Accountants for UK Dentists, Private Healthcare and Medical Professionals
As your accountant for healthcare professionals UK dentists and GPs trust, we know the reality: Dentists, chiropractors, physiotherapists, osteopaths, private GPs and consultants do not train for years to spend evenings reconciling associate splits, VAT exemptions and NHS pension paperwork. They train to treat patients. Whether you run a practice, work as an associate, or split your time between NHS and private — we handle the tax side so you can focus on the clinic side.
NDCA is an ACCA-regulated accountancy practice for UK dentists, chiropractors, physiotherapists, optometrists, private GPs, consultants and NHS doctors, working exclusively on Xero. Fixed monthly fee. Practice accounts, NHS pension awareness, associate payments and personal tax — all handled, every year.
Contact us today for a free consultation to walk through your situation.
Accountant for healthcare professionals UK — private practice, where most of our work sits
Private practice, covered Dentists, chiropractors, physiotherapists, optometrists, podiatrists, private GPs and specialist clinics — we handle every speciality, with the detail that matters to each:
Dentists — practice accounts, associate payments, NHS pension certificates, equipment allowances.
Chiropractors, physios and osteopaths — VAT exemption position, professional body fees, structure planning as income grows.
Optometrists and podiatrists — partial exemption where clinical and retail income mix.
Private GPs and consultants — the most tax-efficient structure across NHS and private income.
Associates and locums — self assessment, fee tracking, rolling tax forecasts.
The tax issues private practice clinicians ask us about
Eight questions come up on almost every first call with a private practice clinician.
Sole trader or limited company?
Below around £50,000 net profit a year, sole trader is often simpler and almost as tax-efficient. Above £80,000 a limited company usually wins on tax. The middle band is genuinely case-by-case. We model both routes before recommending one — and for some clinicians, the right structure is actually a partnership rather than either.
VAT exemption — and where it does not apply
Most genuinely medical services provided by a qualified healthcare professional are VAT-exempt under VAT Notice 701/57. But cosmetic dentistry, aesthetic treatments, product sales (contact lens solution, dental whitening kits, supplements, orthotics) and some non-clinical work are standard-rated. The line between exempt and standard-rated catches out a lot of practices and triggers VAT registration unexpectedly. We get the position right and keep it right.
Associate contracts and self-employment status
Associate dentists and self-employed clinicians have to look like genuine self-employed workers to HMRC — own equipment, own indemnity, choice of patients, freedom over hours. Where the contract is essentially employment dressed up as self-employment, HMRC can reclassify and the practice ends up with backdated PAYE bills. We review associate agreements and flag where the risk sits.
Capital allowances on clinical equipment
Dental chairs, X-ray and CBCT machines, ultrasound equipment, chiropractic adjusting tables, physio treatment couches, optometry equipment — most clinical equipment qualifies for the Annual Investment Allowance (100% deduction up to £1,000,000 per year). For practices buying or upgrading equipment, getting the timing of the purchase right against the tax year matters.
Salary, dividend and pension planning for practice owners
For practice owners running a Ltd, the salary/dividend mix changes with every Budget. Dividend rates rose in April 2026 (basic rate now 10.75%, higher rate 35.75%). We recalculate the optimal extraction strategy each year and model employer pension contributions, which are often the most tax-efficient profit extraction route.
Practice purchase, sale and goodwill
Buying or selling a practice has CGT, stamp duty and Business Asset Disposal Relief implications. Goodwill in a healthcare practice is treated differently to most other professional practices. We work alongside specialist healthcare brokers and lawyers on the deal structure and tax position.
Making Tax Digital for sole-trader clinicians
Sole trader dentists, chiropractors, physios and any healthcare professional with qualifying income above the current MTD threshold now fall into MTD for Income Tax. The threshold is being phased down over time. We get you set up on Xero before your first quarterly deadline.
NHS pension awareness for mixed-income clinicians
For clinicians with NHS work alongside private practice — consultants, private GPs, NHS-mixed dentists — NHS pension growth still counts towards your annual allowance. The interaction between NHS pension growth and private practice income can produce unexpected tax charges. We flag the position annually so problems get addressed in time.
NHS pension — where most tax surprises come from
For GPs, consultants and salaried doctors, NHS pension growth counts towards your annual allowance (currently £60,000, tapered down to £10,000 for high earners). Most tax surprises in this sector come from this interaction, not from practice profit. We handle the full picture: annual allowance forecasting, Scheme Pays elections, McCloud remedy reassessments, and Cost Claim-Back Scheme applications where HMRC charges arise from the remedy. If your pension statement has ever produced a number that did not make sense, this is exactly what we sort out.
What we handle for each type of healthcare professional
Healthcare is not one audience. Different clinicians have different tax positions and need different things from an accountant.
Structure planning
Sole trader, partnership or limited company — modelled against your actual numbers, not a rule of thumb.
