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M M M. Medical Money Management. Authorised by the Financial Services Authority. PRACTICE FINANCE By Chris Hopkinson. MMM. Why was the Cost/Notional Rent Scheme Introduced?. Medical Money Management. MMM. Why was the Cost/Notional Rent Scheme Introduced? Answer: Because it saves the

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M m m

MMM

Medical Money Management

Authorised by the Financial Services Authority

PRACTICE FINANCE

By

Chris Hopkinson

MMM


Medical money management

Why was the Cost/Notional Rent

Scheme Introduced?

Medical Money Management

MMM


Medical money management1

Why was the Cost/Notional Rent

Scheme Introduced?

Answer: Because it saves the

Government a lot of money!

Medical Money Management

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Cost rent is approved costs x prescribed percentage
COST RENT IS:Approved Costs x Prescribed Percentage

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COST RENT IS:The rental paid by the PCT to the Practice for the use of the DOCTORS’ SURGERY, thereby allowing the PCT’s Patients to be treated

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NOTIONAL RENT IS:The current Market Rent assessed by the District Valuer based on the Alternative use “VALUE OF THE DOCTORS’ SURGERY.

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NOTIONAL RENT IS:The rental paid by the PCT to the Practice for the use of the DOCTORS’ SURGERY, thereby allowing the PCT’s Patients to be treated

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Cost notional rent

Continues for as long as the building is used to treat the PCT’s Patients

COST/NOTIONAL RENT

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Cost notional rent1

Providing the Cost/Notional Rent is mostly sufficient to cover the interest on a loan, there is little financial consequence should a doctor

Die

Leave

Retire

From a Practice

COST/NOTIONAL RENT

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Cost notional rent2
COST/NOTIONAL RENT cover the interest on a loan, there is little financial consequence should a doctor

The fact that most Doctors have to borrow money to build or buy into a Surgery is largely irrelevant to the payment of the Cost or Notional Rent.

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Cost notional rent3
COST/NOTIONAL RENT cover the interest on a loan, there is little financial consequence should a doctor

Questions to ask?

  • When will I be expected to buy a share of the surgery premises?

  • How will the share be valued?

  • Is the Practice in receipt of Cost or Notional Rent?

  • Whichever – how much and when was the last triennial review?

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Cost notional rent4
COST/NOTIONAL RENT cover the interest on a loan, there is little financial consequence should a doctor

Additional Details Required

  • Existing Loan Details:

    Amount

    Term

    Rate (Fixed or Variable)

  • Repayment Method

  • Security

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M m m

M M M cover the interest on a loan, there is little financial consequence should a doctor

Please note:

The content of this presentation is intended for general guidance only and you should seek specific financial advice before taking action on any aspect of it.

The risk profile of investment products varies and should be matched to your individual attitude to risk.

The value of certain investment products can go down as well as up.

Some funds may include investments that are not designated in sterling and the prices may alter purely as a result of exchange rate movements.

Past performance is not necessarily a guide to future performance.

Medical Money Management

Authorised by the Financial Services Authority


Break
BREAK cover the interest on a loan, there is little financial consequence should a doctor

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The nhs pension scheme nhsps

The NHS Pension Scheme (NHSPS) cover the interest on a loan, there is little financial consequence should a doctor


Agenda
AGENDA cover the interest on a loan, there is little financial consequence should a doctor

  • Summary of main scheme conditions and benefits.

  • Retirement benefits: calculation

  • Early retirement: the effect

  • Maximum service

  • Topping-up benefits

    - added years

    - AVCs

  • Ill-health retirement

  • Death benefits


Contributions
CONTRIBUTIONS cover the interest on a loan, there is little financial consequence should a doctor

  • 6% personal contribution for both practitioners and officers. Income tax relief.

  • Lower NI for salaried officers; contracted out

  • Employing authority (e.g GP Surgery) - 4% contribution

  • Remainder: Subsidised by DOH (Treasury) - not ‘funded’, pay-as-you-go. Effect?


Nhsps benefits
NHSPS BENEFITS cover the interest on a loan, there is little financial consequence should a doctor

  • Tax free lump sum on retirement

  • Inflation-proof pensions (normal, early, widows & dependants) - 60 onwards (55 special classes)

  • Death in service gratuity: 2 x pensionable pay


Calculating pension benefits
CALCULATING PENSION BENEFITS cover the interest on a loan, there is little financial consequence should a doctor

  • Officers: accrual basis = 1/80th pension plus 3/80th TFC for each year of service

  • general medical practitioner 1.4% of “total dynamised career NHS pensionable earnings” for each year of service (pension); 3 times for cash


Worked example practitioner
Worked example: Practitioner cover the interest on a loan, there is little financial consequence should a doctor

  • Practitioner joins NHSPS at age 24

  • Assume retirement at age 60

  • Assume dynamised career average is £ 42,000 pa

  • Total (revalued) career earnings = £1,512,000

    (36 years x £ 42,000)

