Accountants for UK Dentists, Private Healthcare and Medical Professionals
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 works with UK dentists, chiropractors, physiotherapists, osteopaths, optometrists, podiatrists, private GPs, consultants, locum doctors, nurses, allied health professionals and private healthcare practices. We charge a fixed monthly fee so your practice accounts, NHS pension awareness, associate splits and personal tax position are managed every year — not panicked at after a deadline lands. We are an ACCA-regulated accountancy practice working primarily on Xero.
Contact us today for a free consultation to walk through your situation.
Private practice — where most of our healthcare work sits
Dentists, chiropractors, physiotherapists, osteopaths and private healthcare clinics share a set of issues that the rest of the accounting world does not really understand. Practice profit. VAT exemptions where they apply and standard-rated work where they do not. Associate contracts. NHS-private income splits. Capital allowances on equipment. Salary and dividend planning. Practice purchase and exit. We work with you on all of it.
Dentists
Most dentists run their own practice. NHS contracts, private fee income, associate dentist payments, hygienist sessions, lab fees, capital expenditure on chairs, X-ray and CBCT equipment — the picture is more complex than most accountancy firms recognise. We handle the practice accounts, corporation tax, associate self-employment payments, NHS pension certificates where relevant, and the salary and dividend planning that decides what the principal takes home each year. For dentists buying or selling a practice, we work alongside specialist dental brokers and lawyers on the deal structure.
Chiropractors
Most chiropractors are private practice — sole trader, partnership, or limited company. We handle practice bookkeeping, VAT exemption position (chiropractic care is VAT-exempt; product sales are not), GCC registration and indemnity costs as allowable expenses, associate chiropractor payments, and the sole-trader-vs-Ltd decision as your income grows. For multi-site chiropractic businesses, we coordinate the management accounts so each clinic’s profitability is visible separately.
Physiotherapists and osteopaths
Whether you work as a self-employed physio in clinics, run your own practice, hold contracts with sports teams or insurers, or split between NHS and private work — we handle the income reconciliation, expense allocation, professional body fees (CSP, IOC, BAcC), and personal tax. Practice owners get the same support as dentists and chiropractors — capital allowances, payroll for support staff, and the structural decision around incorporation.
Optometrists and podiatrists
Independent optometry and podiatry practices have a specific VAT position (eye tests, sight tests and clinical podiatry are exempt; lens sales, frames and product retail are standard-rated). The exempt-vs-standard split has to be calculated cleanly each VAT period. We handle the apportionment, the partial exemption calculations where applicable, and the wider practice accounts.
Private GPs, consultants and specialist clinics
Consultants with NHS and private income, private GPs running their own clinics, aesthetic practices, fertility clinics and other specialist private healthcare businesses. The split between NHS PAYE income and private practice income changes the structure of the whole tax position. We model both routes (sole trader and limited company), advise on the most tax-efficient route at your income level, and handle both sides under one engagement.
Associate clinicians (any speciality)
Associate dentists, locum chiropractors, freelance physios, locum doctors — anyone working under a self-employed contract for an established practice. We handle self assessment, expense tracking for professional fees (GMC, GDC, GCC, HCPC, indemnity), and the rolling tax forecast so you have months of warning about the size of the bill, not days.
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 doctors and consultants — where NHS pension awareness matters most
For GPs, consultants, locum doctors, and salaried doctors working primarily in the NHS, the most-asked tax issue is not practice profit — it is NHS pension growth and how it interacts with the annual allowance. The NHS pension is one of the most valuable parts of any clinician's overall reward. It is also the source of most tax surprises in the sector.
Then keep the following existing sub-sections in this order:
- Annual allowance — £60,000 with tapering
- The tapered annual allowance for high earners
- Lifetime allowance — abolished
- Scheme Pays
- The McCloud remedy — what doctors need to do
- Gifted products and PR — the rules that trip everyone up
- The Cost Claim-Back Scheme
- Acting on an NHS pension election
Keep the existing wording of these sub-sections as they are — the technical content is accurate and well-written. Only the position on the page changes.
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.
Who we work with
NDCA healthcare clients fall into a few groups. Private practice and associate clinicians come first because that is where most of our healthcare work sits.
- Dentists running their own practice (NHS, private, or mixed)
- Associate dentists working under self-employed contracts
- Chiropractors in private practice — sole trader, partnership, or limited company
- Physiotherapists, osteopaths and sports therapists
- Optometrists and podiatrists running independent practices
- Private GPs and consultants with mixed NHS and private income
- Aesthetic clinics, fertility clinics and specialist private practices
- Locum doctors and locum allied health professionals
- GP partners and salaried GPs (NHS general practice)
- Hospital consultants with NHS and private practice income
- Junior doctors and trainees
- Allied health professionals across NHS and private sectors
- Closing line: 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.
Reviews
Discover why businesses trust us for dependable accounting services and practical financial advice.
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.
Practice bookkeeping on Xero, statutory accounts and corporation tax, payroll for nurses, hygienists and receptionists, VAT where applicable (cosmetic dentistry is standard-rated, NHS and routine dentistry is exempt), associate dentist self-employment payments, NHS pension certificates where applicable, capital allowances on equipment, and personal tax for the principal. For practice purchase or sale, we work alongside specialist dental brokers and solicitors on the deal structure.
For most chiropractors, the answer depends on your net profit. Below around £50,000 a year, sole trader is often simpler and almost as tax-efficient — National Insurance is the main cost difference. Above £80,000, a limited company usually wins. Between those, it is genuinely case-by-case. We model both routes and walk through the actual tax difference at your numbers before recommending one. The decision is also affected by what you plan to do with the profits — reinvest, take as personal income, or build the business up to sell.
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.
It depends on the contract and the way you actually work. Genuine self-employment usually means: own indemnity insurance, own equipment, choice of patients/hours where reasonable, ability to send a substitute, and you bear the financial risk of bad debts. Where most of those are missing and you are paid like an employee, HMRC may reclassify the arrangement — and the principal practice ends up with backdated PAYE bills. We review associate agreements and flag where the risk sits.
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 — provided they are wholly and exclusively for your work. GMC, GDC, GCC, HCPC, NMC and GPhC registration fees, MPS / MDU / MDDUS indemnity, BMA / BDA / RCC subscriptions, Royal College fees, exam fees and Royal College assessments — all allowable. We track these through Apron so they are claimed automatically rather than missed at year-end.
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.
Based in Worthing, West Sussex. We work with healthcare clients across the UK — most engagements are fully remote, but in-person meetings are available for clients within driving distance of Sussex.
Yes. Send us a few details about your situation and we will come back within one working day with a fixed monthly quote and a recommendation. No obligation, no awkward phone call to your current accountant — we handle the switching paperwork if you decide to move.
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
