Specialist Limited Company Accountants for Doctors & Medical Professionals
Should a doctor trade through a limited company? The honest answer is that it depends on how much you earn privately, how much you need to draw, whether IR35 applies and how much you value NHS pension accrual. What it should never depend on is a rumour in the doctors’ mess. We model both routes on your real figures, and if a company is right we form it, run it and file everything for one fixed monthly fee.
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We form and run medical limited companies for clinicians across the UK. The right structure depends on where your income comes from and what you intend to do with the profits.
Company accounts, corporation tax, a salary and dividend plan, capital allowances on equipment and profit retention where you do not need to draw everything.
Company formation, IR35 and off-payroll status reviews, VAT where medico-legal work applies, and a comparison against umbrella and sole trader routes.
Companies where treatment is largely non-exempt, VAT registration and planning, staff payroll and equipment finance for clinic owners.
Report income and expert witness fees handled through the right structure, with VAT registration where the work falls outside the medical exemption.
Everything a medical company needs, in one fixed monthly fee, from formation through to the moment you decide to close it.
Incorporation at Companies House, share structure advice, business bank account support, PAYE and VAT registration, and HMRC authorisations set up correctly from day one.
Year end accounts and CT600 returns prepared and filed on time, with capital allowances, allowable expenses and R and D relief considered where relevant.
An optimal remuneration plan reviewed each year, covering salary level, dividend timing, pension contributions from the company and the effect on your personal allowance.
Written status assessments for each engagement, review of client determinations, and practical steps to strengthen your position where the contract genuinely allows.
RTI payroll for you and any staff, VAT returns under the correct scheme, confirmation statements, registered office and all Companies House filings handled.
A company is a powerful structure and an unforgiving one. These are the mistakes we see most often and the ones we prevent:
Incorporating before checking the IR35 position
Losing NHS pension accrual without realising it
Drawing dividends when there are no distributable reserves
Overdrawn director loan accounts and section 455 tax
Personal spending run through the company bank account
Missing VAT registration on medico-legal or cosmetic income
Late confirmation statements and Companies House penalties
Running a company is straightforward when someone competent is watching it. Here is what you get with us:
A written comparison of sole trader and company on your actual numbers, including the NHS pension impact, before you commit to anything.
Status reviews on every engagement and support challenging determinations that do not reflect how you actually work.
Salary, dividend and company pension contributions reviewed annually against current thresholds rather than set once and forgotten.
Accounts, corporation tax, VAT, payroll and confirmation statements filed on time, with reminders well in advance.
We monitor your account through the year so section 455 charges and benefit in kind problems never build up unnoticed.
One agreed monthly fee covering the company and your personal return, with unlimited telephone and email support.
Setting up properly takes about a week. Our three-step process gets your company running quickly and keeps you compliant all year:
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.
Chartered, experienced and genuinely specialised in healthcare. Here is what working with us looks like in practice:
We use Xero, Quickbooks, Sage & many other online software.
Meet, call or email the same qualified accountant who knows your practice and your pension position.
Free telephone & email support
throughout the year.
Our team have over 100 years of combined experienced.
Never Miss any deadline with our automated email reminders.
We’re an ICAEW, ACCA & AAT accredited Firm.
Take a back seat and let our specialist healthcare accountants handle everything. Switching accountant mid-year is straightforward and you never need to speak to your old firm:
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.
It can be, particularly where you have substantial private income and do not need to withdraw all of it. Retained profits are taxed at corporation tax rates rather than higher rate income tax. Once you draw everything out the advantage narrows sharply, and NHS pension accrual is lost on that income, so the answer must be calculated rather than assumed.
No. Employment income from an NHS trust or practice must be paid to you personally through PAYE. A company is only relevant to genuinely self-employed private, locum, medico-legal or consultancy work, and even then IR35 may apply.
Yes, for the income concerned. Work performed through your own limited company is generally not pensionable in the NHS Pension Scheme. For clinicians still building substantial NHS service, that lost accrual can outweigh the corporation tax saving, which is why we always model both.
Where you provide services through your own company to a public sector body or a medium or large private client, the client determines whether the engagement is inside the off-payroll rules. Inside means tax and National Insurance are deducted at source. We review contracts and working practices and challenge determinations where appropriate.
Typically a modest salary that preserves your state pension record and uses allowances efficiently, with the balance taken as dividends, adjusted for your other income and any employment allowance position. The optimal figures change each year with thresholds, so we review it annually.
It records money moving between you and the company outside salary and dividends. If you owe the company money at the year end and it is not repaid within nine months, the company pays a temporary section 455 charge, and a benefit in kind can arise on the interest. We monitor it monthly so it never becomes a surprise.
Only if taxable turnover exceeds the threshold. Most clinical treatment for the protection of health is exempt, but medico-legal reports, expert witness work, some cosmetic procedures and consultancy or training income are standard rated. We track your taxable turnover and register you at the right moment.
Yes. Employer pension contributions are usually an allowable deduction for corporation tax and are not subject to National Insurance, which often makes them the most efficient way to extract value from a medical company. The Annual Allowance still applies, including any NHS scheme growth.
Costs incurred wholly and exclusively for the business, including indemnity and professional subscriptions, courses, clinical equipment, business travel, professional fees, business insurance, use of home under the appropriate method and employer pension contributions. Personal spending must stay out of the company account.
Small companies can often be struck off, and where reserves are larger a members voluntary liquidation may qualify for business asset disposal relief. Both routes need planning ahead of the final distribution, so speak to us before you stop trading rather than after.
We charge a fixed monthly fee covering accounts, corporation tax, payroll, confirmation statement and your personal tax return, with VAT and bookkeeping added where needed. You get the quote before we start.
Yes. We obtain professional clearance and the handover records from your current accountant, review the position for anything that needs correcting, and take over the filings from that point.
Please double-check the figures before you act. The tax, NHS pension and accounting information on this page is general guidance for UK doctors and healthcare professionals, not personal advice. Tax rates, allowances, thresholds and NHS pension rules change regularly, including at each Budget and at the start of every tax year on 6 April. Corporation tax rates, dividend allowances, salary and dividend planning thresholds and associated company rules change frequently. Always cross-check any rates or figures against HMRC, the NHS Business Services Authority and the latest Budget announcements, or speak to one of our qualified accountants before acting. CruseBurke cannot accept liability for decisions made solely on the basis of this page. Last reviewed: August 2026.
