Sector

Accounts and tax for clinicians and care businesses, without the jargon on either side

For locums, private practices, dental and pharmacy businesses, physiotherapists and care providers.

What makes healthcare different

Exempt income, moving employment status and pensions

Medical services are largely VAT exempt, which means VAT on costs cannot be recovered and any taxable income, such as cosmetic treatments, reports or room hire, has to be identified and separated. Cross the threshold on the taxable part and partial exemption arrives.

Locums move between employment, self employment and their own company, sometimes in the same tax year. NHS pension contributions and annual allowance charges need careful handling, and care providers face CQC registration costs alongside heavy payroll.

Who we act for

Every kind of healthcare business

Locums and consultants

Doctors, dentists and allied professionals working across several settings.

Private practices

Consultant companies and clinics with private income alongside NHS work.

Dental and pharmacy

Associate agreements, split fee income, stock and NHS contract income.

Care providers

Care homes and domiciliary care with heavy payroll and regulatory costs.

What we handle

Clinicians, practices and care businesses

Locum bookkeeping and Self Assessment, including IR35 where you work through a company. Private practice and consultant company accounts. Dental associate and principal accounts with the fee split calculated from the schedule rather than estimated.

Pharmacy accounts and stock. VAT partial exemption and the split between exempt medical services and taxable supplies, which is where most practices go wrong.

NHS pension records, superannuation certificates and annual allowance planning. Care home and domiciliary care payroll with sleep in shifts, National Minimum Wage compliance and the reporting CQC inspections tend to ask for.

Packages

Sole Trader Essentials £39 a month for locums
Company Core £99 a month for practice companies
Company Growth £179 a month with payroll
Virtual Finance Department for larger care providers

See pricing

The taxable part is where VAT bites

Cosmetic work, medico legal reports, room hire and retail sales are usually taxable even when your main service is exempt. Once those exceed £90,000 you must register, and partial exemption then governs what you can recover.

Questions

Frequently asked

Is my income VAT exempt?

Medical care provided by a registered professional for the protection, maintenance or restoration of health is exempt. Cosmetic work, reports and retail sales usually are not. The distinction is about purpose, not who performs it.

How are dental associates taxed?

Usually as self employed, based on the associate agreement and how the practice actually operates. The fee split, lab costs and materials all need to come from the schedule rather than the bank.

What about the NHS pension annual allowance?

High earners can exceed the annual allowance and face a charge, sometimes payable through Scheme Pays. It needs modelling before the year end rather than discovering it afterwards.

Do you handle sleep in shifts?

Yes. Sleep in payments and National Minimum Wage compliance are a recurring risk area in care, and the payroll has to reflect the current position correctly.

Should a locum use a limited company?

It depends on income level, whether IR35 applies to your engagements and whether you need the money personally. We compare both routes on your actual figures.