Accounting for practice owners

Six, and profit is not the first of them. Loaded staff cost as a percentage of fee income — loaded meaning gross pay plus employer's National Insurance at 15% above the £5,000 secondary threshold plus pension contributions, not the payroll summary total. Lab and materials percentages against your private mix. Chair utilisation, measured in sessions actually worked rather than sessions offered. UDA delivery against contract, tracked monthly so a shortfall is a conversation in October rather than a clawback in April. The NHS, private and plan mix. And profit per surgery, which is the only one of the six that tells you whether the next chair pays for itself. We report all six quarterly against dental benchmarks.

Yes — nurses, receptionists, practice managers, therapists and employed hygienists, with real time information submitted on or before each payday and PAYE due by the 22nd of each month. Auto-enrolment is part of the same service: assessment every pay period against the £10,000 earnings trigger, the statutory minimum contributions on qualifying earnings between £6,240 and £50,270, and the re-declaration cycle every three years. We also get the self-employed hygienist and associate arrangements right, which is the part that carries real risk. A contract that says self-employed while the working reality says employed is a status problem, and the exposure sits with the practice, not the individual.

Often, but the answer turns on things a generic incorporation calculation ignores. Corporation tax at 19% below £50,000 of profits and 25% above £250,000, against income tax at 45% above £125,140, makes the headline arithmetic look obvious. Then the GDS contract has to be novated with commissioner consent, goodwill has to be valued and its transfer has capital gains consequences for you personally, and property is usually better left outside the company. The pension point is the one most often got backwards: a provider shareholder keeps access to the NHS Pension Scheme through an incorporated practice — it is the associate performer who cannot pension income earned through their own limited company. We model five years in pounds first.

It changes the analysis far more than the bookkeeping. NHS, private fee-per-item and plan income behave like three different businesses sharing a building: different gross margins, different lab percentages, different cash timing, and very different risk. NHS income is contracted and predictable but capped and clawback-exposed. Private is uncapped and demand-sensitive. Plan is the most valuable of the three to a buyer because it is recurring. If your accounts show one turnover figure, you cannot see which of the three is carrying the practice, and you will steer the mix by accident. Ours split it, and put a margin against each part.

Enough to cover the fit-out finance, the extra nurse loaded properly, and the profit you would have made using the space some other way. The fit-out is the smallest of the three. A chair, cabinetry and installation financed over five years, plus a full-time nurse at £26,000 of gross pay, is a fixed cost base before a single patient sits down — and the nurse costs more than £26,000 once employer's NIC and pension are added. The question is never whether the surgery will be busy; it is whether it will be busy on the sessions that are currently empty. We model it against your actual utilisation, not against capacity.