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CARDIFF - 02920 731274


Graham Paul has acted for doctors and dentists for over forty years. Both professions have particular accounting standards that can best be undertaken by a specialist medical accountant.

Graham Paul is a member of

  • UK200 Group Healthcare Section

    David Paul is a Committee Member

  • Institute of Chartered Accountants in England & Wales Healthcare Group

  • AISMA (Association of Independent Specialist Medical Accountants)

  • NASDAL (National Association of Specialist Dental Accountants and Lawyers)

    David is a member of the Superannuation Committee

AISMA and NASDAL set the “Gold Standard” for accounting requirements for doctors and dentists, acting for between 25%-30% of all GPs in both professions.

Healthcare staff attend the annual conferences of AISMA and NASDAL together with frequent training days so keeping our knowledge fully up to date on developments in both professions.

As the overwhelming majority of our doctor and dentist clients are members of the NHS Pension Scheme, Healthcare and Tax Departments liaise closely in monitoring and advising on recent changes in the taxation of pension schemes in general and the NHSPS in particular.

Doctors and dentists need a specialist medical accountant. Graham Paul with over forty years of expertise and specialism provides such a service. Over many years we have helped our doctor and dentist clients achieve their full financial potential.


We are specialist Dental accountants and a member of NASDAL (National Association Of Specialist Dental Accountants and Lawyers). We are in touch with all the latest developments in the dental field. NASDAL acts for about 25% of all dental general practitioners in the UK. NASDAL undertakes an annual survey of dental earnings, profits and expenses from which we are able to benchmark our client performance against their peers.

We act for over 50 dentists, a mixture of principals (practice owners), associates, salaried dentists and since 2006, dental body corporates (limited liability companies).

NASDAL also undertakes a quarterly goodwill survey. This helps us to keep abreast of the up to date values of our dental clients practices.

Over the last four decades we have assisted our dental clients in buying and selling their practices. We advise our clients on the most appropriate structure for their financial and practicing needs, sole practitioner, partnership, expense share or dental body corporate.

If dental clients are to achieve the best results from their complex practice arrangements, an experienced specialist accountant is needed. Graham Paul fulfils that need for our dental clients.

The 2006 dental contract introduced major changes in the way all dentists accounted for their pensionable earnings and superannuation. As a member of NASDAL and on their Superannuation Committee David Paul was instrumental in drafting, with the Pension Agency, the definitive Superannuation Guidance Notes. These notes help all dentists in the NHSPS (NHS Pension Scheme) to correctly return their pensionable earnings.

NHS Pension Scheme (NHSPS)

We act for over 300 doctors and dentists who are members of the NHSPS. The NHSPS is one of the best final salary schemes in the UK. As such its members are very vulnerable to the recent tax charges imposed on all pension schemes, the better the scheme, the greater the risk.

The attached article is one that has been circulated to our clients who are members of NHSPS and at risk.

Your pension is under attack!

As an active member of the NHS Pension Scheme (NHSPS), one of the largest pension schemes in the world, you will, on retirement, enjoy exceptional benefits.

Recent changes to taxation of pension schemes put these benefits at risk. The better the scheme, and the NHSPS is one of the best, the greater the risk. This threat takes a two pronged attack.

  • An annual allowance charge (AA)
  • A lifetime allowance charge (LTA)

Annual Allowance Charge

You are presently able to invest £40,000 annually in your pension before a tax charge starts to bite. This is not the superannuation you pay on which you receive tax relief but something called a Pension Input Amount, which is calculated using a complicated formula.

The allowable Pension Input Amount has reduced from £255,000 to £50,000 to £40,000 with proposals from all political parties to reduce the figure even lower. If you have a total taxable income in excess of £150,000, the £40,000 entitlement is reduced further by £1 for every £2 of taxable income in excess of £150,000 up to £210,000. If your income is in excess of £210,000, then AA is reduced to £10,000.

Lifetime Allowance Charge

This is the amount you can invest over your working life to pay for your pension. The amount you can invest has steadily reduced from £1.8 million to £1.5 million to £1.25 million and from 1 April 2016 to £1 million. Once these limits are exceeded penal rates of tax apply. The NHSPS, as with the annual allowance, has devised a formula to calculate the lifetime allowance figure. These rules only apply to the NHSPS.

If you also have a private pension scheme your chances of falling foul of pension taxation increase substantially as the premiums paid will be added to your Pension Input Amount for AA calculations and the fund created will be taken into account for LTA.

