Accountants for Doctors, Dentists & Healthcare

The NHS pension problem that creates tax bills from nowhere

Pension growth in the NHS scheme counts toward the annual allowance (£60,000, tapering down for high earners) — and in a high-inflation or promotion year, deemed growth can blow through it without a penny extra in your pocket. The result is an unexpected tax charge, sometimes five figures. Specialists know the mechanics: checking pension savings statements, electing 'scheme pays' by the deadline, and planning sessions or private work around the taper thresholds.

Locums, IR35, and getting the structure right

A locum working through their own limited company for NHS trusts is almost always inside IR35 (public-sector rules put the status decision on the trust since 2017), while private-sector and mixed work needs case-by-case review. The wrong structure means either unnecessary tax or an HMRC challenge. Medical accountants run the status tests, compare umbrella versus limited versus agency PAYE properly, and handle the pension consequences of each.

Dentists: associates, practices, and incorporation

Associate dentists lost their automatic self-employment treatment in 2023 — status now follows the actual working arrangement, and practices carry the risk of getting it wrong. Practice owners face NHS contract accounting, UDA performance tracking, staff payroll, and the perennial incorporation question. Dental-specialist accountants benchmark practice performance against sector norms — useful leverage when buying, selling, or negotiating an associateship.

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