Focus on: our Healthcare team and what it can do for you

At Monahans, our dedicated team of specialist medical accountants work daily with a range of practices and individual healthcare professionals. One of their driving motivations is to empower the profession to become more business focused as it strives to meet the challenges that the NHS financial landscape demands.

The team delivers a broad spectrum of services, all of which you can view here. But what are the challenges that the healthcare profession is facing and how is Monahans helping practices to take control of their finances?

What is your key focus at the moment?
We are increasingly taking on medical practices as clients, many of whom are joining together to form Primary Care Networks (PCN). These networks are becoming more complex and are experiencing more money being fed through them than ever before. As income ramps up, so does the importance of ensuring the accounting is correct.

Deferring income is one of the major stumbling blocks. Practices and PCNs receive income, and HMRC would expect this to recognised in those accounts so that tax can be paid on it. But some PCNs are being advised that they can push income forwards – known as ‘deferring’.

The problem is that HMRC has given specific criteria and legislation about when this is allowed, and we are seeing accountants who are deferring when they shouldn't be. The increase in the flow of income over the past year has made it all the more crucial to deal with this correctly and follow the strict rules and regulations.

If clients do come to us with these issues, our team will liaise with the accountants to understand the reasoning behind the decisions made and then work with them to ensure that HMRC’s rules are being adhered to.

Our key message to clients is to avoid assumptions that your accountant is handling everything. Instead we want to help people to have a solid grasp of their finances and an awareness of the options available to them. We encourage our clients to think about healthcare practices like a commercial business, with income, expenses, and profit. PCNs can be a strange beast because they are essentially large accumulations of money floating in the ether. This can give people the impression that these funds can be used however they want but, in reality, this money simply needs to be treated as profit in the classical sense.

What challenges did your clients face in 2022?
From our conversations with clients, we are sensing increasing amounts of pressure on everyone, whether that be GPs, practice managers or just finance staff in general. Everyone is being asked to do more with less time and resources. Profitability may be positive but from a qualitative and a work-life perspective, the workload is impacting healthcare professionals, causing some to choose part time hours or to reduce their commitments to the practice as they try to regain some balance in their life.

What are you helping clients with currently?
Outside of our usual services we’ve also been focusing time on ‘the Xero Project’ – essentially working with Xero's accounting software to create bespoke reports which are designed to give practices better management information.

By delivering quarterly management reporting, practices gain useful real-time information, so that they don’t get caught off-guard at the end of the year by any profit surprises. And with Making Tax Digital (MTD) emerging on the horizon, stepping-stones like this will help to put teams in the best stance to benefit from digitisation and inform their understanding of the business.

The value of using Monahans for your management reporting isn’t just being HMRC compliant. We will also give you better information to run your business and relieve the pressure on your practice manager who can lean on us for support with other tasks such as bookkeeping.

We also put a lot of emphasis on the consultative side of our work. Practices facing complex decisions such as whether to structure themselves differently, pursue a new partnership or become incorporated, are encouraged to use us as a sounding board and advice resource.

Why should clients choose Monahans?
Our team focuses on providing exceptional service to a smaller number of practices, rather than taking on more than we have capacity for. We want to forge sustainable growth and strive to achieve quality over quantity.

Our team never over-promises or guarantees to work miracles as there are many shifting factors at play, but we are passionate about supporting our clients’ needs and easing the pressure already on their shoulders. We are happy to go above and beyond to do so.

We are experts in the field and provide grounded advice that is tailored to a practice’s priorities, rather than assuming they want the same accountancy service everyone else does. This could mean offering flexible support when needed, such as providing bookkeeping support for six months, rather than pressuring practices to take on a long-term commitment.

For practice managers trying to navigate challenges within the NHS, having someone to guide them through the process and chase people when necessary is invaluable. Our clients are not finance professionals and have other priorities, so we can help to free up their precious time and give real-life context to the numbers which they can use to make informed decisions.

What’s on the horizon for healthcare accounting?
The implications of any changes in NHS salaries will need to be considered this year and we are expecting to see increasing numbers of GPs liable for the additional rate as well as some paying more tax on their pension growth. No matter what changes 2023 may bring we will be there alongside you, supporting you in understanding the potential impacts and how you may be able to mitigate them.

If you would like to find out more about the peace of mind that Monahan’s Healthcare services can offer your business – get in touch with the team today.

Iwona Silverio