  • Pension = 1.4% x £1,512,000 = £21,168 pa

  • Lump sum = 3 x £21,168 = £63,504


Worked example officer
Worked example: Officer cover the interest on a loan, there is little financial consequence should a doctor

  • Officer joins NHS at age 25

  • Has 2 years break to carry out VSO work at the age of 35, then returns to NHS

  • Assume retirement at age 60

  • Assume final earnings at retirement are £53,200

  • Total Service = 33 years

  • Pension = 33/80ths x £53,200 = £21,945 pa

  • Lump sum = 3 x £21,945 = £65,835


Nhs pension scheme early retirement
NHS PENSION SCHEME cover the interest on a loan, there is little financial consequence should a doctor(EARLY RETIREMENT)

  • Voluntary early NHS retirement from age 50 is possible, but NHS pension benefits reduced if taken prior to age 60

  • No reduction applies for ill health retirement, and dependants’ benefits based on unreduced pension


How does this affect the worked example practitioner
How does this affect the worked example? cover the interest on a loan, there is little financial consequence should a doctor(practitioner)

  • Practitioner had entered service at 24

  • Assume early (voluntary) retirement at 55

  • Therefore, only 31 years potential

  • Assuming same career average (£42,000pa) total career earnings = £ 1,302,000

  • Pension = 1.4% x £ 1,302,000 x 75% = £13,671pa

  • Lump sum = 3 x 1.4% x £ 1,302,000 x 86% = £47,028


How does this affect the worked example officer
How does this affect the worked example? cover the interest on a loan, there is little financial consequence should a doctor(officer)

  • Practitioner had entered service at 25

  • Assume early (voluntary) retirement at 57

  • Assuming same final earnings (£53,200pa)

  • Only 30 years potential (2 year VSO break)

  • Pension = 30/80th x £53,200 x 84% = £16,758pa

  • Lump sum = 3 x 30/80th x £53,200 x 92% = £55,062


Maximum service allowed
MAXIMUM SERVICE ALLOWED cover the interest on a loan, there is little financial consequence should a doctor

  • pensionable “service” may not exceed….

  • 40 years by age 60

  • 45 years by age 65

  • (different for special classes)

  • service after age 70 does not count and benefits will be paid


Funding for maximum pension benefits practitioners salaried nhs appointment
FUNDING FOR MAXIMUM PENSION BENEFITS cover the interest on a loan, there is little financial consequence should a doctor(practitioners / salaried NHS appointment)

  • NHS EARNINGS - ADDED YEARS

    - AVCs

    - FSAVCs

  • NON-NHSearnings - Personal Pension


Ill health retirement
Ill-health retirement cover the interest on a loan, there is little financial consequence should a doctor

  • payable when “permanently” incapable of discharging duties efficiently because of physical or mental infirmity

  • retirement benefits of pension and lump sum payable if member retires on grounds of permanent ill-health and has at least 2 years service

  • service 2 - 5 years - contributing service not increased

  • service from 5 - 10 years - contributing service doubled (subject to maximum reckonable service by 65)

  • service of more than 10 years - increased to greater of 20 years (subject to 65 limit) or add 6 years 243 days (subject to age 60 maximum)


Death benefits overview
Death Benefits (overview) cover the interest on a loan, there is little financial consequence should a doctor

  • 3 elements - what are they?

  • Lump sum gratuity

  • Spouse’s pension

  • Dependants’ allowance


Death gratuity
DEATH GRATUITY cover the interest on a loan, there is little financial consequence should a doctor

  • Death in pensionable employment before 70

  • 2 x pensionable earnings

  • paid to surviving widow or widower (unless notice in writing to not do so)

  • if no spouse (or as above), paid to personal representatives


M m m

  • Death after pension becomes payable cover the interest on a loan, there is little financial consequence should a doctor

  • 5 x pension (less amount already paid)

  • (provided not greater than 2 x last PE less TFLS

  • Death with preserved pension

  • 3 x member’s pension (revalued to date of death)


Widows
Widows cover the interest on a loan, there is little financial consequence should a doctor

  • 3 months member’s final pay (6 months if 1+ child)

  • Then pension of 50% of member’s pension based on ill health

  • In retirement, widow’s pension is 50% of non-actuarially reduced pension

  • marries after leaving = post 1978 service only


Widowers
Widowers cover the interest on a loan, there is little financial consequence should a doctor

  • Largely as for widows but only based on service since April 1988

  • ‘past’ service may have been bought up to July 1989

  • Pre 88 service may be taken into account if demonstrable dependent widower


Children s allowances
Children’s allowances cover the interest on a loan, there is little financial consequence should a doctor

  • Child under 17 or in full time education

  • 25% of member’s pension (50% if 2+)

  • 33% and 67% for orphans

  • As for widows, dependant’s allowances are based on non-actuarially reduced pensions


Nhsps contribution benefit records
NHSPS Contribution/Benefit Records cover the interest on a loan, there is little financial consequence should a doctor

  • Scotland: Scottish Public Pensions Agency, St Margaret’s House, 151 London Road, Edinburgh, EH8 7TG

    Tel: 0131 244 3585

  • England/Wales: NHS Pensions Agency, Hesketh House, 200-220 Broadway, Fleetwood, Lancs, FY7 8LG

    Tel:01253 774774

  • Northern Ireland: HPSS (Superannuation), Waterside House, 75 Duke Street, Londonderry, BT47 1FP

    Tel: 01504 31900


Claiming tax relief on nhs pension contributions
Claiming cover the interest on a loan, there is little financial consequence should a doctor tax relief on NHS pension contributions

  • general practitioner, age 47, has £40,000 of NHS pensionable earnings and claims tax relief on NHSPS contribution….

