Not every doctor does, but the case for one becomes stronger as soon as your tax affairs extend beyond a single NHS payslip. If you have private fees, locum income, consultancy work, partnership profits, a limited company or investment income, you are dealing with more than one set of rules and often more than one deadline. An accountant can make sure everything is reported correctly, that allowable expenses are not missed, and that tax payments are planned for rather than discovered. Doctors with purely salaried NHS income and no other complications may find their position is straightforward, but it is worth checking before assuming that.

NHS employment income is normally taxed through PAYE, with tax deducted at source. Private fees, locum payments made directly to you, medico-legal income and consultancy earnings are generally reported through Self Assessment instead. Both elements need to appear on the same tax return so that the overall liability is calculated correctly, and this often creates or changes payments on account for the following year. Getting the split right matters, because duplication or omission of income is one of the most common reasons for a return being amended or queried.

Yes. Locum work tends to involve multiple engagements, varying rates, agency statements and travel between sites, all of which need to be recorded accurately. We can help with bookkeeping, income and expense summaries, and the preparation of your Self Assessment return. We also look at which costs may be allowable, such as travel between temporary workplaces where the rules permit, medical indemnity cover and professional subscriptions. Where a locum works through a limited company or an intermediary, off-payroll working rules may affect how an engagement is treated, so it is worth reviewing the structure before assuming a particular approach.

Costs that are incurred wholly and exclusively for the purposes of your work may be allowable, and common examples include medical indemnity or defence union subscriptions, professional body and royal college fees, specialist equipment, and relevant training or continuing professional development. Travel and mileage can also be claimed where the journeys are genuine business travel rather than ordinary commuting. The detail matters, though — some training costs are not allowable if they prepare you for a new role rather than maintaining your existing one, and personal costs cannot be mixed in with professional ones. We review expenses against your specific circumstances rather than applying a blanket list.

It depends on your level of private or consultancy income, how you are engaged by clients, and how much administration you are willing to take on. Working through a limited company can suit some doctors with substantial private or consultancy work, but it brings additional obligations such as annual accounts, Corporation Tax returns, payroll and potentially VAT. Off-payroll working rules can also mean that a company structure does not produce the result some doctors expect, particularly where work is carried out for public sector bodies or larger organisations. This is an area where an individual review is essential, because the answer is genuinely different from one doctor to the next.

Many medical services are exempt from VAT, so a doctor providing clinical care may not need to register even when income is significant. However, not everything a doctor does is exempt — some consultancy, medico-legal work, training, publishing or advisory services can fall outside the exemption. Whether registration is required therefore depends on the nature of the services and on total taxable turnover against the registration threshold. It is worth reviewing if your work mix changes, since VAT treatment can differ between activities carried out within the same practice or company.

Pension contributions and pension income can both affect your tax position, and for doctors with high earnings the annual allowance rules may be relevant, including where the allowance is tapered. Where contributions exceed the available allowance, there can be a tax charge to deal with, and there are mechanisms for settling it through the scheme in some cases. Because these rules interact with your total income, including private work, it helps to look at the position during the year rather than after it ends. We work through the accounting and tax side and can flag when specialist pension advice is worth taking.

Changing accountants is usually a straightforward process. Your new accountant writes to the previous firm to confirm the change, requests professional clearance, and takes over the relevant records, accounts and tax return history. Much of this can be handled remotely, with documents shared securely and meetings held by phone or video, which suits doctors working across different sites and shift patterns. What matters far more than postcode is whether your accountant understands medical income, professional expenses and the structure you work within.