In-depth guidance on GP tax planning, NHS pension complexities, locum tax returns, and private practice structures. Written specifically for medical professionals navigating UK tax regulations.
The Additional Roles Reimbursement Scheme is widely misread as free money for extra staff, when it is a reimbursement of defined employment costs up to a capped maximum, with real tax and VAT consequences for whoever does the employing. This guide takes the practical employer view: which roles are reimbursable, how the cap works, who can legally employ the staff and how each model changes the payroll, the NHS pension, the Employment Allowance and, most importantly, the VAT supply-of-staff question. It closes with how the reimbursement should sit in the accounts.
When a salaried or sessional GP is offered a partnership, the practical question is what you actually pay to come in, and what that money buys. This page isolates the capital buy-in itself: a contribution into the partnership capital accounts for your share of net assets, working capital and any premises share. It explains parity (working up from a reduced share to a full, equal profit share over an agreed period), and how the figure is set and valued, namely on net assets per the accounts and a surveyor or District Valuer basis for premises, never an NHS goodwill multiple. It is the money-and-mechanics page for joining, not a broad pros-and-cons of partnership.
NHS GP practice goodwill cannot be sold and has not been saleable since 1 April 2004. This guide explains the prohibition, why it exists, what actually changes hands on a partnership buy-in or buy-out, the one private exception, and why the dental goodwill playbook does not apply to GPs.
A dispensing GP practice supplies medicines directly to eligible patients and earns an income stream most practices never see. This guide explains how dispensing income is generated through drug reimbursement and dispensing fees, how it sits in the practice accounts as turnover with a matching drug-purchase cost and stock, how it is taxed as trading income, and the unusual VAT position where NHS dispensed drugs are zero-rated, personally administered drugs are exempt and private-prescription drugs are standard-rated.
Beyond the core Global Sum and QOF, a GP practice can earn a long tail of extra income from enhanced services: nationally directed schemes (DES) the practice can opt into, and locally commissioned services (LES) that vary by area and ICB. This guide explains what these streams are, who commissions them and how to weigh whether a service is worth signing up to, then covers the part competitors skip: how the income is taxed as ordinary practice trading profit and where the VAT line falls.
Most GPs do not have the buy-in capital sitting in cash, so they borrow it, and the good news is that the interest on a loan taken out to buy into or contribute capital to a partnership qualifies for income tax relief. This page explains how a GP finances a buy-in (a partnership-capital loan, building capital from undrawn profit, or a mix), the tax relief on the loan interest (how it works, the conditions, the cap on income tax reliefs and how it is claimed), and the cash flow of servicing the loan against partnership drawings. It is the funding-and-relief page that sits underneath the buy-in and the due diligence.
Two GPs can work side by side under very different legal arrangements. In an expense-sharing arrangement each GP is effectively a separate practitioner sharing premises and staff costs; in a full partnership the GPs pool and share profit. This guide explains the difference, the legal test that decides which one you are in, and the tax, accounting and liability consequences of each.
A GP partner draws a steady monthly amount but is taxed on something different: their full allocated profit share, whether or not they drew it as cash. This page is the practical, cash-flow-first treatment of that gap: why the two figures diverge, the timing mismatch it creates (drawings now, tax bill later), and a workable method for reserving for income tax, Class 4 National Insurance, payments on account and superannuation, so the January and July bills never come as a shock.
Basis period reform quietly changed how every GP partnership is taxed: partnerships now pay tax on the profit arising in the tax year itself rather than on the profit of the accounting year ending in it. This is the dedicated deep-dive for a GP practice: the move to the tax-year basis from 2024/25, the one-off 2023/24 transition year, how overlap relief was used up, the option to spread the transition profit over five years, and the apportionment a practice faces if its accounting date is not 31 March or 5 April.
When partners leave a GP partnership faster than new ones join, liability for the surgery does not shrink to match. A leasehold practice can leave the remaining partners holding the whole lease, and an owner-occupier practice can leave departing partners unable to sell their premises share. This guide explains how the last man standing risk arises, the protections that exist, and how the partnership deed and ownership structure are used to manage it.
Most GP partnerships run a mutual assessment period, a trial stretch during which the incoming GP and the existing partners decide whether to offer and accept parity or permanency. This page explains what that period is, and, the substance of the page, the financial due diligence an incoming GP should do during it: read the accounts, understand the premises position and last-man-standing risk, check the NHS contract and list size, read the partnership deed, understand drawings versus profit, and surface any outstanding liabilities. It is the look-before-you-leap page for joining a partnership, framed around the trial period that gives you the window to do it.
A GP practice is paid for its NHS work through a monthly PCSE statement, but the amounts are not always right: Global Sum can lag a list-size or weighting change, QOF and enhanced-services payments can be late or short, and premises figures can drift. This guide explains how to read the PCSE Online statement, how to reconcile each line against the Statement of Financial Entitlements and the practice's contract, and how to spot, query and recover an underpayment, with the discipline tied back to accurate trading profit and the partners' shares.