Clinical Commissioning Groups (CCGs)

A helping hand

Business structuring

Payroll and HR consultancy

IT strategy and consultancy

Governance and support

Accounting and audit

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How our Healthcare Group can help

As a top 20 firm of Chartered Accountants, we have a multi-disciplinary dedicated Healthcare Group with a wealth of knowledge and considerable experience in the sector.

With CCGs only recently established, we can provide you with the right cost effective advice and support as you develop. With our in-depth knowledge, experience and capabilities, we share aspects of best practice to help you and your members succeed.

With CCGs only recently

established, we can provide you with the right cost effective advice and support as you develop.

Accounting and audit

Company secretarialOutsourced bookkeeping

Recruitment consultancy

Tax planning and compliance

Membership secretariat

Pensions and superannuation

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• We act for a wide range of GP clients in London and the South East

• We advised the British Medical Association (BMA) over the new GP contract

• We are regular contributors to the medical press

• We advise LMCs and Practice Manager groups

Our credentials

This guide outlines some of the key areas where we can help and add value to your CCG and its constituent members:

• NHS Pension Scheme and superannuation• Managing your people - Payroll and HR• Understanding and preparing the figures• Governance

We can also offer help on membership and management issues, such as tax planning, accounting, internal audit and IT strategy.

Please email healthcare@ks.co.uk if you would like further copies of this guide.

Recent changes in pension legislation may affect an individual’s position under the NHS Pension Scheme, resulting in having to pay additional tax. The method used to calculate whether additional tax charges will apply is complicated and the results are not known until after the end of the tax year, making it difficult to plan ahead.

The benefits received from being a member of the NHS Pension Scheme both before and after retirement are often not properly understood. Although the main benefits won’t crystallize until retirement, which could be a long way in the future, these are extremely important as part of long-term financial planning.

Some members consider leaving the Scheme in order to avoid immediate tax charges, but giving up the benefits of the Scheme could be one of the worst financial decisions made. It is, therefore, essential to understand the options and to receive proper advice.

Under the NHS Pension Scheme, it is possible for an immediate tax liability to be met by marginally reducing the benefits. This means that an individual still enjoys all of the additional benefits under the Scheme, such as future accrual, lump sum death benefits and/or spouse’s and dependant’s pension, should one die before retirement. How we can help...Our Healthcare Group can clarify the areas that can appear difficult to understand and guide you to making the right decision for you.

Common areas of confusion are:

• How much do I pay as a member of the Scheme?

• What benefits do I actually get?• Am I going to need to pay more tax and, if so,

how much?• What options do I have for paying this

extra tax?• Should I even consider leaving the Scheme?

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Understanding the NHS Pension Scheme and what it means

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Managing people within an organisation is a vital element for success. Being able to find the right employees, motivate and retain them, and quickly deal with difficult issues, are critical in developing your workforce.

How we can help…Our consultants are able to provide pragmatic, commercial solutions to your people issues when and how you need them.

We can provide:

• Advice by telephone or face to face, regarding any issues with your employees;

• Support on individual issues or longer term projects;

• Sessions with your management team, covering issues such as recruitment, performance or absence management, motivating employees and dealing with disciplinary or grievance problems;

• Guidance to ensure that your employment contracts and policies provide a sound foundation for your HR systems, whilst protecting the interests of your group;

• Advice on employment law when issues become more complex.

Whatever your HR issue, our “can do” ethos means that we always look to provide solutions to your problems, which deliver results in a cost-effective manner and in a way which suits the culture of your group.

For more information, please visit:www.hrinsight.co.uk.

Managing your people

One of the most important aspects of any CCG is the ability to communicate and inform. The financials and figures can be frequently misunderstood by healthcare professionals, who may have limited understanding of the language used and processes involved. This can lead to frustration and costly delays.

How we can help…Our Healthcare Group can provide all the tools needed to understand accounts, budgets and, in particular, the jargon!

We can work on an individual or group basis over a short period of time to develop the financial management skills needed to deal with the business side of running a CCG.

