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Healthcare

Strategic Practice Growth & ICS Navigation

Leading through the integrated care era

The shift towards Integrated Care Systems (ICS) and the past strengthening of Primary Care Networks (PCNs) represented the most significant structural change in the NHS and primary care in a generation. 

For GP partners, this requires a transition from managing a single small business to leading a sophisticated, collaborative healthcare entity. Strategic growth is no longer optional; it is a necessity for achieving operational scale and financial resilience.

At Armstrong Watson, we act as lead advisors for practices looking to expand, merge, or formalise their collaborative structures. We provide the financial architecture that allows you to provide exceptional patient care while maintaining a profitable and sustainable partnership.

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Healthcare mergers, acquisitions & federations

Merging practices is a complex legal and financial undertaking. We provide the "financial glue" that holds a merger together:

Due Diligence

We perform deep-dive financial reviews of potential merger partners, identifying hidden liabilities, varying drawings structures, and differing capital account balances.

Harmonisation of Accounts

We align disparate accounting policies to ensure a "day one" consolidated financial view, allowing the new partnership to operate as a single entity from the start.

Governance Frameworks

We help you design the financial governance of the new entity, including how "Top Slice" central costs are shared and how profits are allocated across multiple sites.

Navigating the ICS and PCN funding landscape

The ICS model changes how funding flows into primary care and can help you navigate these. 

  • Workforce planning: We model the financial impact of hiring through the ARRS and the new GP reimbursement scheme, ensuring your PCN and your practice are utilising its full entitlement without creating unfunded long-term liabilities.
  • Contractual compliance: We ensure your subcontracting arrangements and inter-practice agreements are robust, tax-efficient, and compliant with the latest GMS, PMS and APMS contract variations.

Digital transformation and estates strategy

Growth often requires significant capital investment in technology and buildings.

  • Cloud migration: We lead the digital transformation of your finance function, moving you to integrated cloud systems that offer real-time reporting across multiple PCN sites.
  • Estates advisory: Whether you are applying for ICB support or exploring a private development, we provide the financial modelling needed to support your business case for new or expanded premises.

Recent news stories

GP practices

29th April 2026

2026/27 GMS Contract: what’s been imposed and how GP practices can protect finances

Doctor with patient

22nd March 2026

Making Tax Digital (MTD) for Income Tax: what you need to know

law firm

6th February 2026

Bank interest and partial exemption – A new VAT risk for law firms?

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