Healthcare accountants for clinicians and providers
Healthcare income rarely arrives in one neat figure. Locum shifts, mixed NHS and private work, practice drawings, stock and locum cover all change the tax and cash picture. We work with that complexity every week.
We know how much healthcare professionals give to look after everyone else, often in demanding, unpredictable environments — so let us take the numbers off your plate. We've spent years working alongside GPs, consultants, dentists, pharmacists and allied providers, and we understand how NHS and clinical settings actually work, not just how the accounts look from the outside. You focus on your patients; we'll make sure your finances are in good order behind the scenes.
A standard small-business accounting pack often misses the realities of clinical work: multiple payers, IR35 questions, associate arrangements, pharmacy margins and equipment spend all change the numbers in ways a generic template does not anticipate. We set up your books, your payroll and your tax plan around how the practice actually earns, rather than forcing NHS and private income through a one-size-fits-all system built for a different kind of business.
That means paying close attention to detail most firms skim over: NHS Pension Scheme annual allowance calculations and pension savings statements, the employment-status test for locum and sessional work, and the split between NHS salary, private fees and dividends where a practice operates through a limited company. Get these wrong and you either overpay tax or store up a problem for a future compliance check — we build the records so the answer is right the first time, not corrected at year end.
Consultant Doctors
Consultant income usually combines an NHS job plan with private practice fees, and often runs through a personal service company. We keep NHS salary, private billings and dividends clearly separated, structure your company and drawings tax-efficiently, and review your NHS Pension Scheme annual allowance and pension savings statements each year so growing private work does not create an unexpected tax charge. We also handle waiting-list initiative and additional session income, insurer and self-pay billing, and the VAT position on any private clinic work.
Locums & GPs
Locum and GP work often spans several sites, agencies and payment methods. We help you track income and allowable expenses, review employment-status questions, and plan tax, pensions and drawings around an uneven year rather than a single salary. Where you hold an NHS Pension, we check annual allowance and pension savings statements each year so a strong year does not trigger an unexpected tax charge, and for GP partners we help set sensible monthly drawings against variable practice profit.
Clinics & Dentists
Dental and clinic finance is shaped by associate models, private mix, lab bills and equipment. We look at treatment profitability, stock and consumables, and the cash needed for tax, drawings and capital spend, then keep Companies House and HMRC filings in step. Associate dentists and clinicians working under NHS or private contracts need income properly separated from practice-level costs, and we help principals set fair superannuation and expense-sharing arrangements across the surgery so each associate's tax position stays clean.
Pharmacies
Pharmacy accounts need clean matching of contractor statements, a clear view of dispensing versus retail margin, and a staffing mix that the cashbook can support. We help owners see where margin is made or lost, and keep VAT, payroll and year-end on timetable. We reconcile NHSBSA payment schedules against your till and wholesaler data monthly rather than at year end, so category-M price changes and clawback show up in your numbers as they happen rather than as a year-end surprise.
Allied Providers
Physio, optometry, care and community providers often combine clinic income, contracts and room-hire costs. We build a chart of accounts and a simple KPI pack so owners can see utilisation, payroll cost and tax due without waiting for year end. For practices renting clinic space to self-employed practitioners, we also help structure room-hire and revenue-share agreements so each party's invoicing and tax treatment is clear from the outset, not queried after the event.
How we work with healthcare professionals
Discovery call
A short, no-obligation call to understand how you're set up — sole trader, partnership or limited company — and where NHS, private and any locum income currently sits. We'll tell you plainly whether we're the right fit before anything is agreed.
Set-up & timetable
We move your records onto Xero (or tidy up what's already there), agree a fixed monthly fee, and set a filing timetable for VAT, payroll, Corporation Tax and Self Assessment so nothing is left to the last week.
Ongoing support
Regular check-ins and a secure portal for questions, plus an annual review of NHS Pension annual allowance, drawings and tax planning ahead of each deadline, not after it.
Healthcare accounting questions
Do you deal with NHS Pension annual allowance calculations?
Yes. We review your NHS Pension Scheme annual allowance and pension savings statements each year, flag any tapered or scheme pays position early, and factor the result into your Self Assessment so there are no surprises at filing time.
Can you advise on locum IR35 and employment status?
We review each engagement against the off-payroll working rules, help you keep the right paperwork for genuinely self-employed locum work, and flag any assignment that looks more like disguised employment before it becomes a compliance risk.
I have both NHS and private income — can you handle both in one set of accounts?
Yes, this is the majority of our healthcare clients. We keep NHS salary, private fee income and any dividends clearly separated in your records, so your tax return reflects the true source of each pound rather than a single blended figure.
Should my practice incorporate as a limited company?
It depends on your income level, NHS Pension position and long-term plans — incorporation suits some practices and not others. We model the tax difference against your actual numbers before recommending either way, rather than assuming one structure fits all.
Day-to-day bookkeeping, payroll and tax filings are covered on our services page. If you're weighing up a change of accountant or a change of structure, a short call is the easiest way to find out where you stand.
Talk to a healthcare accountant
Book a short discovery call and we will tell you plainly whether we are the right fit.
Get in touch