VAT exemption
The line between exempt medical services and standard-rated work (cosmetic treatment, product sales) gets missed often. We keep the position right.
Associate contracts
We review agreements and flag where HMRC could reclassify self-employment as disguised employment.
Capital allowances
Dental chairs, imaging equipment, treatment couches — claimed correctly and timed against your tax year.
Who we work with
Practice-owning dentists, chiropractors and physios, private GPs and consultants with mixed NHS and private income, associate and locum clinicians across every speciality, and NHS doctors at any career stage from junior doctor to consultant. If your situation is not on the list, send us a message — it almost certainly fits.
How NDCA works
Three things make our service different for healthcare professionals specifically.
Fixed monthly fee
You pay one price every month for everything we agreed at the start — bookkeeping, practice accounts, corporation tax, associate payment tracking, self assessment, NHS pension awareness. No clock-watching. No surprise invoice when a practice or pension question comes up.
A real human, fast
You get a named accountant who understands healthcare practice complexity, not a ticket queue. Most queries get a reply within one working day, which matters when a practice decision needs making this week.
Built around the way clinicians work
Clinical hours, practice rotas, NHS sessions, private patient lists, on-call work, locum sessions, weekend clinics — clinicians work irregular schedules and the financial picture follows the pattern. We build the workflow around clinical schedules and tax deadlines, not the other way round.
Xero is the only platform we use
For dentists, chiropractors, physios, optometrists and private healthcare practices, we use Xero. Live bank feeds, real-time bookkeeping and clean management accounts mean you can see practice profitability month by month, not nine months after year-end.
For associate clinicians and locum doctors, Xero handles irregular income, fragmented expense capture and multiple income streams better than spreadsheets ever do. If you are not yet on Xero, we migrate you across as part of onboarding. If you are already there, we plug straight in.
Apron for invoice capture
Healthcare professionals accumulate paperwork from across every source — GMC, GDC, GCC, HCPC, MPS or MDDUS renewals annually, Royal College and faculty fees, course fees, exam fees, journal subscriptions, equipment purchases, mileage logs, hospital parking receipts. Apron is included in your monthly fee — no separate subscription.
You snap a photo of a receipt or forward an invoice to your dedicated Apron email address. Apron extracts the supplier, date, amount, VAT and line items, and pushes them into Xero against the right category. By the time year-end arrives, every allowable expense is supported by paperwork already in the system.
Practice tax question or NHS pension issue?
Healthcare income is more complex than most accountants are set up to handle. Send us your situation — we will come back within one working day with a fixed monthly quote.
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Switching from another accountant
If you already have an accountant and they treat your practice like a generic Ltd, your tax position may be worse than it needs to be. Switching is simpler than people think. We send your current accountant a professional clearance letter, collect your records, and pick up where they left off. Most clients are fully on-boarded within two weeks.
You do not need to wait for the next tax year. You do not need an awkward phone call. We handle it.
Healthcare and private practice accounting FAQs
For most healthcare clients, NDCA pricing falls between £65 and £250 per month depending on complexity. A salaried GP, junior doctor or sole-trader chiropractor with a single income source sits at the lower end. Dentists running a practice, GP partners with shares in a partnership, and multi-site clinic owners sit higher. Practice accounts, payroll, VAT, self assessment and corporation tax are typically included. Specialist work — practice purchase/sale, Scheme Pays elections, McCloud reassessments — may be quoted separately. We give a fixed quote after a 15-minute call.
Mostly yes — under VAT Notice 701/57, genuinely medical services provided by registered healthcare professionals are exempt from VAT. But the exemption applies to medical care, not to product sales (orthotics, supplements, dental whitening kits, contact lenses), cosmetic-only treatments, or non-clinical training services. Where you have a mix of exempt and standard-rated income, you may still need to register for VAT once the standard-rated income crosses the threshold (currently £90,000). We work out the apportionment and keep the position right.
NHS pension growth counts towards your annual allowance (currently £60,000). Even consultants with relatively normal income can exceed it in high-pay-progression years. We flag the position annually so problems can be addressed in time, and coordinate with specialist NHS pension advisers on Scheme Pays elections and McCloud reassessments where the technical work needs deeper expertise.
Xero, exclusively for the bookkeeping. We integrate Xero with Apron for receipt and supplier invoice capture. For NHS pension certification, McCloud reassessment and annual allowance forecasting, we use Xero data alongside dedicated NHS pension worksheets.
Yes. NDCA is an ACCA-regulated accountancy practice. We carry professional indemnity insurance and are registered with the Information Commissioner's Office for data protection.
We are remote-first. We work with healthcare professionals and practices across the UK so location does not matter.
Ready to hand over the tax side?
Most healthcare clients hand us the NHS pension certificates, the private practice accounts, the locum invoices and the professional expenses once a year — and never think about HMRC deadlines again. Send us a few details — we will come back within one working day with a fixed monthly quote
