How to… find the best practice accountant

Use a specialist firm for relevant financial advice, suggests Carole Slingsby The best practice accountants do more than produce the annual accounts and handle the partners' tax affairs.

Their knowledge of NHS general practice and the expert advice they provide can be instrumental in keeping the practice's finances healthy and helping the GPs plan ahead.

Specialist accountants

This expertise is only available from firms that specialise in GP practices. You can expect to pay a specialist firm more than the local high street accountant, but as they compete with each other for GPs' business, their fees should be affordable.

The 22 firms on page 46 told us about their services but there are many other medical specialist firms too. You should not regard the fact that a firm has been included as a recommendation.

Size of accounting firm

It is not the size of the medical specialist accountants that matters most but the quality of service. Some of the larger firms have a division specialising in GPs but also have clients from many other business sectors. Others with hundreds of GP practice clients deal mainly with the medical sector and other healthcare-related businesses such as pharmacy and dentists. Some small firms may be entirely geared towards GP clients.

Wide knowledge

A specialist accountant should have a thorough knowledge of how practices are funded (from the global sum to the quality framework), be familiar with the GMS statement of financial entitlements, PMS contracts and the NHS pension scheme. The firm should also be up to speed on practice based commissioning (PBC), alternative provider medical services contracts and the developing primary care market. The firm needs to be able to deal competently and promptly with all taxation matters and with GPs' superannuation.

Personal service

Practices need a personal service, dealing with one particular accountant and their same support team at the firm and not be passed between different accountants.

The annual accounts should be prepared on time and the accountant should visit the practice to discuss them with the partners.

The accountant should produce a commentary on the figures. The firm should be prepared to deal promptly with routine queries, telephone calls and emails and advise on bookkeeping, cash flow and monitoring partners' drawings without making additional charges. Performance statistics (which small firms cannot provide) comparing different client practices' income and profits are also useful.

Selecting a firm

 It makes sense to shop around. Invite two or three firms to visit the practice to talk about their services. Before their visit, the practice could send them draft accounts figures to test their knowledge. One of the best ways to find a good firm is by recommendation. Ask neighbouring practices how they rate their accountants.


The fees the firms charge will depend on the size of the practice, its circumstances and, to some extent, the area of the UK it is in. Most firms agree an annual fee with the practice that covers a package of services. What will and won't be included can vary a lot so compare firms. With partners' individual tax returns and GPs' annual NHS pensionable income certificates, some firms include either or both with the basic annual cost while others, both attract an additional fee.

Changing accountants

If the practice uses a specialist firm but you are thinking of moving, you could ask it to suggest why it should keep your business. Can it offer an improved service? Is it prepared to adjust the fees? However, be wary of changing to another specialist accountant simply to save on fees. If the current accountant is providing an excellent service but is a little more expensive it may be better to stick with them.

Fees and services, page 45; special medical accountant details,page 4


Normally included

  • Annual accounts preparation.
  • Meeting GPs to discuss draft accounts.
  • Except with very small firms, performance figures comparing client practices.
  • Partnership tax return and tax computation.
  • Advice on bookkeeping.
  • Answering routine queries.
  • Advising on projected profits and tax liability.
  • Dispensary accounts.    

Extra charge may be made

  • Partners' personal tax returns.
  • GP certificate of NHS pensionable income.

Normally provided at extra cost

  • VAT accounting.
  • Setting up a limited company for non-NHS income.
  • Setting up a limited company social enterprise for PBC/APMS purposes.
  • Advising on PBC/APMS.
  • Handling HM Revenue & Customs' investigation into the practice.
  • Personal finance (including pensions and investments) advice if firm has in-house financial services team.
  • Payroll service if available.

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