Accountants for Private Hospitals, Clinics & Care Homes
A private hospital, day-surgery unit or care home is one of the most demanding businesses to account for: consultant fees and insurer receipts, agency and bank staff on the payroll, CQC-registered activity, and VAT that is mostly exempt but never entirely. Our accountants for hospitals in London handle all of it. CruseBurke has advised British businesses since before the Second World War, so scale and complexity are familiar ground.
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Hospitals and healthcare groups are complex organisations with several income streams and a large payroll. We work with each of the following, and the priorities differ in every case:
Insurer and self-pay income reconciliation, consultant fee arrangements, statutory accounts and management reporting by department.
Occupancy and fee income tracking, local authority and private resident billing, agency staff cost control and CQC-ready records.
VAT partial exemption on mixed medical and cosmetic work, capital allowances on theatre and imaging equipment, and payroll for clinical teams.
Consolidated accounts, intercompany recharges, group VAT and site-by-site profitability reporting for expanding providers.
We provide a full finance function for healthcare providers, from daily bookkeeping through to statutory accounts and board-level reporting.
Full expensing and Annual Investment Allowance claims on theatre, imaging and ward equipment, plus group relief and tax planning.
Healthcare is largely VAT exempt, but cosmetic work, pharmacy sales, catering and room hire are not. We calculate partial exemption correctly.
Companies House and HMRC filings on time, plus monthly management accounts showing income and margin by department or site.
Large-volume payroll including bank and agency shifts, unsocial hours, statutory pay and pension auto-enrolment, filed accurately every cycle.
NHS Pension administration and support for consultants on Annual Allowance, plus correct treatment of self-employed consultant fees.
Healthcare providers deal with financial pressure no other sector matches: fee income arriving from insurers, local authorities and self-pay patients at different speeds, agency cost that moves weekly, and CQC obligations sitting on top. These are the issues we handle:
NHS Pension administration and Annual Allowance queries
Cash flow while insurer and local authority payments lag
VAT partial exemption on mixed exempt and taxable income
High-volume payroll with bank, agency and unsocial hours
Capital allowances on theatre, imaging and ward equipment
Financial records that stand up to CQC and funder scrutiny
Modelling the finances of a new site or acquisition
Hospital and care home finances need specialist knowledge, because the mistakes are expensive. Here is what you get with our healthcare team:
We understand NHS funding, insurer income, consultant fee models and care home fee structures.
Management accounts by department, site or service line, ready for the board pack each month.
We calculate and document the exempt and taxable split so recoverable input VAT is not lost.
Bank shifts, agency cover, unsocial hours and auto-enrolment processed accurately every cycle.
Accounts, returns and payroll filed on time, with records that stand up to funder and CQC scrutiny.
Clear pricing agreed up front, so you get full expert service with no hidden extras.
Managing the finance function is not why you went into healthcare. Our three-step process gets you set up quickly and keeps the board informed:
We begin by getting to know your practice and understanding your unique needs. This step ensures we have a clear picture of your operations and your goals.
Based on our initial discussion, we create a personalised plan designed specifically for you. The aim is to keep everything organised and easy to follow. You can rest assured that your numbers are being handled with expert precision.
From there, we take care of the ongoing work and keep you updated with reports. You’ll always know what’s happening, and we’re always here to answer your questions, ensuring you have a clear picture of your financial health at all times.
Our roots go back further than the Second World War and our team is built around the healthcare sector. Here is what working with us looks like:
Using the latest technology to offer customised financial strategies that help healthcare practices grow and thrive.
A dedicated accountant who knows your sites, your income mix and your reporting deadlines.
Our team is here whenever you need guidance. We offer unlimited support to ensure your financial management is always on point.
Our team has over 100 years of combined accountancy experience.
Never Miss any deadline with our automated email reminders.
We’re an ICAEW, ACCA & AAT accredited Firm.
Take a back seat and let our healthcare accountants handle everything. Switching part way through the year is straightforward and we deal with your old accountant for you:
Reach out to us, and we’ll discuss your needs and how we can help your healthcare practice thrive.
We’ll send over a simple letter to formalise our partnership and get everything in motion.
If you're switching, we’ll take care of contacting your previous accountants to make the transition smooth.
From there, sit back and relax. We’ll manage your accounts, taxes, and everything in between, keeping your practice running smoothly.
We provide a range of services, including financial reporting, tax planning, payroll, budgeting, and regulatory compliance.
Yes, we manage payroll for hospitals, and ensure compliance with UK employment laws.
We provide regular financial reports, typically monthly or quarterly. Depending on your needs.
While we have a strong presence as accountants for hospitals in London, we help doctors and medical professionals all over the UK. We can work with you effectively wherever you are.
Just give us a call or drop us an email for a free consultation. We’ll review your situation and help take the stress out of your accounts. It’s that easy!
Medical care by a registered professional is exempt, but cosmetic treatment, pharmacy retail, catering, car parking and room hire are taxable. Because you make both types of supply you can only recover part of your input VAT, and the calculation must follow an agreed method. We prepare it and keep the workings for HMRC.
Often yes. Fixtures such as lifts, nurse call systems, sanitary ware, heating and lighting frequently qualify, even within a building purchase. A capital allowances review on a refurbishment or acquisition regularly uncovers relief that was never claimed.
Yes. We process high-volume payroll including bank shifts, agency invoicing, unsocial hours enhancements, statutory pay and pension auto-enrolment, and we reconcile agency cost against budget each month.
It depends on whether the consultant is engaged as a self-employed practitioner, through their own company, or as an employee. Each has different tax, IR35 and VAT consequences. We review the arrangements and document the position properly.
Yes. We set the chart of accounts up so income and cost can be reported by site, ward, theatre or service line, which is usually what boards and lenders actually want to see.
We are based at 12 London Road, Morden, and act for healthcare providers across London, Surrey, Kent and Essex, plus multi-site groups nationally. Cloud accounting means location is never a barrier.