The Way Forward

All political parties look at pension schemes as a "cash cow" for raising revenues. There is, therefore, a high risk that the taxation of pension schemes will be tightened even further putting at risk your eventual pension benefits. Year on year management and review of your pension arrangements is now essential. Failure to do so could result in an unexpected and penal tax demand.

If you have exceeded the AA charge, currently £40,000, the NHS Pension Agency has a statutory duty to inform you using a form called an Annual Allowance Pension Savings Statement. No such duty applies to anyone else who does not meet this criteria. However, a member of the NHSPS can apply for their individual Annual Allowance Pension Savings Statement.

Graham Paul is compiling a register for clients who are members of the NHSPS. This register provides the data base in assessing your risk to pension taxation. The register is reviewed on a "traffic light" basis. Once you are on an amber or red light we would advise you to take active steps, in conjunction with your specialist Independent Financial Advisor, to mitigate your risk to the pension tax charges. The obtaining of details from the NHSPS, particularly the Annual Allowance Pension Savings Statement, is the major source of information needed to compile the register.

We can collate this information on your behalf once you receive it from NHSPS. If you wish to proceed down this route, we enclose a letter of request in triplicate to the Pension Agency. The 'Office copy' and 'NHSPS' copies need your signature and to be returned to us in the enclosed business reply envelope. We will submit the request to NHSPS. The reply will come to you at your home address. Please forward any reply to us, as and when you receive it.

Remember you are at risk from the new pension tax regime. Graham Paul are here to help you mitigate that risk.


We are specialist medical accountants and a member of AISMA (Association of Independent Specialist Medical Accountants) the UK200 Healthcare Group and ICAEW Healthcare Group.

We act for over 230 doctors with a mixture of 26 GP practices, hospital consultants and locums. Where a doctor has a private practice these practices have been incorporated where there is a tax or operating advantage to the doctor.

Our expertise directly relevant to GP Practices includes:

  • Forty years experience of accounting for twenty six GP Practices throughout Wales which have over one hundred and forty GP Partners.
  • Excellent working relationships with Health Boards and Shared Services Partnership.
  • Extensive experience in pensionable pay and superannuation matters.
  • Detailed working experience relating to cost/notional rent and matters concerning surgery premises.
  • Succession planning for partnership changes.

AISMA acts for around 30% of all GP practices in the UK and undertakes an annual survey of GP earnings, profits and expenses. We are therefore able to provide detailed benchmarking statistics for our GP practices using this annual survey.

This is a direct comparison with their Welsh GP peers identifies those areas where our GP practices are strong and those areas where there is potential for improvement.

As well as the more traditional services provided by the firm, we are increasingly providing a wide range of value added services to our medical clients. We are committed to providing high levels of training to our personnel. All our healthcare staff attend regular updating seminars including the annual AISMA two day conference.

As there are constant changes in the accounting, pension and superannuation requirements an experienced, specialist medical accountant is an essential requirement if our doctor clients are to receive the best financial management advice.

Graham Paul has the experience and specialism to meet the needs of our medical clients.



Attached is a statement from NHS Pensions relating to a change in the regulations to the NHS Pension Scheme.

You will see from the statement which was introduced very quietly that for certain GP Practices this may be a ticking time bomb. The new regulations bring in a potential charge as a cost to the practice by way of a levy that is payable to the NHS Pension Scheme.

This potential charge arises in the following circumstances.

  • It is applicable to the 1995 Scheme and only applies to the Officers Section (employees).
  • It applies to pay rises given by the practice to employees in the last three years prior to retirement.
  • The charge applies where the pay rise given exceeds a CPI plus 4.5% of the previous year’s salary.

You will see from the example in the statement that a pay rise of a fraction under £10,000 can cost the practice by way of a charge under the final pay control of a fraction over £38,000.

The provisions of the final pay control will mean that great care has to be taken with pay rises for long serving employees nearing their retirement date.

Enhanced Protection

Enhanced Protection was introduced in the very early days of pension taxation and secured, for those lucky enough to qualify, a much higher level of lifetime allowance. This protection is very valuable securing a fixed value for the lifetime allowance, set against a rapidly reducing amount for the lifetime allowance.

If you are a member of the 1995 NHS Pension Scheme, the holder of an Enhanced Protection Certificate and born after April 1962 you have now lost Enhanced Protection. If you are in this situation and HM Revenue & Customs has not been informed urgent action is required to avoid esculating penalties.

For further information and help please contact David Paul, telephone number 01656 679800 or email d.paul@grahampaul.com

Next Step:

Please contact us if you need further advice, have any questions about our services, would like a free consultation or a free fee quote.



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