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.

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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.