Registered number:
(A Company Limited by Guarantee)
For the Year Ended
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Mastercall Healthcare
(A Company Limited by Guarantee)
Company Information
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Mastercall Healthcare
(A Company Limited by Guarantee)
Contents
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Mastercall Healthcare
(A Company Limited by Guarantee)
Strategic Report
For the Year Ended 30 September 2024
The Directors present the Strategic Report for the year ended 30 September 2024.
During the financial year to 30 September 2024, Mastercall’s turnover increased by £669,064 from £17,198,255 to £17,897,289. Our operating profit increased from £726,427 in 2023 to £760,195. Profit before tax is £806,326 compared with £738,093 in 2023.
In addition to being higher than the previous year, turnover is also higher than the budgeted plan for the year. This improved financial outturn is as a result of our:
∙carefully monitored financial processes and controls including rigorous scrutiny of budget performance;
∙proactive approach to identification of new business opportunities;
∙compliance with and delivery against our 2022/25 Business Plan strategic objectives;
∙excellent operational controls.
We are committed to our social value ethos and ensuring the best use of the NHS pound to deliver safe, effective, innovative, exceptional quality services and being an employer of choice. Despite the financial challenges facing the NHS and the significant financial deficit impacting Greater Manchester, the new Integrated Care Systems landscape will hopefully continue to provide greater opportunities for collaborative working and closer integration with other health and social care system partners. It was hoped that the new Provider Selection Regime, which became statute (PSR) in January 2024, would see a move away from competitive market procurement in preference to ‘direct award’ based on qualifying criteria. This would provide stability for the incumbent provider and reduce lengthy and costly procurements. However, unfortunately and perhaps due to the severe financial challenges the system is facing, commissioners seem to be favouring open market procurements and/or short-term extensions of existing contracts. There have been a number of contributing factors that have impacted positively on the financial outturn for 2023/24. These include our responsive approach to winter pressures and the establishment of an Acute Respiratory/Home Visiting Service. We are also committed to our diversification strategy including the provision of Digital Transformation and Business Intelligence Services. As with last year’s report, the Board of Directors considers the current liquid reserves to be both sufficient and necessary for the future needs of the organisation.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Strategic Report (continued)
For the Year Ended 30 September 2024
The Board considers the full range of business risks affecting Mastercall on a regular basis and, where appropriate, takes action to address such risks. The principal risks and uncertainties affecting Mastercall are detailed below:
Workforce
During 2024, we have continued to see a demonstrable change in GP workforce supply. This has had a positive impact on rota fill-rates. There are a number of contributing factors for this such as the change of working practice in primary care and lower dependency on the use of locum GPs. However, we cannot become complacent and the situation could change as a result of the political landscape. We have mitigated the risk of over-performance on rota fill rates with a seasonally variable rota which takes into account seasonal factors and fluctuations in activity. In December 2022, we became a Real Living Wage Employer and invested in a number of Employee Benefit schemes that support Mastercall becoming an ‘employer of choice’. These include:
∙Wagestream - a financial wellbeing platform.
∙Sage Benefits - an employee benefits package.
