants for healthcare federations produce statutory accounts, contract-level profitability, member practice statements and the board reporting that keeps directors informed and commissioners satisfied.
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We act for at-scale primary care providers of every shape, from small federations formed by a handful of practices to large community interest companies delivering multiple commissioned services.
Statutory accounts, corporation tax, contract-by-contract profitability and shareholder practice reporting for companies limited by shares or by guarantee.
CIC reporting requirements, asset lock considerations, grant and contract income recognition, and reserves policies that satisfy commissioners.
Rota costing, session and shift payroll, subcontractor payments to practices and clinicians, and pricing models that make a service viable before you bid.
Employment of ARRS and network staff on behalf of PCNs, recharge mechanics, VAT on staff supply and clean reconciliation back to network funding.
Every service below is built for organisations delivering NHS contracts at scale, where margins are thin, contracts are short and evidence matters.
Companies House and HMRC filings prepared on time, with accounting policies suited to NHS contract income, deferred income and provisions for clawback.
Income and cost analysed by contract and service line, so the board can see which services fund the organisation and which quietly drain it.
RTI payroll for salaried and sessional staff, NHS pension where applicable, and off-payroll status reviews for clinicians engaged through their own companies.
Reviews of where healthcare exemption ends and standard rated staff supply begins, partial exemption calculations and practical restructuring where VAT is being lost.
Monthly management accounts, cash-flow forecasting, reserves monitoring and shareholder practice statements presented in board-ready format.
At-scale providers carry commercial risk on NHS margins. Contracts are short, staff costs are fixed and a VAT error can consume an entire year’s surplus. These are the issues we fix:
VAT on staff supplied to practices and networks
Contracts won at a price that never covered on-costs
Deferred income and clawback provisions handled inconsistently
Subcontracted clinicians and off-payroll status risk
Shareholder practices unclear on surpluses and distributions
Thin reserves with no forecast of the cliff edge
Board packs that arrive too late to change anything
At-scale primary care needs an accountant who understands both NHS contracting and ordinary company law. Our team works across both. Here is what you get:
Profitability by contract and service line, so bidding decisions and exit decisions are based on evidence rather than optimism.
Practical reviews of staff supply, recharges and partial exemption, with restructuring options where VAT is eroding your margin.
Status reviews for sessional clinicians engaged through personal companies, with documented determinations that stand up to scrutiny.
Clear statements for member practices covering income, costs, surpluses and any distribution, which keeps the membership onside.
Management accounts delivered on a fixed timetable, so the board acts on current numbers instead of history.
An agreed annual fee covering accounts, tax, payroll and reporting, quoted up front with unlimited support included.
Federation boards are made up of busy clinicians and managers. Our three-step process gets the organisation set up quickly and keeps directors 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 your federation’s accounting to us is straightforward and does not interrupt contract delivery:
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.
A GP federation is normally a limited company owned by member practices, so it pays corporation tax on its taxable profits in the ordinary way. Being an NHS provider gives no automatic tax exemption. Where the federation is a community interest company or has charitable elements, the position is different and needs specific advice.
Often yes. Providing healthcare is exempt, but supplying staff who work under another organisation’s direction is generally a standard rated supply of staff. Whether your arrangement is a supply of services or a supply of staff depends on the contracts and the practical control of the workers, so it should be documented carefully.
Income should be recognised as the service is delivered, with any amount received but not yet earned carried forward as deferred income. Where a contract carries performance conditions or clawback, a provision may also be needed. Getting this wrong flatters early years and creates a shock later.
If a clinician provides services through their own limited company and the federation is a medium or large organisation, the federation must determine status and issue a determination. Where the engagement is inside the off-payroll rules, tax and National Insurance must be deducted. We review contracts and working practices and document the conclusion.
Yes, and many do. The federation employs the staff, claims or receives the reimbursement through the network, and recharges the network or its practices. The employment costs, reimbursement and any VAT on the recharge all need to line up, which is precisely where problems usually appear.
Options include dividends to shareholder practices, reduced subcontract pricing, reinvestment in services or building reserves. Each has different tax consequences for the practices and different governance implications. We model the options and set out the effect on partner tax before the board decides.
There is no fixed rule, but organisations delivering short-term NHS contracts with substantial fixed staff costs usually need enough free reserves to cover redundancy and wind-down obligations if a major contract is lost. We help boards set and monitor an explicit reserves policy.
Yes. We produce monthly or quarterly management accounts with contract-level analysis, cash-flow forecasts, reserves monitoring and commentary written for a board rather than for accountants.
Yes. We run RTI payroll for salaried, sessional and bank staff, handle NHS pension where the organisation is a direction or determination employer, and manage auto-enrolment for everyone else.
We quote a fixed annual fee based on turnover, the number of contracts and whether payroll, VAT and management accounts are included. The quote is agreed before any work begins so there are no hourly surprises.
We can help you cost it. We build the financial model behind the bid, including on-costs, pension, cover, overheads and a realistic margin, so you know before submission whether the price is viable.
Yes. We are based in Morden, South London and act for at-scale primary care providers across England using secure cloud accounting, video meetings and electronic signatures.
