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Registered number:
FOR THE YEAR ENDED 31 MARCH 2025
Page Kirk LLP
Chartered Accountants and Statutory Auditors
Sherwood House
7 Gregory Boulevard
Nottingham
NG7 6LB
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CONTENTS
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COMPANY INFORMATION
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STRATEGIC REPORT
FOR THE YEAR ENDED 31 MARCH 2025
The directors present the strategic report for the year ended 31 March 2025.
The company delivered another strong set of financial results during the year to 31 March 2025, with turnover increasing by 10.05% to £14,284,248 (2024: £12,979,746), this represented a normalising of demand with most activities being present for the full 12-month period.
Whilst the company experienced continued success in its services, its operations are conducted within a persistent theme of sustained pressure on NHS funding as also seen in prior periods. The NHS and local ICB system face considerable financial challenges. There seems little prospect of significant new investment in the health system in the short term and making every pound count will continue to be important. The challenge to manage patient demand within the resource constraints at our practices remains unprecedented. Significant work has been done on ensuring the right workforce model is in place and at scale opportunities are explored through collaboration such as with the centralised back-office efficiency programme. The impact of this can be seen in the increase in profits this year. The clinical model is under continual review and refinement to optimise value, with a plan in development to move all practices to a “total triage” model to improve patient access within current resources in 2025/26. Significant national changes are occurring in the NHS due to the 10-year plan and the move to neighbourhood health as well as significant changes to the role and footprint of the Integrated Care Board (ICB). Maintaining relationships is vital during challenging times. We continue to work with Nottingham City Place-Based Partnership (PBP) and Primary Care Networks (PCNs) to ensure we are in the right arenas to influence and hopefully attract new business. Irrespective of national direction for the NHS and the impact on local systems, NCGPA must continue to be known for being an innovator and identify opportunities to improve existing services and developing new service models. The company's pre-tax profits have increased to £250,813 (2024: £44,792), with the net asset position on the balance sheet increasing to £597,995 (2024: £423,247). The directors are pleased with the financial performance during the year. The directors consider that the company remains well placed to continue providing quality medical services as part of their strategic plans. The following provides detail of services delivered and the impacts on the local community along with patient feedback. An acute “On the Day Service” is provided to patients of Nottingham City East PCN offering 190 GP appointments per week. A clinical service to deliver physical monitoring of patients under the care of the Nottinghamshire HealthCare Foundation Trust Eating Disorder Service enhances their physical health, reducing risks of health deterioration, and addressing healthcare inequalities. Community Gynae Service sees partnership working with the two other Nottingham & Nottinghamshire GP Federations and Nottingham University Hospitals NHS Trust to deliver appointments for women referred routinely for triage/advice/treatment, and to be referred on to secondary care services as appropriate. This community service provides a single point of access for service users in a central and easily accessible location providing a multi-skilled approach. The Enhanced Primary Care Services scheme offers a variety of clinical services including phlebotomy, ECG provision, spirometry and woundcare to circa 30,000 patients registered at four City practices, improving patient experience and outcomes while reducing unwarranted variation in clinical practice and health inequality. The GP+ Enhanced Access service provides approximately 1,600 appointments per week that support delivery of evening and weekend clinical care on behalf of eight PCNs/41 practices across the City, improving patient
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STRATEGIC REPORT (CONTINUED)
FOR THE YEAR ENDED 31 MARCH 2025
access and addressing health inequality.
Stub it has supported over 2,000 citizens to quit smoking and the service has supported the Targeted Lung Health Check program, supporting the PBP and Public Heath priority to address Smoking and Tobacco Control.
The principal risks faced by the company are as follows:
Retention, renewal and replacement of contracts It is a time of change for the NHS due to the implementation of the 10-year plan and the move to neighbourhood working. NCGPA will need to continue to build upon its reputation and relationships with commissioners, PBP partners and its practice members directly and through PCNs to ensure it remains the provider of choice for new contracts as they become available. Investing in trusting relationships with partners in the local health and care system, including other local GP Federations within Nottingham & Notts, is crucial to securing new business. Having a place in the right forums and being agile enough to respond with innovative solutions to problems is key to acquiring new business. Existing contracts for clinical services and ‘back office’ functions continue to be reviewed for both quality and financial value and viability. Practice List Sizes for managed practices Income is quickly impacted by increase or reductions in list size with adjustments to costs and resources taking longer to implement. Therefore, list size stability is important to ensure a resilient business model and consistent quality. Work is on-going with all our practices to improve patient satisfaction and the quality of care to ensure they attract and retain patients. Workforce recruitment and retention Workforce recruitment and retention continue to be a challenge with gaps in permanent staff being covered by agency and locum staff which incurs premium pay rates. This impacts on our ambitions for new work as our staffing model needs to reflect the actual market conditions. By engaging in GP training and "growing our own" staff, providing research and educational opportunities along with an excellent place to work, this risk is partially mitigated. Credit and Cashflow risk The directors do not feel that there is a credit risk to the company as its main sources of income are from the NHS and it has zero debt. Cashflow risks are kept to a minimum by maintaining tight internal controls and monitoring procedures.