We believe these investments have had a positive impact on our recruitment and attrition performance. HMRC Enquiries As outlined in note 21 to the accounts, HMRC has initiated enquiries into the employment status of a substantial number of doctors engaged by the company. An unfavourable outcome could lead to significant financial liabilities and have broader implications for the company’s future business model. Given its potential impact, this remains a significant risk to the organisation. Loss of Contract Risk and Impact of Legislative Changes Mastercall continues to be challenged with short-term extensions of core contracts and potential re-procurements. For several years, the loss of a key contract has posed a significant risk. The majority of our contracts, in particular our substantial contracts (Stockport and Trafford SMOC services), all came to an end on 31 March 2024. Whilst we have received confirmation of a two-year extension of these contracts, it is likely that the new PSR may cause delays on commissioning intentions moving forwards. Mastercall is committed to collaborative working at both a local and Greater Manchester level to ensure best outcomes for our population and the NHS. The majority of Mastercall’s contracts for NHS services are based on block activity contracting principles. This places all of the risk of increased activity on the organisation, as costs rise based on the need to satisfy demand and ensure safe patient services are delivered. Our Dental Services continue to experience demand that is quadruple that for which we were initially commissioned. This risk continues to be mitigated by Commissioners increasing the contract value in order that we can increase capacity to meet demand.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Strategic Report (continued)
For the Year Ended 30 September 2024
Greater Manchester Urgent Primary Care Alliance (GMUPCA)
The GMUPCA is a Community Interest Company consisting of three member organisations, Mastercall, Bardoc, GTD Healthcare, Salford and Wigan. It has been commissioned by the Greater Manchester Health & Social Care Partnership to deliver the:
∙GM Clinical Assessment Service;
∙GM Dental Service;
∙GM UEC Adastra Integration Service.
As with our other core contracts, the above contracts were commissioned to 31 March 2024. However, such was the success and positive impact on the urgent and emergency care (UEC) system that these services have now been re-commissioned for a further two years.
IT System Risk
Patient safety is our overarching priority and, therefore, Mastercall relies heavily on a resilient and highly performing IM&T infrastructure that maintains optimum functionality 24/7, 365 days a year. Mastercall continues to significantly invest in our IT infrastructure, supporting the use of digital technology and innovation to ensure a safe level of service delivery. We made provision to invest in Mastercall’s IT network and infrastructure in Spring 2023 to ensure it remains fit for purpose and stays at the forefront of technological methods of service delivery and innovation. A further commitment is to ensuring compliance with cyber security requirements including the production of a Cyber Security Policy and ensuring all staff receive the appropriate training.
The Company's financial key performance indicators are as follows:
Further information on our performance can be found in our Quality Accounts published on our website.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Strategic Report (continued)
For the Year Ended 30 September 2024
The outturn for 2023/24 is significantly better than predicted and, with the implementation of our revised Strategic Business Plan for 2022-2025, creates opportunity, vision and direction for an equally, if not more, successful 2024/25.
We remain optimistic about the evolution of the new ICS and opportunities for wider integrated working and provision of services, in particular opportunities for expansion of the CAS and, at a more local level, the opportunities of system partner integration to support prevention and out of hospital service provision. Mastercall is grateful for the continued commitment of its dedicated workforce without whom we could not provide the CQC rated ‘OUTSTANDING’ for caring services. We will continue to embrace new business opportunities to further strengthen our social value ethos and vision of providing the very best patient care at the very best place for the patient.
This report was approved by the board and signed on its behalf.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Directors' Report
For the Year Ended 30 September 2024
The directors present their report and the financial statements for the year ended 30 September 2024.
The directors are responsible for preparing the Strategic Report, the Directors' Report and the financial statements in accordance with applicable law and regulations.
In preparing these financial statements, the directors are required to:
∙select suitable accounting policies for the Company's financial statements and then apply them consistently;
∙make judgements and accounting estimates that are reasonable and prudent;
∙prepare the financial statements on the going concern basis unless it is inappropriate to presume that the Company will continue in business.
The directors are responsible for keeping adequate accounting records that are sufficient to show and explain the Company's transactions and disclose with reasonable accuracy at any time the financial position of the Company and to enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the Company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.
The profit for the year, after taxation, amounted to £582,454 (2023 - £567,297).
The company is a limited by guarantee social enterprise organisation and therefore no dividends are distributed.
The directors who served during the year were:
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Mastercall Healthcare
(A Company Limited by Guarantee)
Directors' Report (continued)
For the Year Ended 30 September 2024
A review of the company's activities for the year ended 30 September 2024 and its future prospects is set out in the Strategic Report.
The company's policy is to consult and discuss with employees through emails and at meetings any matters likely to affect them. Information about matters of concern to employees is given through information bulletins and reports which seek to achieve a common awareness on the part of all employees of the financial and economic factors affecting the company's performance.
