Accountant for healthcare practices and locums: the same-day answer a year-end accountant cannot give
Accountant for healthcare practices and locums who are also clinicians: one finance function covering payroll, pensions, VAT and the monthly figures you use to decide who you hire and what you charge.
Most practices learn how the spring went somewhere around the following autumn. By then the associate is on the payroll, the rota is rebuilt and the private fees are set. The open question is what you would have done differently if the figures had landed in March.
Ardein is an outsourced finance function for healthcare practices, dental and care providers and locum companies, run remotely from Chester by Gavin Jardine MIAB. It delivers payroll and pension duties, VAT, year-end accounts and monthly management information on an agreed date. Fees are scoped to the work after seeing the records, and the handover is managed at no separate charge.
“They don't feel like a contractor. They get fully involved in the business and are well respected by all.”
UK SME owner
- IAB member (MIAB 292185)
- Anti-money-laundering supervised
- Established 2021
Three things you’d know before the next associate starts
Know whether the practice can carry another clinician
Payroll, pension cost and list income sit in the same monthly report, so the answer is arithmetic rather than instinct.
Sign the equipment purchase with the payback in front of you
Finance cost against the treatment income it has to produce, worked out before the agreement is signed.
See which site, list or contract earns the margin
Income and direct cost are coded consistently each month, so the comparison holds up when you act on it.
Three decisions that went wrong because the figures came late
These are the moments practice owners describe when they first call, usually after the event.
- Hire
“We took on a second associate in April and only worked out in November that the list never grew enough to cover the cost.”
Seven months of salary and employer pension went out against income that was never there. The payroll figure existed; nobody set it against the income it was meant to generate.
- Purchase
“We financed a new chair over five years and nobody could tell me what it had to bill each month to pay for itself.”
The repayment was affordable and the utilisation was not checked. A single month of treatment income by surgery would have settled it before signing.
- Price
“I put the private fees up across the board because I could not see which treatments were losing money.”
Two profitable services lost patients so that one unprofitable one could keep running. The coding needed to separate them had never been set up.
- Day 90
What it looks like when the answer is in the room
The report arrives on the same date each month, before the partners meet. Payroll, pension and locum cost sit next to the income they produced, by site and by list. When someone asks whether the practice can afford the associate, the meeting answers it that afternoon. The purchase, the rate and the rota get decided on figures that are weeks old rather than a year old.
Quick check · no email
If your accountant cannot tell you this week whether the practice can carry another clinician, what payroll and pensions are running at, and which site earns its keep, you have the wrong accountant
Three questions about your current accountant, answered honestly.
Question 1 of 3
Could they tell you by Friday whether the practice can carry another associate at the rate you would have to pay?
Could they tell you today what payroll and employer pension cost last month, against the month before?
Could they tell you which site, list or contract produced the margin last month?
You are making clinical and commercial decisions on figures you cannot see until the year is closed. That is exactly the gap the review is built to map.
You are better served than most practices, with one area still running blind. The value of a fixed reporting date is that the answer is there before the meeting, not after it.
You have a finance function that keeps pace, and there is little for us to add. The guide on the first ninety days will still be worth ten minutes if you are planning growth.
What your year-end accountant does well, and what it leaves you guessing about
Both do real work, and only one of them answers the question you have on a Tuesday.
The year-end accountant
Files accurate statutory accounts and the corporation tax return on time.
Works from records handed over in one go, often months after the events in them.
Answers a question about last year quickly, and a question about this month slowly.
Is the right service if compliance is genuinely all the practice needs.
A finance function reporting monthly
Bookkeeping, VAT, payroll and pension duties run to a timetable you can see.
Management information on the agreed date, ahead of the partners’ meeting.
Margin by site, list or contract, so the rate you set has a basis.
One accountant inside the practice, with new capacity capped at four clients a month.
Eight decisions your current figures should already answer
Work down the list and mark the ones you could settle this week.
- 01
Can you say what one more associate costs, fully loaded, including employer pension?
Payroll and pension cost reported monthly against the income that clinician generates.
- 02
Do you know which site or list carried the margin last month?
Income and direct cost coded consistently, so the comparison is real.
- 03
Could you price a private treatment from cost rather than from the practice down the road?
Service-level reporting built from the monthly records.
- 04
Do you know what the new equipment has to bill each month to pay for itself?
Payback worked through before the finance agreement is signed.
- 05
Is your locum spend visible as a separate line, month by month?