  • pensionable NHS earnings £ 40,000

  • 6% NHSPS contribution (15% max) £ 2,400

  • Tax relief (40% of £ 2,400) £ 960


Who can fund personal pensions
Who can fund personal pensions? cover the interest on a loan, there is little financial consequence should a doctor

  • general medical practitioners / salaried NHS officers with non-NHS earnings

  • general medical practitioners with non-pensionable NHS earnings

  • general medical practitioners who wish to fund the NHSPS and a personal pension (simultaneously) from their NHS earnings. They must decide (annually) to waive tax relief on their NHSPS contribution for this exercise


Waiving tax relief on nhs pension contributions
Waiving cover the interest on a loan, there is little financial consequence should a doctor tax relief on NHS pension contributions

  • pensionable NHS earnings £ 40,000

  • 6% NHSPS contribution (15% max) £ 2,400

  • Tax relief (£ 960 waived) £ NIL

  • 25% personal pension contribution £ 10,000

  • Tax relief (40% of £ 10,000) £ 4,000

    Notes: GP has obtained £ 3,000 extra tax relief (£4,000 minus £1,000)

    GP is funding NHSPS and personal pension simultaneously from same source of NHS earnings


Pension for doctors spouses
Pension for Doctors’ spouses cover the interest on a loan, there is little financial consequence should a doctor

  • employer contributions to spouse pension attract tax relief at the employer’s top rate of tax

  • pension fund accumulates tax-free and is returnable to employer as tax free fund should spouse die before retirement

  • Use new Stakeholder Schemes - £300 per month contribution irrespective of earnings

  • tax-free lump sum of up to 25% of accumulated fund

  • benefits can be taken at any age after 50 (from 2004)


Break1
BREAK cover the interest on a loan, there is little financial consequence should a doctor


Planning protection
Planning / Protection cover the interest on a loan, there is little financial consequence should a doctor

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Basic financial planning protection issues
Basic Financial Planning/Protection Issues cover the interest on a loan, there is little financial consequence should a doctor

Life Assurance

  • Term Assurance - Level, Convertible and Decreasing

  • Family Income Benefit

  • Whole Life - With Profit and Unit Linked

  • Endowment - Low Cost, With Profit and Unit linked

  • Writing Policies under Trust

MMM


Basic financial planning protection issues1
Basic Financial Planning/Protection Issues cover the interest on a loan, there is little financial consequence should a doctor

Critical Illness

Provides a capital sum in the event of being diagnosed with a qualifying illness

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Income protection
Income Protection cover the interest on a loan, there is little financial consequence should a doctor

Permanent Health Insurance

Provides a regular income after a waiting period (deferred period) to a pre-determined age (normally age 60) or until return to work

Benefits are tax free

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Income protection1
Income Protection cover the interest on a loan, there is little financial consequence should a doctor

Permanent Health Insurance

Points to Consider:

Definition of Illness

Definition of Occupation

Practice Agreement

Level of Cover

NHS Ill-health Retirement Benefits

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Income protection2
Income Protection cover the interest on a loan, there is little financial consequence should a doctor

Locum Cover

Provides a regular income after a waiting period for a specific period of time (usually up to 12 months after incapacity)

Premiums qualify for tax relief

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Income protection cover
Income Protection Cover cover the interest on a loan, there is little financial consequence should a doctor

What the PCT Provides?

Superannuable Income for up to 12 months providing medical services continue to be provided for patients

PCT Locum Allowance for up to 12 months subject to residual list size (and other factors)

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Income protection cover1
Income Protection Cover cover the interest on a loan, there is little financial consequence should a doctor

Cover should dovetail with Practice Agreement

Do not over insure

Benefits are taxable unless Locum employed

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Income protection cover2
Income Protection Cover cover the interest on a loan, there is little financial consequence should a doctor

Locum Costs vary

PCT support varies

Current Locum Costs are £1,300+ per week

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The end
THE END cover the interest on a loan, there is little financial consequence should a doctor

MMM


M m m

M M M cover the interest on a loan, there is little financial consequence should a doctor

Please note:

The content of this presentation is intended for general guidance only and you should seek specific financial advice before taking action on any aspect of it.

The risk profile of investment products varies and should be matched to your individual attitude to risk.

The value of certain investment products can go down as well as up.

Some funds may include investments that are not designated in sterling and the prices may alter purely as a result of exchange rate movements.

Past performance is not necessarily a guide to future performance.

Medical Money Management

Authorised by the Financial Services Authority


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