There have been no significant events affecting the Company since the year end.
The auditors, Hurst Accountants Limited, will be proposed for reappointment in accordance with section 485 of the Companies Act 2006.
This report was approved by the board and signed on its behalf.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Independent Auditors' Report to the Members of Mastercall Healthcare
We have audited the financial statements of Mastercall Healthcare (the 'Company') for the year ended 30 September 2024, which comprise the Statement of Comprehensive Income, the Statement of Financial Position, the Statement of Cash Flows, the Statement of Changes in Equity and the related notes, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 ‘The Financial Reporting Standard applicable in the UK and Republic of Ireland' (United Kingdom Generally Accepted Accounting Practice).
We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditors' responsibilities for the audit of the financial statements section of our report. We are independent of the Company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the United Kingdom, including the Financial Reporting Council's Ethical Standard and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.
In auditing the financial statements, we have concluded that the directors' use of the going concern basis of accounting in the preparation of the financial statements is appropriate.
Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the Company's ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.
Our responsibilities and the responsibilities of the directors with respect to going concern are described in the relevant sections of this report.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Independent Auditors' Report to the Members of Mastercall Healthcare (continued)
The other information comprises the information included in the Annual Report other than the financial statements and our Auditors' Report thereon. The directors are responsible for the other information contained within the Annual Report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.
We have nothing to report in this regard.
In our opinion, based on the work undertaken in the course of the audit:
∙the information given in the Strategic Report and the Directors' Report for the financial year for which the financial statements are prepared is consistent with the financial statements; and
∙the Strategic Report and the Directors' Report have been prepared in accordance with applicable legal requirements.
In the light of the knowledge and understanding of the Company and its environment obtained in the course of the audit, we have not identified material misstatements in the Strategic Report or the Directors' Report.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Independent Auditors' Report to the Members of Mastercall Healthcare (continued)
Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an Auditors' Report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.
Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:
Identifying and assessing potential risks related to irregularities
In identifying and assessing the risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, we considered the following:
∙The nature of the industry and sector in which the company operates; the control environment and business performance including key drivers for directors' remuneration, bonus levels and performance targets.
∙The outcome of enquiries of local management and parent company management, including whether management was aware of any instances of non-compliance with laws and regulations, and whether management had knowledge of any actual, suspected, or alleged fraud.
∙Supporting documentation relating to the Company's policies and procedures for:
- Identifying, evaluating, and complying with laws and regulations
- Detecting and responding to the risks of fraud
∙The internal controls established to mitigate risks related to fraud or non-compliance with laws and regulations.
∙The outcome of discussions amongst the engagement team regarding how and where fraud might occur in the financial statements and any potential indicators of fraud.
∙The legal and regulatory framework in which the Company operates, particularly those laws and regulations which have a direct effect on the financial statements, such as the Companies Act 2006, pensions and tax legislation, or which had a fundamental effect on the operations of the Company, including General Data Protection requirements, and Anti-bribery and Corruption.
Audit response to risks identified Our procedures to respond to the risks identified included the following:
∙Reviewing the financial statements disclosures and testing to supporting documentation to assess compliance with the provisions of those relevant laws and regulations which have a direct effect on the financial statements.
∙Discussions with management, including consideration of known or suspected instances of non-compliance with laws and regulations and fraud.
∙Evaluation of the operating effectiveness of management’s controls designed to prevent and detect irregularities.
∙Enquiring of management about any actual and potential litigation and claims.
∙Performing analytical procedures to identify any unusual or unexpected relationships which may indicate risks of material misstatement due to fraud.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Independent Auditors' Report to the Members of Mastercall Healthcare (continued)
We have also considered the risk of fraud through management override of controls by:
∙Testing the appropriateness of journal entries and other adjustments. We have used data analytics software to identify accounting transactions which may pose a heightened risk of material misstatement, whether due to fraud or error.
