Key takeaways from the AISMA 2025 Conference for GPs and Practice Managers
As AISMA members, one of the highlights of the year, is for our team to attend the annual AISMA conference, stay ahead of the latest changes in the sector, and bring back valuable insight for our clients.
This year marked the 30th Annual AISMA Conference, and five members of our team attended. Below is a round-up of the most important updates, risks, and opportunities for GP practices — all with practical takeaways you can act on now.
Drugs – How to Boost Your Margins and Top Profit Tips!
Are you leaving profit on the table? Many practices are – and it’s often due to underclaiming, pricing issues, or poor stock control. Drug income remains one of the most valuable income streams for practices – but only if you’re managing it effectively.
Key actions to maximise drug profits:
• Claim everything you’re entitled to – underclaiming is still common.
• Get what you’re owed – ensure payments match claims.
• Manage suppliers and optimise prescribing – smart sourcing pays off.
• Flu vaccines – often the most valuable drug. Check claims, quantities, and wastage.
• Accurate bookkeeping – this underpins your drug income recovery.
• Minimise wastage – especially with expensive stock.
Want help reviewing your current process? We have a Drug Profit Checklist and can point you to teams like Ash Lane Medical Business Solutions that could help you regain control, save staff time and maximise your drug profits
IR35 – Are You at RISK?
If you’re using Locums through limited companies or agencies, you could fall foul of IR35 rules – and the financial consequences can be significant.
IR35 (aka Off-payroll working) affects those who supply services via an intermediary (e.g. a limited company or LLP). If HMRC believes a Locum is effectively an employee, PAYE and NIC will apply — plus penalties.
Key IR35 Scenarios:
• Direct hire (no intermediary): Not caught by IR35
• Via Ltd Company/LLP/Partnership: May be within scope
• Via agency or chambers: IR35 may apply — depends on control and employment status
Use HMRC’s Employment Status Checker Tool — HMRC will stand by the result if it’s used correctly.
Need help reviewing your Locum arrangements? If you are worried about your status, get in contact with us and we can help you determine the correct tax treatment.
PCNs – What’s Next for Primary Care Networks?
The PCN model is evolving. One of the core changes is a greater push toward collaboration with non-GP providers to form integrated neighbourhood teams.
Why it matters:
• Patients expect faster access and better outcomes.
• PCNs are now central to delivering that – but GP practices remain under pressure.
• Practices must align their services with enhanced access goals while maintaining financial viability.
This is a space to watch – and plan for.
VAT – Don’t Be Caught Out After It’s Too Late!!
More practices are being audited — and HMRC is getting sharper. The biggest risk? Incorrect VAT treatment of services, especially around staff supply and cosmetic procedures.
Medical Services & VAT – What You Need to Know:
• Services must pass the “purpose test”: they must relate to the protection, maintenance, or restoration of health to be exempt from VAT.
• Must be carried out or supervised by a registered health professional.
Common VAT traps:
• Supplying staff under third-party control = VATable
• Supplying clinicians under your own clinical control = VAT exempt
• Cosmetic procedures = Standard rated, unless part of a health treatment programme
Top Tip:
Prescribed drugs and medicines are zero-rated until at least 31 March 2027 — but many purchases are standard-rated. If you’re VAT-registered, you could reclaim VAT on eligible purchases.
If your practice has a mix of exempt and VATable income, partial exemption rules may apply. Don’t wait for an HMRC letter.
Read more in HMRC VAT Notice 701/57
Pensions – Are You Missing Out on Benefits or Compensation?
The pension system continues to frustrate many GPs especially with ongoing issues from PCSE and the complexity around the McCloud remedy.
What you need to check now:
• Have you submitted your Type 1/2 Superannuation Certificates?
• Are your annual pension statements up to date?
• Have you received a Remedial Pension Savings Statement (RPSS)?
If your records are incomplete, you may be:
• Missing out on pension growth benefits
• Inaccurately assessed for pension tax liabilities
• Delaying your retirement decisions
A new PCSE team is being set up to resolve these issues — but we’re already helping clients chase missing records, review RPSS calculations, and recover lost time (and money).
There’s also a compensation scheme to reclaim some of the accountant fees incurred for these reviews.
Why This Matters
The financial and regulatory landscape for GP practices is getting more complex — and the margin for error is shrinking. Whether it’s tax, VAT, pensions, or drug income, small oversights can now have big financial consequences.
This blog isn’t just an update – it’s a wake-up call.
Here’s what you should do next:
• Review your drug income strategy
• Reassess your Locum arrangements
• Get on top of your VAT and pension position
How we can help
Need help navigating any of these areas? Reach out to our dedicated healthcare accounting team – we work with GP practices like you and know how to spot the risks and the opportunities. Email us: healthcare@robson-laidler.co.uk