There’s a lot of noise at the moment around pressure in primary care.

Rising costs, structural change, and ongoing uncertainty have left many GP practices questioning how sustainable the model really is.

But from a banking perspective, the view is very different.

In this episode of Beyond the Balance Sheet, Katie Collin is joined by Lucy Brine, Director of Healthcare at Lloyds Bank, to talk through how GP practices are actually being assessed when it comes to funding, risk and long-term stability.

It’s a perspective most practices don’t usually get access to.

They discuss what really matters behind the scenes, from partnership structures through to premises and cash flow, and how lending decisions are actually made.

• Why GP practices are still seen as a stable sector
• What banks look at when funding buy-ins, buy-outs and premises
• Why valuations don’t always match expectations
• How partnership structures affect lending decisions
• How PCNs have evolved and the challenges around managing shared funds
• Where cash flow pressure is actually showing up

If you’re making decisions around growth, property or partnership changes, this episode gives you the context you need.

In this episode of Beyond the Balance Sheet, Katie Collin is joined by Dr Matt Slavin, clinical psychologist and performance specialist, to unpack what stress is really doing to primary care leaders and what it takes to stay effective without burning out.

This is a practical conversation for GP partners, PCN leaders and clinicians carrying responsibility across a system in constant change. They explore why burnout is rarely about “needing a break”, and more often about prolonged pressure, weak boundaries, and a system that never properly resets.

Together, they cover:

→ Why chronic stress stops you thinking clearly (and pushes you into reactive mode)

→ What burnout actually looks like in the body and brain, and why rest alone doesn’t fix it

→ Compassion fatigue, secondary trauma, and the emotional load clinicians carry

→ Leadership transitions, partnership change, and the unspoken pressures that follow

→ The habits that protect performance: boundaries, decompression, focus, and reset routines

If you’ve been feeling tired-but-wired, permanently behind, or like you’re carrying more than is sustainable, this episode gives a clear starting point and practical tools you can actually use.

Guest: Dr Matt Slavin, Clinical Psychologist and Performance Specialist.

Resources & Links:

Connect with Katie Collin https://www.linkedin.com/in/katie-collin/ and Ramsay Brown https://ramsaybrown.com/

Connect with Dr Matt Slavin https://www.drmattslavin.com/

In this episode of Beyond the Balance Sheet, Katie Collin sits down with Graham Crossley, founder of Medifintech and an NHS pension specialist, to unpack one of the most persistent and misunderstood issues facing NHS professionals today: whether their pension record can actually be trusted.

With widespread missing service, administrative errors and ongoing delays linked to the McCloud Remedy, many GPs and consultants are unsure where they stand or what action they should be taking. Graham explains why these issues are far more common than most people realise and why making decisions without first checking the underlying data can be costly.

In this episode, they explore:

• Why NHS pension records frequently contain missing or incorrect service

• The first document members should request to sense-check their pension record

• McCloud Remedy explained in practical terms

• The difference between RPSS and RSS and why so many members are still waiting

• Why large tax bills should not be viewed in isolation

• The risks of opting out or “opting in and out” without proper modelling

• Contingent Decisions and reinstating service: when it can help and when it can go wrong

• What NHS pension members should do next

Guest:

Graham Crosley

Founder of Medifintech. Graham specialises in NHS pensions, supporting members, accountants and advisers with pension analysis, error correction and complex issues including McCloud Remedy, annual allowance and service reinstatement.

Resources and links:

Connect with Katie Collin

Connect with Ramsay Brown

Connect with Graham Crossley

Learn more about Medifintech

Disclaimer

This podcast is for general information only. Ramsay Brown are chartered accountants, not financial advisers. NHS pension and tax decisions can have significant long-term consequences and advice should be taken based on individual circumstances.

In this episode of Beyond the Balance Sheet, Katie Collin sits down with Diane Holden, Senior Partner Success Manager at Xero, to break down one of the biggest changes to income tax in decades. Making Tax Digital will transform how locums, clinicians, landlords and sole traders manage and report their income.

Diane explains what MTD really involves, who will be affected first, and how Xero can make the transition smoother and far less stressful.