∙Challenging assumptions made by management in their significant accounting estimates, and assessing whether the judgements made in making accounting estimates are indicative of a potential bias; and
∙Evaluating the business rationale of any significant transactions that are unusual or outside the normal course of business.
We also communicated relevant identified laws and regulations and potential fraud risks to all engagement team members and remained alert to any indications of fraud or non-compliance with laws and regulations throughout the audit. There are inherent limitations in the audit procedures described above, and the further removed non-compliance with laws and regulations are from the events and transactions reflected in the financial statements, the less likely we would become aware of them. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion.
A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our Auditors' Report.
This report is made solely to the Company's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the Company's members those matters we are required to state to them in an Auditors' Report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the Company and the Company's members, as a body, for our audit work, for this report, or for the opinions we have formed.
for and on behalf of
Chartered Accountants & Statutory Auditors
3 Stockport Exchange
SK1 3GG
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Mastercall Healthcare
(A Company Limited by Guarantee)
Statement of Comprehensive Income
For the Year Ended 30 September 2024
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Mastercall Healthcare
(A Company Limited by Guarantee)
Registered number: 05224356
Statement of Financial Position
As at
The financial statements were approved and authorised for issue by the board and were signed on its behalf by:
The notes on pages 16 to 29 form part of these financial statements.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Statement of Changes in Equity
For the Year Ended 30 September 2024
Statement of Changes in Equity
For the Year Ended 30 September 2023
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Mastercall Healthcare
(A Company Limited by Guarantee)
Statement of Cash Flows
For the Year Ended 30 September 2024
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Mastercall Healthcare
(A Company Limited by Guarantee)
Analysis of Net Debt
For the Year Ended 30 September 2024
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
Mastercall Healthcare is a private company limited by guarantee, incorporated in the United Kingdom, company number 05224356. The address of its registered office and principal place of business is International House, Pepper Road, Hazel Grove, Stockport, Cheshire, SK7 5BW.
The nature of the Company's operations and its principal activity is that of a healthcare provider.
2.Accounting policies
The financial statements have been prepared under the historical cost convention unless otherwise specified within these accounting policies and in accordance with Financial Reporting Standard 102, the Financial Reporting Standard applicable in the UK and the Republic of Ireland and the Companies Act 2006.
The Company's functional and presentational currency is GBP.
The preparation of financial statements in compliance with FRS 102 requires the use of certain critical accounting estimates. It also requires management to exercise judgement in applying the Company's accounting policies (see note 3).
The following principal accounting policies have been applied:
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
2.Accounting policies (continued)
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
2.Accounting policies (continued)
At each reporting date the Company assesses whether there is any indication of impairment. If such indication exists, the recoverable amount of the asset is determined which is the higher of its fair value less costs to sell and its value in use. An impairment loss is recognised where the carrying amount exceeds the recoverable amount.
Depreciation is charged so as to allocate the cost of assets less their residual value over their estimated useful lives, using the straight-line method.
Depreciation is provided on the following basis:
The assets' residual values, useful lives and depreciation methods are reviewed, and adjusted prospectively if appropriate, or if there is an indication of a significant change since the last reporting date.
Gains and losses on disposals are determined by comparing the proceeds with the carrying amount and are recognised in profit or loss.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
2.Accounting policies (continued)
Provisions are measured as the best estimate of the amount required to settle the obligation, taking into account the related risks and uncertainties.
Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the asset and settle the liability simultaneously.
Basic financial assets
Basic financial assets, which include trade and other receivables, cash and bank balances, are initially measured at their transaction price including transaction costs and are subsequently carried at their amortised cost using the effective interest method, less any provision for impairment, unless the arrangement constitutes a financing transaction, where the transaction is measured at the present value of the future receipts discounted at a market rate of interest.
Discounting is omitted where the effect of discounting is immaterial. The Company's cash and cash equivalents, trade and most other receivables due with the operating cycle fall into this category of financial instruments.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
2.Accounting policies (continued)
Impairment of financial assets
Financial assets are assessed for indicators of impairment at each reporting date.
