Accountants for Healthcare in Teddington

It covers the same core disciplines as any accountancy service — bookkeeping, accounts, tax returns, payroll, VAT and compliance — but applied to how healthcare income and healthcare businesses actually work. In practice that means preparing Self Assessment returns that combine NHS pay with private fees, locum or agency income, treating private practice accounts correctly, running payroll for practice staff and associates, advising on VAT where services fall outside the healthcare exemption, and helping with structure decisions such as whether to incorporate a practice or bring in a partner. It also means dealing with HMRC on your behalf where needed and giving you a realistic view of what you will owe and when.

In most cases, yes. If you have income that is not fully taxed at source — private patient fees, locum or agency work, medico-legal reports, teaching income, rental or investment income above the reporting thresholds — you will usually need to complete a Self Assessment return. The trickier part is not the filing itself but the payments on account that accompany it, because HMRC expects a portion of next year's tax in advance. We help you work out what is genuinely taxable, what you can claim against it, and how much to set aside so the January and July payments do not arrive as a shock.

Yes, and this is one of the most common situations we deal with. NHS salary is normally taxed through PAYE, while private work, locum sessions and associated expenses sit outside it. Both need to be reported together, and the private side usually needs its own accounts or a clear income and expense summary. Getting the split right matters, because it affects your total tax liability, your payments on account and whether certain expenses are deductible. We also look at pension-related questions where they arise, such as NHS pension annual allowance considerations, and flag when specialist pensions advice may be needed.

Common claims for clinicians include professional registration and regulatory fees, medical or professional indemnity insurance, professional body subscriptions, necessary equipment and instruments, some uniform and laundry costs, and travel between work locations where it is not ordinary commuting. Practice owners may also claim premises costs, clinical waste disposal, software, staff costs and the business proportion of home use where relevant. The rules are specific, and some expenses are only allowable in particular circumstances, so it is worth having them reviewed rather than assuming. We help you separate what is genuinely claimable from what is not, and make sure the record keeping supports the claim if HMRC asks.

It depends on what you provide. Many healthcare services delivered by appropriately qualified professionals are exempt from VAT, but not everything is — cosmetic and aesthetic treatments, non-clinical services, retail sales such as products dispensed or sold, and mixed supplies can fall outside the exemption. Whether you need to register depends on your taxable turnover and the nature of your services, not simply on the fact that you work in healthcare. We look at your specific activities, advise on registration where it is required, and handle VAT returns and record keeping so the position is clear and properly reported.

Practice payroll usually includes salaried clinicians, administrative and reception staff, and practice managers, plus associates, who are often treated differently and may be engaged on a self-employed basis depending on the arrangement. Each category affects pay, tax, National Insurance, pension auto-enrolment and reporting in different ways, and getting the treatment wrong can create liabilities for the practice. We run payroll on a regular cycle, produce payslips and RTI submissions, deal with starters, leavers, statutory payments and pension contributions, and help you document the basis on which associates and locums are engaged.

There is no universal answer, because it depends on your income level, how many people you work with, whether you hold practice premises, how you want to take money out, and what you plan to do in the next few years. A sole trader or partnership structure is often simpler and cheaper to administer, while a limited company can offer different tax treatment and limited liability but brings additional filing, payroll and reporting obligations. The right structure can also change as your work evolves. We review your circumstances and explain the practical trade-offs, so you can make a decision based on your situation rather than a general rule of thumb.

Yes. Most of the day-to-day work — bookkeeping, payroll, VAT, accounts and tax returns — can be handled remotely, with documents shared securely and questions answered by email, phone or video call at times that fit around clinics and lists. The starting point is a conversation about how you are paid, what records you currently keep, what is already filed with HMRC and what is worrying you. From there we can confirm what support you need, what you would be responsible for providing, and how the working relationship would run, so you know exactly what to expect before anything changes.