In my last year of school I took myself off for three weeks of work experience in accounts departments: one week at a local hospital, one in a large local business and one in an accounting practice. I absolutely loved my week in practice and was lucky enough to get a job there straight after my A-levels. I studied AAT and then ACCA; I was caring for my mum, so it was fantastic to have ACCA’s day-release option.
I’ve spent almost all of my career in the healthcare team at Duncan & Toplis. I’ve grown the portfolio and we’re now a team of 16. Because healthcare is so niche, you really do need to be doing it 100% of the time to keep up with all the changes. While the expenditure is pretty standard, the income streams are constantly changing; no two years in the NHS are the same. I always describe healthcare accounting as Marmite: people either love it or hate it.
I feel so lucky to have a career I love so much. Every working day I am happy to get up knowing I am going to work with an amazing team and lovely clients. Some clients I have known for 30 years; they feel like family.
With flu vaccination funding, small errors can result in practices missing out
We work predominantly with GP practices, which are generally partnerships and sole traders. We also work with primary care networks, where GP practices work collaboratively to deliver services more efficiently with patient list sizes of over 30,000. We support federations, too, which tender for bigger contracts that are then delivered by practices. And we work with other healthcare businesses such as those delivering minor surgery, locum GPs, advanced nurse practitioners and pharmacies.
Within our ‘healthcare bubble’, we deliver a range of services – anything from bookkeeping, VAT and pension certificates to accounts and business services support. Every client is different, so we tailor our support, from occasional guidance through to providing wider finance management. We particularly look at clients’ income streams, making sure they are claiming funding for all of the services they deliver and that claims are being made correctly. A good example is flu vaccination funding, where small errors in coding or claims can result in practices missing out on income.
You need to be aware of what funding is available to be able to support primary care networks
Funding is the greatest challenge in healthcare; if we can help a struggling practice to be financially viable, it is really rewarding. Some funding flows through the primary care networks and federations, so you need to be aware of what is available. The government’s changes to employer national insurance contributions have had a significant impact on many practices. Because they are government funded, GP practices are unable to claim Employment Allowance, and the support they receive through contract payments is not directly linked to their actual salary costs. Instead, it is calculated using a formula based on weighted patient list size and a proportion of the contract sum, which means that changes can affect practices in very different ways.
I feel very privileged to have recently joined the board of the Association of Independent Specialist Medical Accountants. I look forward to collaborating with the other amazing board members to ensure that we continue to deliver the highest quality service to our healthcare clients and our teams.
Outside of work, I love attending ballet classes. I am also a qualified ballet teacher so occasionally get roped in to teach. My son asked to start golf lessons when he turned five and last year I decided to join him!