This report was approved by the board on 11 December 2025 and signed on its behalf.
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DIRECTORS' REPORT
FOR THE YEAR ENDED 31 MARCH 2025
The directors present their report and the financial statements for the year ended 31 March 2025.
The profit for the year, after taxation, amounted to £175,227 (2024 - £37,555).
The directors who served during the year were:
The auditors, Page Kirk LLP, will be proposed for reappointment in accordance with section 485 of the Companies Act 2006.
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DIRECTORS' REPORT (CONTINUED)
FOR THE YEAR ENDED 31 MARCH 2025
As the company has on average over 250 employees, we are required to state our policies in relation to employment of people with disabilities and our engagement with employees.
Disability It is the company’s policy to give full and fair consideration to the employment of disabled people (and people who become disabled whilst in employment by the company) to ensure their requirements are adequately covered and to comply with any current legislation regarding disabled persons. This includes: - The full and fair consideration of applications for employment. - The provision of training whilst employed, and. - Ongoing opportunities for career development and promotion. Our approach is supported by our Equality, Diversity, and Inclusion Policy and Workforce Change Policy which are in place to prohibit bullying, harassment or victimisation of people with disabilities. The company is committed to equal opportunities and supports the employment of disabled persons. Applications from disabled candidates are considered on merit, and where existing employees become disabled, every effort is made to provide continuing employment and appropriate training. Employee engagement With our policies mentioned above, the company has an expectation that its employees always act in a professional manner considering the personal information that the company holds. For any employee-related matters, the board is informed of anything in this regard during its quarterly board meetings and, for any urgent matters, the company’s human resources department will take appropriate action. The company performs employee surveys on a regular basis to monitor issues arising allowing the human resources department to act accordingly and advise the board appropriately. Furthermore, the Chair and Chief Executive annually invite all staff to meet with them to hear their views, concerns and questions. Where there are any significant matters that affect the employees directly, these are communicated using the company’s email/intranet. Business performance information is shared regularly with department heads and this is cascaded down through the organisation to ensure all staff are aware of the financial and economic environment we are operating in. Staff are also briefed via a monthly Chief Executive update email and regular staff newsletters.
This report was approved by the board on
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DIRECTORS' RESPONSIBILITIES STATEMENT
FOR THE YEAR ENDED 31 MARCH 2025
The directors are responsible for preparing the Strategic report, the Directors' report and the financial statements in accordance with applicable law and regulations.
Company law requires the directors to prepare financial statements for each financial year. Under that law the directors have elected to prepare the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice), including Financial Reporting Standard 102 ‘The Financial Reporting Standard applicable in the UK and Republic of Ireland'. Under company law the directors must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the Company and of the profit or loss of the Company for that period.
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.
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INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF NOTTINGHAM CITY GP ALLIANCE LIMITED
We have audited the financial statements of Nottingham City GP Alliance Limited (the 'Company') for the year ended 31 March 2025, which comprise the Profit and loss account, the Balance sheet, 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).
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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INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF NOTTINGHAM CITY GP ALLIANCE LIMITED (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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INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF NOTTINGHAM CITY GP ALLIANCE LIMITED (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:
We obtained an understanding of the legal and regulatory frameworks within which the company operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Companies Act 2006, taxation legislation and money laundering regulations.
We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be the override of controls by management, the understatement of revenue, and the recoverability of debtors. Our audit procedures to respond to these risks included: • Enquiries of management about their own identification and assessment of the risks of irregularities. • Sample testing on the posting of journals. • Reviewing regulatory correspondence and professional fees. • Detailed substantive testing on the completeness of income. • Reviewing the recovery of year-end debtors after the balance sheet date. Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. We are not responsible for preventing non-compliance and cannot be expected to detect non-compliance with all laws and regulations.
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.
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INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF NOTTINGHAM CITY GP ALLIANCE LIMITED (CONTINUED)
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 and Statutory Auditors
Sherwood House
7 Gregory Boulevard
NG7 6LB
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PROFIT AND LOSS ACCOUNT
FOR THE YEAR ENDED 31 MARCH 2025
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BALANCE SHEET
AS AT 31 MARCH 2025
The financial statements were approved and authorised for issue by the board and were signed on its behalf on
The notes on pages 16 to 28 form part of these financial statements.
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STATEMENT OF CHANGES IN EQUITY
FOR THE YEAR ENDED 31 MARCH 2025
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STATEMENT OF CHANGES IN EQUITY
FOR THE YEAR ENDED 31 MARCH 2024
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STATEMENT OF CASH FLOWS
FOR THE YEAR ENDED 31 MARCH 2025
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
The company is a private company limited by share capital, incorporated in England and Wales.
The address of its registered office is: NHS Upper Parliament Street 79a Upper Parliament Street Nottingham NG1 6LD The financial statements were authorised for issue by the Board on.
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 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).
At the time of approving the financial statements, the directors have a reasonable expectation that the company has adequate resources to continue in operational existence for the foreseeable future. Thus the directors continue to adopt the going concern basis of accounting in preparing the financial statements.
