Kay's LinkedIn profile

I loved maths at school and one of the professions my mum suggested I explored was accountancy. In year 13 at school, I took myself off for 3 weeks work experience - one week at a local hospital in the accounts department to experience public sector accounting, one week in a large local business to experience accounting in industry and one week in an accounting practice. I absolutely loved my week in practice and was lucky enough to get a job there starting that summer straight after finishing my A-levels. 

I studied AAT on day release and then ACCA. I was caring for my mum, and block release was not an option for me, so it was fantastic that I had the day release option with ACCA and could get up at 5.30am to get my poor mum up before I headed off to catch the train to Nottingham University for the day. She was so supportive and sat patiently every morning after I left so early until the morning carer arrived who came in during the week whilst I was working and studying.

I’ve spent almost all of my career in the healthcare team at Duncan & Toplis where I became a director in 2016 and a shareholder in 2018. I’ve grown the healthcare portfolio and we’re quite a large team now with 16 of us. Because healthcare is so niche, you really do need to be doing it 100% of the time to keep up with all the changes. Whilst the expenditure is pretty standard, the income streams are constantly changing – there are no two years in the NHS that are the same. I always describe healthcare accounting as Marmite – people either love it or hate it.

I feel so lucky to have a career I love so much. Every working day I am happy to get up in a morning knowing I am going to work with an amazing team and lovely clients. Some clients I have known for 30 years now – they feel like family! Each and every member of our team is so dedicated to making sure we deliver a great service to our healthcare clients. 

We work predominantly with GP practices which are generally partnerships or sole traders. We work with PCNs (primary care networks) where GP practices work collaboratively to deliver services more efficiently with patient list sizes of 30,000 plus. We support Federations, which are similar to PCNs in terms of collaboration but are companies that tender for bigger contracts that are then delivered by different practices within that Federation. We also work with other healthcare businesses such as those delivering minor surgery, locum GPs, advanced nurse practitioners and pharmacies to name a few.

Within our ‘healthcare bubble’, as I call it, we deliver anything from bookkeeping, VAT, pension certificates as well as the accounts and business services support. Every client is different, so we tailor our support depending on what each practice needs, from occasional guidance through to providing wider finance management support.  We particularly look at clients’ income streams making sure they are claiming funding for all of the services they deliver and that claims are being made correctly. A good example is flu vaccination funding, where small errors in coding or claims can result in practices missing out on income they are entitled to receive.

After the recent annual AISMA (the Association of Independent Specialist Medical Accountants) conference I shared a free checker with all of my practices after it was identified that more than £4 million of flu vaccination funding had been unclaimed or underclaimed nationally.

Missed claims or incorrectly entered claims mean that much needed income doesn’t flow through. Our years of experience means that we can make a difference by helping practices maximise income and support the long-term sustainability of general practice.

Funding is the greatest challenge in healthcare. We all see in the press that practices are closing so ultimately if we can help a struggling practice to be financially viable, it is really rewarding. Some funding flows through the primary care networks and federations so you need to be aware of what funding is available from where to be able to support them. 

The changes introduced by the government around employer National Insurance contributions have also had a significant impact on many practices. Because GP practices are government funded, they are unable to claim Employment Allowance, and the support they receive through contract payments is not directly linked to their actual salary costs. Instead, it is calculated using a formula based on weighted patient list size and a proportion of the contract sum, which means changes can affect practices in very different ways.

I feel very privileged to have recently joined the board of AISMA - a highly respected and well recognised Association. I very much look forward to collaborating with the other amazing board members to ensure that as an organisation we continue to deliver the highest quality service to our healthcare clients and our teams. I am committed to supporting our members and working closely with national healthcare organisations and representatives to drive meaningful impact.

Outside of work I love attending ballet classes and am also a qualified ballet teacher so occasionally get roped in to teach. My son asked to start golf lessons when he turned 5 and so last year I decided to join him and have also started lessons!