1. GP UPDATE APRIL 2015

2. Lentells Healthcare Directors Jane Jordan FCCA Andrew Spear FCCA Jo Fursman FCCA

3. Lentells Healthcare Team Act for over 150 GP practices Throughout Westcountry & beyond Large team based in Chard

4. 2015/2016 CONTRACT CHANGES Global sum increase 3% £73.56 to £75.77 PMS uplift £1.66 per weighted patient Overall pay increase 1.16%

5. 2015/2016 CONTRACT CHANGES CONTINUED GMS PMSAPMS MPIG reinvestment£0.55-- ES reinvestment£0.41 Inflation uplift£1.25 TOTAL UPLIFT£2.21£1.66

6. 2015/2016 CONTRACT CHANGES (CONTINUED) OOH deduction reduce from 5.46% to 5.39% PPG and alcohol incorporated in baseline Unplanned admissions continues Maternity/paternity locum reimbursement : £1,113 2 weeks, £1,734 onwards Other directed enhanced services continue

7. 2015/2016 QOF Stays at 559 points QOF point increases 2.06% £156.92 to £160.15 List size for QOF increases 7,052 to 7,233 PMS points = GMS points

8. SENIORITY Seniority reduction 15% pa from 1/4/2014 First adjustment due October 2015 No new joiners from 1/4/2014 Seniority entitlement retained when moving between practices

9. OTHER 2015/2016 CONTRACT CHANGES Named GP Expansion of on-line access to records and on- line appointment bookings

10. OUT OF AREA ENHANCED SERVICE Available 5/1/15 – 31/3/16 Register patients outside area - no home visits Your patients may register elsewhere Normal PMS/global sum fees Fees to see patients registered elsewhere: In hours £15.87 Home visit £60

11. PUBLICATION OF GP EARNINGS FOR 2014/2015 YEAR Practice website by 31 March 2016 Excludes non NHS income, dispensing, premises and some NHS income Disclose number of full/part time GP (part time is less than 9 sessions) Includes salaried GPs and long term locums

12. EMPLOYEE SUPERANNUATION RATES 2015/2016 to 2018/2019 Pensionable EarningsContribution Rate Up to £15,4315% £15,432 - £21,4775.6% £21,478 - £26,8237.1% £26,824 - £47,8459.3% £47,846 - £70,63012.5% £70,631 - £111,37613.5% £111,377 and over14.5% Employer’s rate increased to 14.3%

13. SUPERANNUATION ADMIN Staff pension to be paid by 19 th – penalties for non-compliance Changes in GPs - revise estimate of superannuation pay form Beware abnormal pay increases prior to retirement

14. SUPERANNUATION AND SALARIED GPs Estimate of superannuable pay form determines monthly payments on account Liaise with local team at end of year to reconcile POA to amount due Adjustments made on NHS income statement

15. SUPERANNUATION AND SALARIED GPs (CONTINUED) Salaried GP Type 2 Superannuation Certificate by 28 February Further adjustments on NHS income statement if employee contributions at incorrect rate Liaise with salaried GP regarding this adjustment only

16. FEDERATION AND CCG WORK Federation work if an Employing Authority: – Employees superannuable – Self-employed not superannuable CCG Work: – Employees superannuable – Self-employed GPs superannuable – GP solo if self-employed payments directly to GP

17. AUTO-ENROLMENT Affects all practices unless all staff are in NHS/other qualifying pension scheme Check staging date on-line at Pensions Regulator Fines for non-compliance:- £400 initially £500 per day where 5 – 49 employees Opt out – employers cannot encourage

18. AUTO ENROLMENT OPTIONS Administrate internally/use payroll provider NOW NEST People’s Pension IFA Warning: Do not leave it until the last minute

19. TAX ISSUES PAYE codes for partners: NT OT IOOL DO Tell accountant when new coding notices received

20. CLASS 4 NIC Where GPs have self employed and employed income, potential to overpay NIC Either: – Defer and pay balance later – Overpay with tax return and claim refund 2015/2016 onwards all dealt with on tax return

21. CLASS 2 NIC ISSUES Currently £2.75 per week Separate payments to stop 2015/2016 Last bill July 2015 Incorporate within 6 monthly tax bills Per March 2015 budget, will cease entirely (date TBC)

22. NIC FOR STAFF £2,000 Employer NIC allowance does not apply to GP practices 15/16 Employer NIC 0% on staff under 21 Must earn less than UEL (£815 pw) Employee NIC still applies

23. PMS CONTRACT REVIEWS Due by March 2016 To put PMS practices on equitable funding with GMS practices Already done in some areas Check the figures carefully

24. CONVERSION TO GMS Option to move from PMS to GMS at any time Check the amounts due under GMS GMS is contract for life PMS subject to 6 months notice

25. GMS CONTRACT INCOME Global sum at £75.77 per patient OOH opt out at 5.39% Temporary residents Quarterly childhood immunisations Quarterly seniority Different payment dates

26. MERGER CONSIDERATIONS What do you hope to achieve? Confidentiality and cost sharing agreement Review of finances Types of contract

27. MERGER CONSIDERATIONS (CONTINUED) Property and borrowing issues Superannuation and tax issues Staff issues IT issues Partnership agreement terms

28. MERGER CONSIDERATIONS (CONTINUED) How to share profits Current account requirements and policies Drawings policies Upfront costs Other options

29. Any Questions? Jo Fursman – jo.fursman@lentells.co.ukjo.fursman@lentells.co.uk Jane Jordan – jane.jordan@lentells.co.ukjane.jordan@lentells.co.uk Andrew Spear – andrew.spear@lentells.co.ukandrew.spear@lentells.co.uk www.lentells.co.uk

30. DISCLAIMER These presentation notes are for guidance only. We recommend professional advice should be obtained before acting on any information contained in them.