Locum cost tracked apart from permanent payroll in the monthly pack.
- 06
Are pension assessments and declarations dealt with on schedule every run?
Auto-enrolment duties handled as part of the payroll routine.
- 07
Do you know today what the corporation tax bill will look like?
The liability visible long before it falls due, not at filing.
- 08
Does the report land on the same date every month?
A fixed reporting date, provided the information is with us.
What a practice actually hands over
Three pieces of work that between them decide how quickly you can answer a question.
Payroll and pension duties for clinical and support teams
Regular runs, employer pension duties and The Pensions Regulator dealt with on schedule, with locum cost kept visible separately.
Management information on the agreed date
Cash, debtors, creditors and performance by site or list, produced while the month can still be influenced.
A finance lead for the hire, the rate and the purchase
Virtual FD input for the decisions that move the practice, without a full-time finance salary.
Entry 01
What changes when the figures arrive before the meeting rather than after it
One promise carries most of the value for a practice owner who is also seeing patients.
Figures as recorded in client work · names withheld
What clients say
“They don't feel like a contractor. They get fully involved in the business and are well respected by all.”
UK SME owner
What you can decide at thirty, sixty and ninety days
The first ninety days move the practice from annual figures to monthly ones.
You know what you are actually buying
Scope agreed, AML checks done, records collected. If there is an existing accountant or bookkeeper, we handle the handover.
The payroll and income figures can be trusted
Bookkeeping complete, banks reconciled, patient and supplier balances making sense, with historic gaps identified.
Month end stops landing on your evening
Routines set for bills, credit control, payroll, pension duties and reporting, with responsibilities agreed between you and Ardein.
The hiring decision takes an afternoon
Monthly management information on a fixed date, showing cash, debtors, payroll cost and performance by site or list.
Who we turn down, and why that should matter to you
We do not take on cash businesses, which rules out practices where a meaningful share of income never reaches a bank account.
We do not work on CIS-dependent construction, so a practice with a large in-house build arm is not a fit.
We walk away from anything illegal or reportable to the NCA, and from falsified VAT records.
The relationship does not work if an owner cannot explain the practice or say what they need, and AML checks are not optional.
If none of that applies, the review is the sensible place to find out whether the rest fits.
Questions practice owners ask first
Is the Finance Function Gap Review a sales call?
No. It is a paid sixty-minute review of your bookkeeping and reporting workflow, debtor and creditor visibility, payroll and recurring finance, and the systems you already use. You leave with the top five priorities and an indicative monthly service structure. The fixed review fee is credited in full against onboarding if you go ahead.
We already have an accountant. Is there any point talking to you?
Most practices that come to us already have one. The usual position is that the annual filings are handled properly and nothing arrives month by month. If your accountant can answer the three questions above this week, stay where you are. If not, the review will show you exactly where the gap sits.
What happens with our current accountant if we move to Ardein?
We manage the handover and there is no separate charge for it. We write for professional clearance, request the records and working papers, agree a transition plan around your year end and set out who does what from the first month. You do not have to run the conversation yourself.
How long are we committed for?
The engagement is monthly, with a fee scoped to the work and agreed only after we have seen your records and understood how the practice runs. There is no long tie-in. New capacity is capped at four clients a month, so timing depends on when a place is open rather than on a contract length.
Do you act as an accountant for healthcare practices and locum companies?
Yes. We work with clinics, dental practices and care providers with payroll and pension complexity, and with limited companies run by locums. The work covers bookkeeping, VAT, payroll and auto-enrolment, year-end accounts, corporation tax, director self assessment and monthly management information, delivered remotely from Chester across the UK.
Can you handle payroll and pension auto-enrolment for a mixed clinical team?
Yes. Payroll runs, employer pension assessments, contributions and declarations to The Pensions Regulator are handled on schedule as part of the monthly routine. Locum and sessional cost is reported as its own line, so you can see what flexible cover is actually costing the practice against the income it covers.
Three ways to take the next step
Book the Finance Function Gap Review
You get the five priorities and an indicative monthly structure, and the review fee is credited in full if you go ahead.
Find out what you’d be told 02 · A question firstWant to know if a practice like yours fits?
Call or email Gavin directly and ask the question before committing to anything.
Ask Gavin a question 03 · Still decidingStill deciding
The guide to the first ninety days sets out what changes at day thirty, sixty and ninety, so you can judge the pace before you commit.
Read the guides →