Not every doctor does. If your only income is a straightforward NHS salary taxed through PAYE and you have no private work, locum income or complex expenses, your tax position may be manageable without professional help. Many doctors do need support, though — particularly where private fees, locum shifts, consultancy income, partnership profits or a limited company are involved. Once you have more than one income source or you are filing a Self Assessment return, an accountant can help ensure the return is accurate and that relevant expenses are not overlooked.

It depends on your circumstances rather than your job title. If all your income is taxed through PAYE and there is nothing else to report, you may not need to file. Doctors with private medical income, locum earnings, consultancy fees, untaxed savings or investment income, partnership profits, or high-income child benefit considerations often do need to file. It is worth checking before assuming you are outside the system, because the obligation to notify HMRC can apply even if you have not been asked to file.

Your NHS salary is normally taxed through PAYE, so the tax due on it is collected at source. Private and locum income is generally reported through Self Assessment and taxed on top of your employed income, which means the rate applied to it depends on your overall position within the tax bands. Because PAYE has already accounted for your salary, the Self Assessment calculation brings the two together and works out what remains payable. Getting this right matters, as underpayments can build up quietly over several years.

Medical indemnity insurance, professional body subscriptions, required professional training and continuing professional development, specialist equipment used for work, and professional publications are examples of costs doctors often ask about. Whether a particular expense is allowable depends on the rules for your employment status and the specific purpose of the cost, and some items that are reimbursed by an employer cannot also be claimed. Travel between temporary workplaces can be claimable in some situations, while ordinary commuting generally is not. Because the detail matters, it is worth reviewing your costs rather than assuming either way.

Locum work usually means self-employment or a series of short-term engagements rather than one continuous employment, so income is generally reported through Self Assessment. That creates responsibilities around record keeping, invoicing, expense claims and payments on account, and it can also affect how travel, equipment and professional costs are treated. Where locum work sits alongside an NHS post, the two need to be reported together so the overall tax position is calculated correctly rather than in isolation.

There is no single answer, because it depends on the level and regularity of your private income, your wider earnings, pension arrangements and how you intend to use the profits. Operating through a limited company brings its own compliance requirements, including company accounts, Corporation Tax and payroll obligations for anyone paid through the company. For some doctors it can be a sensible structure, and for others the additional administration is not justified. It is worth reviewing the numbers and the practical implications before making a change.

Yes. Much of the accounting work we carry out for doctors is done through secure digital document sharing and remote communication, which suits doctors whose schedules make daytime appointments difficult. You can send records electronically, discuss matters by phone or video, and receive your accounts and returns digitally. Whether you prefer to work remotely or arrange meetings in person, the process is designed to fit around clinical commitments rather than compete with them.

Changing accountants is usually more straightforward than doctors expect. We would ask for details of your current accountant, confirm your authorisation with HMRC, and request the records and information needed to pick up your affairs. Once the handover is complete, we review your position, identify anything outstanding such as unfiled returns or approaching deadlines, and set out how the work will be handled going forward. It is helpful to start the process before a filing deadline rather than during one.

VAT is not automatically relevant to medical services, as many healthcare services are exempt, but the position depends on the specific services you provide and the nature of your practice. Some doctors provide services that fall outside the exemption, and others exceed the registration threshold through non-medical or mixed income. Where VAT does apply, it brings registration, record keeping and return obligations that need to be managed alongside your other reporting. We can assess whether it is likely to affect you based on what you actually do.

Pension considerations for doctors can be complex, particularly where NHS pension arrangements interact with high earnings, additional private income or annual allowance questions. Contributions and allowance positions can affect your tax position, and the treatment is not the same for everyone. Because the rules and figures change and depend heavily on personal circumstances, this is an area best reviewed with reference to your own earnings, scheme arrangements and plans rather than general guidance.