• What Making Tax Digital is and why HMRC is changing the system

• Who falls into scope and how the new thresholds will be phased in

• Why your 2024 to 2025 tax return determines if you are captured

• How quarterly digital submissions will replace the annual tax return

• How Xero, bank feeds, Hubdoc and a separate business account keep digital records accurate

• How real time data improves tax planning, session decisions, pensioning and profitability

Diane Holden

Senior Partner Success Manager at Xero. Diane supports firms and business owners through digital transformation and has worked closely with Ramsay Brown LLP to prepare healthcare clients for Making Tax Digital.

Connect with Katie Collin

Connect with Ramsay Brown LLP

Connect with Diane Holden

Learn more about Xero

In this episode of Beyond the Balance Sheet, Katie Collin is joined by Gareth Salomon, founder of Xenon Connect, to uncover the hidden bookkeeping errors that can distort financial decisions for GP practices, PCNs, and federations.

What we cover

• Why reconciled bank lines are not the same as accurate books
• The five red flags that quietly distort GP accounts: unreconciled bank items, old unpaid bills, duplicate invoices, misposted bill payments, and duplicate contacts
• Opening balances and why year-on-year comparatives go wrong
• How a simple health score and monthly report helps practice managers, PCNs and federations keep on top of quality
• Governance and fraud detection benefits when margins are tight
• What MTD for ITSA means for bookkeeping accuracy and investigation risk
• Where AI helps, and where professional judgement still matters

About Xenon Connect

Xenon Connect plugs into Xero, QuickBooks Online, Sage and FreeAgent to scan bookkeeping data against double-entry norms, flag likely errors and let you fix them fast. Ramsay Brown uses it to provide monthly health-score reports to clients and to speed up month-end reviews.

Who this is for

GP practices, PCNs, federations and healthcare finance leads who want timely, reliable financials without adding headcount.

Resources mentioned

Xenon Connect

Ramsay Brown LLP bookkeeping and management accounts support

MTD for ITSA overview and readiness support

Work with us

If you’d like help improving bookkeeping quality, monthly reporting or MTD readiness, email hannah@ramsaybrown.com and we’ll set up a short call.

The NHS Ten-Year Plan sets out ambitions for 15,000 new staff, neighbourhood teams and a digital-first NHS. But what does it really mean for GPs and primary care? In this episode of Beyond the Balance Sheet, Katie Collin is joined by partner Laurence Slavin to explore the realities behind the headlines. Drawing on decades of experience advising practices, Laurence reflects on past reforms, the ongoing flaws in funding formulas, the uncertain role of neighbourhoods and PCNs, and what the future might hold for continuity of care and the partnership model.

In this episode of Beyond the Balance Sheet, Katie Collin is joined by Justin Cumberlege, healthcare lawyer at Hempsons, to unpack one of the most talked-about topics in primary care – GP practice incorporation.

Together, they explore:

• The legal and financial implications of moving from partnership to a limited company
• How NHS contracts are affected and what “novation” really means
• Key drivers for incorporation, from liability protection to succession planning
• Common pitfalls and challenges – and how to avoid them
• Practical steps for ensuring a smooth transition

Whether you’re considering incorporation for tax efficiency, improved governance, or greater flexibility in practice ownership, this episode provides a clear, informed view on the opportunities and risks involved.

Guest: Justin Cumberlege – Partner at Hempsons, advising GP practices, PCNs, and federations across the UK.

Resources & Links:

Learn more about Hempsons

Connect with Katie Collin and Ramsay Brown LLP

In this debut episode of Beyond the Balance Sheet, Katie Collin tackles one of the most pressing issues currently facing GP practices — the Employer’s National Insurance increase taking effect from April 2025.

Katie breaks down:

• What the change actually means for practices
• Why the cost increase is significantly higher than it appears
• Who will be hit hardest, and why GP practices are uniquely affected
• What the real cost looks like in pound-per-patient terms
• The ripple effects on staffing, cash flow, and partner drawings

How Ramsay Brown LLP is helping practices forecast, plan, and respond.

Whether you’re a GP partner, practice manager or involved in healthcare finance, this is essential listening if you're trying to stay ahead of the financial curve in 2025.

📩Got a question or topic you’d like covered in a future episode? Email hannah@ramsaybrown.com directly.

🎙️ Next episode: Incorporation – what it really means for your practice, with special guest Justin Cumberledge from Hempsons.