When cash inflows are deferred and represent a financing arrangement, the fair value of the consideration is the present value of the future receipts. The difference between the fair value of the consideration and the nominal amount received is recognised as interest income.
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
2.Accounting policies (continued)
Defined contribution pension plan
The Company operates a defined contribution plan for its employees. A defined contribution plan is a pension plan under which the Company pays fixed contributions into a separate entity. Once the contributions have been paid the Company has no further payment obligations. The contributions are recognised as an expense in profit or loss when they fall due. Amounts not paid are shown in accruals as a liability in the Balance sheet. The assets of the plan are held separately from the Company in independently administered funds.
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
2.Accounting policies (continued)
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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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
2.Accounting policies (continued)
At each reporting period end date, the company reviews the carrying amounts of its tangible assets to determine whether there is any indication that those assets have suffered an impairment loss. If any such indication exists, the recoverable amount of the asset is estimated in order to determine the extent of the impairment loss (if any). Where it is not possible to estimate the recoverable amount of an individual asset, the company estimates the recoverable amount of the cash-generating unit to which the asset belongs.
Recoverable amount is the higher of fair value less costs to sell and value in use. In assessing value in use, the estimated future cash flows are discounted to their present value using a pre-tax discount rate that reflects current market assessments of the time value of money and the risks specific to the asset for which the estimates of future cash flows have not been adjusted. If the recoverable amount of an asset (or cash-generating unit) is estimated to be less than its carrying amount, the carrying amount of the asset (or cash-generating unit) is reduced to its recoverable amount. An impairment loss is recognised immediately in profit or loss, unless the relevant asset is carried at a revalued amount, in which case the impairment loss is treated as a revaluation decrease. Recognised impairment losses are reversed if, and only if, the reasons for the impairment loss have ceased to apply. Where an impairment loss subsequently reverses, the carrying amount of the asset (or cash-generating unit) is increased to the revised estimate of its recoverable amount, but so that the increased carrying amount does not exceed the carrying amount that would have been determined had no impairment loss been recognised for the asset (or cash-generating unit) in prior years. A reversal of an impairment loss is recognised immediately in profit or loss, unless the relevant asset is carried at a revalued amount, in which case the reversal of the impairment loss is treated as a revaluation increase.
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
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.
The Company has elected to apply the provisions of Section 11 “Basic Financial Instruments” of FRS 102 to all of its financial instruments.
Financial instruments are recognised in the Company's Balance sheet when the Company becomes party to the contractual provisions of the instrument.
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 debtors, cash and bank balances, are initially measured at their transaction price (adjusted for transaction costs except in the initial measurement of financial assets that are subsequently measured at fair value through profit and loss) 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 debtors due with the operating cycle fall into this category of financial instruments.
Impairment of financial assets
At the end of each reporting period financial assets measured at amortised cost are assessed for objective evidence of impairment. If an asset is impaired the impairment loss is the difference between the carrying amount and the present value of the estimated cash flows discounted at the asset’s original effective interest rate. The impairment loss is recognised in profit or loss.
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.
Basic financial liabilities
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
2.Accounting policies (continued)
Financial liabilities and equity instruments are classified according to the substance of the contractual arrangements entered into. An equity instrument is 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 creditors, bank loans and other loans are initially measured at their transaction price (adjusting for transaction costs except in the initial measurement of financial liabilities that are subsequently measured at fair value through profit and loss). When this constitutes a financing transaction, whereby the debt instrument is measured at the present value of the future payments 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 creditors are obligations to pay for goods and services that have been acquired in the ordinary course of business from suppliers. Trade creditors are classified as current liabilities if the payment is due within one year. If not, they represent non-current liabilities. Trade creditors 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.
Derecognition of financial instruments
Derecognition of financial assets
Financial assets are derecognised when their contractual right to future cash flow expire, or are settled, or when the Company transfers the asset and substantially all the risks and rewards of ownership to another party. If significant risks and rewards of ownership are retained after the transfer to another party, then the Company will continue to recognise the value of the portion of the risks and rewards retained.
Derecognition of financial liabilities
Financial liabilities are derecognised when the Company's contractual obligations expire or are discharged or cancelled.
The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised where the revision affects only that period, or in the period of the revision and future periods where the revision affects both current and future periods.
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
Analysis of turnover by country of destination:
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
9.Taxation (continued)
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
A contingent liability exists at the reporting date in relation to an ongoing legal case. The company's directors consider it possible that there will be an outflow of economic benefits to the entity. It is impracticable to reliably measure the financial effect of the contingent liability, therefore, an estimate has not been disclosed. It is estimated that the claim may be resolved during the year-ended 31 March 2027.
The Company operates a defined contribution scheme, the assets being held separate from the Company in an independent administered fund. The employer contributions are charged directly to the Profit and Loss account.
In the current year there was a charge to the Profit and loss account in respect of the pension costs for the defined contribution scheme of £1,037k (2024 - £1,038k). Contributions totalling £91k (2024 - £112k) were payable to the fund at the year end and are included within creditors.
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NOTES TO THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2025
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