Common areas of confusion include:

• Coping with the jargon and understanding the terminology (i.e. debtors, creditors, and their roles);

• Differentiating between cash and profit;• Budgets and balance sheets.

Training sessions, lasting no more than an hour or so, could be useful for your staff, Board members and/or your CCG constituent members.

Preparing the figuresWe can, of course, prepare management and annual accounts, together with appropiate benchmarking statistics. We can also offer advice and guidance on various software applications.

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Understanding and preparing the figures

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Every CCG needs to be supported by a sound management structure in order to deliver an effective service, in an efficient manner. For CCGs there is an added consideration in that the Board, who are ultimately responsible for the strategic vision, direction and service delivery of the entity, are often remote from the day to day management activity carried out by the executive team. Nevertheless, the Board has ultimate responsibility for the governance of the CCG, for safeguarding its assets and hence for its general well being.

It is extremely important that CCG Board members are fully aware of their responsibilities and understand the steps they need to take to ensure that the CCG is properly governed. This is particularly relevant in times of change and with the financial constraints and uncertainties that CCGs face.

How we can help…Using the six benchmarks outlined below, our Healthcare Group can help identify areas of strength and weakness in governance practice and act on this to generate positive change for the CCG and your stakeholders.

Six benchmarks of effective governance for the Board:

1. Sound leadership and control2. Clearly defined roles and responsibilities3. Clear focus and direction4. Acting with integrity and objectivity5. Being open and accountable6. Financially sound and prudent

A strong focus on implementing good governance practice will provide several significant benefits to any CCG:

• It brings an understanding of the risks and opportunities that face the CCG, both now and in the future, which, in turn, ensures that opportunities can be taken advantage of, within defined operating constraints;

• It ensures that robust decisions will be made, based on sound and meaningful information, in order to deliver the CCG’s mission;

• Outputs and outcomes will be clearly measured and used as a means of improving future performance and in meeting the needs of beneficiaries;

• There should be a positive impact on reputation and relationships both within the CCG and with external stakeholders.

Governance

Contact us CityDevonshire House60 Goswell RoadLondonEC1M 7ADT 020 7566 4000

HeathrowMiddlesex House800 Uxbridge RoadHayes, MiddlesexUB4 0RST 020 8848 5500

St Albans105 St Peter’s StreetSt Albans, HertsAL1 3EJT 01727 896000

RomfordOrbital House20 Eastern RoadRomford, EssexRM1 3PJT 01708 759759

RedhillSurrey House36-44 High StreetRedhill, SurreyRH1 1RHT 01737 779000 West End141 Wardour StreetLondonW1F 0UTT 020 7304 4646

Kingston Smith’s Healthcare Group More information about Kingston Smith’s bespoke services to the healthcare sector can be found at www.kingstonsmith.co.uk/healthcare

Views expressed in this booklet are those of the contributors. No responsibility for loss occasioned by any person acting or refraining from action as a result of the material in this guide can be accepted by the LLP or any of its associated concerns.

Kingston Smith LLP is registered to carry out audit work and regulated for a range of investment business activities by the Institute of Chartered Accountants in England & Wales. A member of KS International.© Kingston Smith LLP 2013

Paul Samrah - RedhillLead Healthcare Partnerpsamrah@ks.co.uk 01737 781546 Daniel Martine – Romford Partnerdmartine@ks.co.uk 01708 759738

Jon Sutcliffe – City Partnerjsutcliffe@ks.co.uk 020 7566 3810

Keith Halstead – Redhill Partnerkhalstead@ks.co.uk 01737 781567

Maureen Penfold – Heathrow Partnermpenfold@ks.co.uk 020 8848 5503

Silvia Vitiello – St Albans Partnersvitiello@ks.co.uk 01727 896008

Eric Burrow – HR Insight Principal Consultanteburrow@hrinsight.co.uk020 8848 5522

David Painter - Kingston Smith Financial AdvisersChartered Financial Plannerdpainter@kingstonsmith.co.uk020 7566 3729

Heathrow

www.kingstonsmith.co.uk