Financial assets are impaired when events, subsequent to their initial recognition, indicate the estimated future cash flows derived from the financial asset(s) have been adversely impacted. The impairment loss will be the difference between the current carrying amount and the present value of the future cash flows at the asset(s) original effective interest rate.
If there is a favourable change in relation to the events surrounding the impairment loss then the impairment can be reviewed for possible reversal. The reversal will not cause the current carrying amount to exceed the original carrying amount had the impairment not been recognised. The impairment reversal is recognised in the profit or loss.
Financial liabilities
Financial liabilities and equity instruments are classified according to the substance of the contractual arrangements entered into. An equity instruments any contract that evidences a residual interest in the assets of the Company after the deduction of all its liabilities.
Basic financial liabilities, which include trade and other payables, bank loans and other loans are initially measured at their transaction price after transaction costs. When this constitutes a financing transaction, whereby the debt instrument is measured at the present value of the future receipts discounted at a market rate of interest. Discounting is omitted where the effect of discounting is immaterial.
Debt instruments are subsequently carried at their amortised cost using the effective interest rate method.
Trade payables are obligations to pay for goods and services that have been acquired in the ordinary course of business from suppliers. Trade payables are classified as current liabilities if the payment is due within one year. If not, they represent non-current liabilities. Trade payables are initially recognised at their transaction price and subsequently are measured at amortised cost using the effective interest method. Discounting is omitted where the effect of discounting is immaterial.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
Contingent liability Note 21 refers to a contingent liability in respect of a HMRC enquiry into the employment status of numerous doctors whom provide services to the Company. The Directors and their Lawyers do not feel it is appropriate to provide for any potential liability that may arise. Dilapidations provision Management has recognised a dilapidations provision valued at £351,963 (2023: £408,158), which is based on the total costs estimated by an independent report obtained on 18 April 2024, with reasonable subsequent adjustments to account for inflation. £56,195 has been credited to the Statement of Comprehensive Income in the year ended 30 September 2024 (2023: £Nil). Should these estimates vary, the profit or loss and balance sheet of the following years could be impacted.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
There were no factors that may affect future tax charges.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
Profit and loss account
The company is a private company limited by guarantee and consequently does not have share capital. Each of the members is liable to contribute an amount not exceeding £1 towards the assets of the company in the event of liquidation.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
As outlined in note 18, the company remains subject to ongoing HMRC enquiries regarding the employment status of a significant number of doctors providing services to the company. These enquiries are expected to continue for a considerable period before reaching a resolution. An adverse outcome could result in a substantial financial liability and may also impact the company’s future business model. As part of these enquiries, HMRC issued determinations in the previous year for income tax liabilities relating to the 2017/18 to 2019/20 tax years. However, these determinations do not appear to consider tax already paid by the doctors working on a self-employed basis, and their accuracy is currently under review by HMRC. Given the complexity and ongoing nature of the enquiries, management considers it impracticable to estimate the financial impact and timing of any associated cash outflows.
The bank facilities of the company are secured by debenture deed which provides for fixed and floating charges on company assets and property.
The Company operates a defined contributions pension scheme. The assets of the scheme are held separately from those of the Company in an independently administered fund. The pension cost charge represents contributions payable by the Company to the fund and amounted to £628,107 (2023: £612,578). Contributions totalling £124,363 (2023: £116,044) were payable to the fund at the reporting date and are included in creditors.
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Mastercall Healthcare
(A Company Limited by Guarantee)
Notes to the Financial Statements
For the Year Ended 30 September 2024
Payments of sessional fees, at standard rates, were made to directors in respect of medical services rendered to the
company in their capacity as general medical practitioners. The below tables summarise the sessional fees incurred during the year. There were no balances payable to the directors at the year end (2023: Nil).
The company is controlled by the directors through decisions made at board meetings and by its members at general meetings.
The company does not have any shareholders as it is limited by guarantee.
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