Accountants for Healthcare in Merstham: Specialist Tax and Accounting Support

It depends on how you work. A sole trader GP locum or dental associate will usually need Self Assessment covering all income sources, guidance on allowable expenses and payments on account, and advice on whether incorporation would be beneficial. GP partners and practice partnerships need partnership tax returns, profit allocation and drawings support. Incorporated clinicians and clinics need statutory accounts, Corporation Tax calculations and confirmation statements. Across all structures, the recurring requirements are accurate bookkeeping, payroll for practice staff where relevant, VAT monitoring if private or non-medical work is involved, and tax planning on structure, pension contributions and profit extraction.

You are responsible for your own tax position, and that usually means registering for Self Assessment, reporting all income, paying income tax and Class 4 National Insurance, and making payments on account. Locums and associates often have income from several practices, mileage and travel costs, professional indemnity insurance, registration fees and CPD costs that need to be tracked properly. Where you work through your own limited company, the position becomes more involved still, because off-payroll working rules can apply depending on the engagement. An accountant helps keep the reporting accurate and identifies whether your current working arrangement is the most tax-efficient one available to you.

We start by mapping every income stream separately — NHS salary or contract payments, private patient fees, insurer remittances, locum sessions and any non-clinical income — because they are not all treated the same way. In practice, the important work is correct classification, accurate record keeping against each stream, and making sure the right expenses are allocated to the right income. Where pension contributions are involved, we also consider annual allowance implications that can arise for clinicians with higher overall earnings. Keeping the streams distinct from the outset makes the tax return more straightforward and reduces the chance of queries later.

Commonly allowable costs include professional registration fees, professional indemnity and medical defence subscriptions, medical equipment and instruments, uniforms and laundry where appropriate, continuing professional development courses, professional body memberships, business mileage and travel between sites, a reasonable proportion of home costs where you work from home, and accountancy fees. The test is that spending must be wholly and exclusively for the purposes of your work. Personal costs, ordinary commuting, and anything with a dual purpose are not claimable. Keeping receipts and a mileage log through the year makes the position far easier to support if HMRC asks questions.

Most healthcare services provided by registered health professionals are exempt from VAT, which means they do not count towards the registration threshold. However, some private work — cosmetic and purely aesthetic treatments, for example — can be standard-rated, and retail sales such as pharmacy products are taxable. If you provide a mixture of exempt and taxable services, you need to monitor your taxable turnover carefully and, once registered, may need to account for VAT under partial exemption rules. We review how your services are treated and keep that position under review as your private work develops.

Yes. We can run payroll for clinical and administrative staff, including reception teams, nurses, practice managers and salaried clinicians, as well as payments to locums made through payroll. That covers payslips, Real Time Information submissions to HMRC, starters and leavers, statutory payments, variable hours and overtime, and auto-enrolment pension duties. Getting payroll right protects both your staff and the practice, and it removes a recurring administrative task from your week. Where you already have a payroll process in place, we can work with it rather than rebuilding it from scratch.

You should keep details of all income received — NHS payments, private fees, insurer remittances, locum invoices — along with bank and card statements, purchase invoices and receipts, mileage records, pension contribution statements and any contracts or engagement terms. HMRC generally expects records to be kept for at least six years from the relevant filing deadline, and limited companies have similar retention expectations for accounting records. Cloud bookkeeping makes this far easier, because documents can be uploaded as you go and reconciled against bank transactions, rather than being pieced together months later.

The first step is a conversation. Tell us how you work, what income sources you have, whether you operate as a sole trader, partner or limited company, and any deadlines or issues currently worrying you. We will review your existing position — returns filed, records held, VAT and payroll obligations — and explain what support would suit your circumstances. If you decide to proceed, we handle the onboarding: connecting or setting up bookkeeping software, agreeing responsibilities, and building a schedule for accounts, Self Assessment, VAT and payroll. If you have an existing accountant, we can manage the handover with them on your behalf.