Accountants for UK dentists, private healthcare and medical professionals
None of our healthcare clients trained for years to spend evenings reconciling associate splits, VAT exemptions and NHS pension paperwork. We handle the tax side so you can focus on the clinic side.
In short: NDCA is an ACCA-regulated accountancy practice for UK healthcare professionals, including GPs, locum doctors, dentists and private practitioners. We handle NHS and private income, practice accounts, VAT exemption questions and your Self Assessment or limited company accounts. Your agreed services are covered by one fixed monthly fee, with a named accountant who knows your numbers.
We work with dentists, chiropractors, physiotherapists, optometrists, private GPs, consultants and NHS doctors across the UK, with your books kept in Xero. Practice accounts, NHS pension awareness, associate payments and personal tax are all handled, every year.
What NDCA clients say
Verified Google reviews from NDCA clients.
In short: NDCA is an ACCA-regulated accountancy practice for UK healthcare professionals, including GPs, locum doctors, dentists and private practitioners. We handle NHS and private income, practice accounts, VAT exemption questions and your Self Assessment or limited company accounts. Your agreed services are covered by one fixed monthly fee, with a named accountant who knows your numbers.
We work with dentists, chiropractors, physiotherapists, optometrists, private GPs, consultants and NHS doctors across the UK, with your books kept in Xero. Practice accounts, NHS pension awareness, associate payments and personal tax are all handled, every year.
What is on this page?
- Accountant for healthcare professionals UK: private practice, where most of our work sits
- The tax issues private practice clinicians ask us about
- NHS pension: where tax surprises often start
- Who we work with
- How NDCA works
- Cloud accounting that keeps your numbers current
- Apron for invoice capture
- Switching from another accountant
- Healthcare and private practice accounting FAQs
Accountant for healthcare professionals UK: private practice, where most of our work sits
Private practice, covered. Whether you own the practice or work within one, private healthcare spans a wide range of specialities: dentists, chiropractors, physiotherapists, optometrists, podiatrists, private GPs and specialist clinics. We work with each of these, 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?
At lower profit levels, sole trader is often simpler with little tax difference either way. As profit grows, a limited company tends to become more tax-efficient, though exactly where that tips over depends on your other income, how much you need to draw out personally and your appetite for the extra admin. We model both routes against your actual numbers 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 can catch practices out and trigger VAT registration unexpectedly. We check which of your income is exempt and review it whenever your services change.
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 rules differ by profession: NHS GP goodwill cannot be sold, while dental and private practice goodwill usually can. 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 £50,000 fell into Making Tax Digital for Income Tax from April 2026, with the threshold falling to £30,000 from April 2027 and £20,000 from April 2028. We get you set up on Xero before your first quarterly deadline.
NHS pension awareness for mixed-income clinicians
If you combine NHS work with private practice, consultancy or associate income, the two need to be looked at together rather than filed separately. See the NHS pension section below for how we handle the annual allowance side of this.
NHS pension: where tax surprises often start
For GPs, consultants and salaried doctors, NHS pension growth counts towards your annual allowance (currently £60,000, tapered down to a £10,000 minimum for high earners). For many clinicians, this interaction causes more unexpected tax charges than practice profit itself. We forecast your annual allowance position annually, help you use HMRC's public service pension adjustment service where the McCloud remedy changes a past annual allowance charge and coordinate with specialist NHS pension advisers on Scheme Pays elections and McCloud reassessments where the technical work needs deeper expertise. If your pension statement has ever produced a number that did not make sense, we will go through it with you.
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 listed here, get in touch and we will tell you plainly whether we are the right fit.
How NDCA works
What you can expect:
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.
Direct answers from your accountant
You get a named accountant who understands healthcare practice complexity, not a ticket queue. We normally reply the same 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.
Cloud accounting that keeps your numbers current
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?
NHS pension paperwork, associate splits, VAT exemption, practice structure: if any of that sounds familiar, send us your situation and we will give you a fixed monthly quote at the end of your free consultation call.
Reviews
Discover why businesses trust us for dependable accounting services and practical financial advice.
What NDCA clients say
We work with businesses across the UK and beyond, delivering results that speak for themselves. Browse our reviews to see the impact we have made, and if you have worked with us, we would love for you to leave a review on Google
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. How long it takes depends mainly on how quickly your previous accountant sends the records across, and we keep you updated throughout.
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
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.
Even consultants on fairly normal pay can go over the allowance in years of steep pay progression. We forecast your position every year so a charge is spotted early, and bring in specialist pension advisers where the case needs it.
Yes, if you work through your own limited company. For NHS and other public-sector engagements, the trust must issue a Status Determination Statement before you start, and most NHS locum work is currently determined as inside IR35, meaning the fee-payer deducts income tax and employee National Insurance before it reaches your company and restricts what you can claim as expenses. Private engagements with medium or large organisations follow the same rules. Only genuinely small private clients leave the status decision with you. Outside IR35 status depends on real substitution rights, autonomy over how and when you work and financial risk, not just what the contract says.
Interest on a loan taken out specifically to buy a share in a trading or professional partnership, such as a GP or dental partnership, normally qualifies for tax relief, provided the money is used wholly and exclusively for that purchase and the partnership is not an investment vehicle. The relief can be lost if the loan terms stop being commercial or the borrowed money gets used for something else, so it is worth getting the structure checked before you sign. Separately, the goodwill or capital element you are buying may carry its own capital gains implications for the partner selling their share. We handle both sides of that conversation, buyer and seller.
We keep the books in Xero, and we move practices across from other software as part of onboarding. We integrate Xero with Apron for receipt and supplier invoice capture. For annual allowance forecasting and NHS pension certification we work from Xero data and dedicated NHS pension worksheets.
Yes. We set sole-trader clinicians up on Xero and send the quarterly updates, so you are ready before your first deadline.
Yes. We are regulated by ACCA, 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.
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Ready to hand over the tax side?
Once you are set up, you send us your NHS pension statements, private practice figures, locum invoices and professional expenses and we keep track of every HMRC deadline from there. Send us a few details and we will take it from there
