Accountants for Private Hospitals, Clinics & Care Homes
Accountants for Hospitals in Chiswick
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Hospitals and Hospital Organisations We Support
Private Hospitals & Day Surgery Units
Insurer and self-pay income reconciliation, consultant fee arrangements, statutory accounts and management reporting by department.
Care Homes & Nursing Homes
Occupancy and fee income tracking, local authority and private resident billing, agency staff cost control and CQC-ready records.
Specialist & Outpatient Clinics
VAT partial exemption on mixed medical and cosmetic work, capital allowances on theatre and imaging equipment, and payroll for clinical teams.
Multi-Site Healthcare Groups
Consolidated accounts, intercompany recharges, group VAT and site-by-site profitability reporting for expanding providers.
Our Accounting Services for Hospitals
Corporation Tax & Capital Allowances
Full expensing and Annual Investment Allowance claims on theatre, imaging and ward equipment, plus group relief and tax planning.
Bookkeeping & VAT Partial Exemption
Healthcare is largely VAT exempt, but cosmetic work, pharmacy sales, catering and room hire are not. We calculate partial exemption correctly.
Statutory & Management Accounts
Companies House and HMRC filings on time, plus monthly management accounts showing income and margin by department or site.
Payroll for Clinical & Agency Staff
Large-volume payroll including bank and agency shifts, unsocial hours, statutory pay and pension auto-enrolment, filed accurately every cycle.
NHS Pension & Consultant Payments
NHS Pension administration and support for consultants on Annual Allowance, plus correct treatment of self-employed consultant fees.
Key Accounting Challenges for Hospitals
Why Hospitals in Chiswick Choose CruseBurke for Accounting Support
Healthcare Finance Expertise
We understand NHS funding, insurer income, consultant fee models and care home fee structures.
Reporting Built for Boards
Management accounts by department, site or service line, ready for the board pack each month.
VAT Partial Exemption Handled
We calculate and document the exempt and taxable split so recoverable input VAT is not lost.
Payroll at Scale
Bank shifts, agency cover, unsocial hours and auto-enrolment processed accurately every cycle.
Compliance Without the Stress
Accounts, returns and payroll filed on time, with records that stand up to funder and CQC scrutiny.
Fair, Fixed Fees
Clear pricing agreed up front, so you get full expert service with no hidden extras.
Our Simple 3-Step Process for Hospitals
1. Initial Consultation (It’s Free):
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.
2. Customised Plan:
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.
3. Ongoing Support & Updates:
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.
Accounting Support Built Around Hospitals
Technology Driven
Using the latest technology to offer customised financial strategies that help healthcare practices grow and thrive.
Named Healthcare Accountant
A dedicated accountant who knows your sites, your income mix and your reporting deadlines.
Ongoing Support
Our team is here whenever you need guidance. We offer unlimited support to ensure your financial management is always on point.
Experienced Team
Our team has over 100 years of combined accountancy experience.
Free - Email Reminders
Never Miss any deadline with our automated email reminders.
Yes, We Are Chartered!
We’re an ICAEW, ACCA & AAT accredited Firm.
How to Switch to CruseBurke
Take a back seat and let our accountants handle everything. Switching partway through the year is straightforward, and we deal with your old accountant for you:
Get in touch
Tell us about your hospital and current accounting requirements.
Letter of Engagement
We’ll send over a simple letter to formalise our partnership and get everything in motion.
Previous Accountants
If you're switching, we’ll take care of contacting your previous accountants to make the transition smooth.
We Do the Rest
From there, sit back and relax. We’ll manage your accounts, taxes, and everything in between, keeping your practice running smoothly.
FAQs About Accountants for Hospitals
We work with private hospitals, independent hospitals, hospital operators and hospital groups, as well as other hospital-based businesses that need reliable accounting and tax support. Their structures differ widely — some trade through limited companies, some operate across several sites, and some sit within a wider group — and their activities, income streams, staffing and equipment requirements vary just as much. Because of that, the work is tailored to each hospital rather than delivered from a fixed template. If you are unsure whether your organisation fits, it is worth a conversation to establish exactly what you need.
Our services typically cover annual accounts preparation, bookkeeping, management accounts, payroll, budgeting, cash flow forecasting, financial reporting, and tax support including Corporation Tax where applicable and VAT support where relevant. Because hospitals have particular cost profiles, we also look closely at how staff costs, medical equipment, premises, professional services and supplier payments are recorded and reported. Income streams are reviewed carefully too, since hospitals often rely on a mix of funding sources and payment arrangements. Everything is built around producing accurate records and financial information that help you run the organisation with confidence.
Pricing is based on the work your hospital genuinely needs. That means considering the size and complexity of the operation, the volume of transactions, the number of people on payroll, and the level of reporting and compliance involved. We work on fixed, transparent packages wherever possible, so you know what you are paying for and there are no hidden fees or unexpected add-ons. Before any work begins, we set out the scope and the fee clearly, and if your circumstances change over time, the arrangement can be reviewed with you.
Yes. Bookkeeping and payroll are two of the most demanding areas for hospitals, simply because of the volume and variety of transactions and the size of the workforce. We can manage day-to-day bookkeeping so that records stay accurate and up to date, and run payroll for clinical and non-clinical staff, including the associated reporting obligations. Handling these together means staff costs, supplier payments and other outgoings are reflected consistently, which makes management accounts and year-end reporting considerably more reliable.
We do. Management accounts give hospital operators a regular view of performance — income, costs, margins and cash position — so decisions can be made on current information rather than historic figures. Alongside that, we prepare financial reporting suitable for the organisation's structure and any external requirements. For hospital groups and multi-site operators, reporting can be broken down so individual sites, service lines or cost centres can be reviewed separately. The emphasis is on information that is clear enough to act on.
If a hospital operates through a limited company, Corporation Tax will usually apply to its taxable profits, although the exact position depends on the entity structure and the nature of its activities. VAT requires more careful thought: treatment depends on the nature of the supply, the activities involved, the organisation's status and the specific circumstances, so it is not safe to assume that all hospital services are exempt or that every hospital-related supply is taxable. We review how your income streams and costs are treated and help you apply the rules correctly to your situation.
Yes, and these often go hand in hand. Medical equipment and other capital expenditure can be significant and irregular, while payroll, premises and supplier payments tend to be steady and predictable, which makes timing the real challenge. We help build budgets and cash flow forecasts that account for both the routine and the occasional, so you can plan for equipment purchases and other investment without straining day-to-day finances. Where relevant, we also consider how capital expenditure is treated for accounting and tax purposes.
Getting started is usually a straightforward process. We begin with a conversation about your hospital or hospital business, what you have in place already and what you would like to improve, then request the relevant information — accounts, records, payroll details and tax correspondence — from you or your existing accountant. Once we understand the position, we confirm the scope and the fee, and take over the accounting and tax work from there. Switching does not have to be disruptive, and we can liaise with your current accountant on your behalf if that makes things easier.