Physios, nurses, psychologists, therapists, optometrists, podiatrists and more — if you work in healthcare and have income beyond PAYE, we handle the tax side properly.
NHS employment plus a private clinic. Bank shifts plus agency work. A therapy practice built up alongside a salaried role. Healthcare careers rarely fit in one tax box, and the rules around them keep changing.
Employment, agency, bank and private work are each taxed differently — and most healthcare professionals have at least two on the go. The tax return has to stitch them together correctly, or you overpay quietly.
From April 2026, sole traders with gross income over £50,000 must keep digital records and send quarterly updates to HMRC. The threshold drops to £30,000 in 2027 — catching most established private practices.
Registration fees, indemnity, room hire, equipment, CPD — the allowable list for private work is long, and most professionals claim a fraction of it. The rules for employment income are different again, which is where the confusion starts.
We work exclusively with medical and healthcare professionals — physiotherapists, nurses and midwives, psychologists and therapists, optometrists, podiatrists, sonographers, paramedics and more.
Employment, agency, bank and private income brought together in one correct return — with payments on account managed so January never surprises you.
Sole trader vs limited company modelled on your actual figures as the private practice grows — including the pension and NI angles most generic advice skips.
Digital records set up on Xero or QuickBooks with quarterly updates handled — compliant with Making Tax Digital from day one, not scrambling at the deadline.
A proper review of what your profession can claim — registration, indemnity, room hire, equipment, training — against both your private and employment income.
Where a limited company is the right structure — formation, annual accounts, corporation tax and dividend planning, all handled as one service.
A review before each tax year end — pension contributions, timing of income and equipment purchases — while your options are still open.
As a private clinic or therapy practice grows, this question arrives for every healthcare professional. Here's the honest side-by-side.
Making Tax Digital for Income Tax is now live. From April 2026, sole traders and landlords with combined gross income over £50,000 must keep digital records and send HMRC quarterly updates through compatible software — the single annual tax return is being replaced.
The threshold drops to £30,000 from April 2027, with £20,000 to follow — which brings in most established private clinics, therapy practices and freelance healthcare work. Spreadsheets and shoebox receipts don't meet the requirements; the records themselves must be digital.
If you're over the threshold and still on annual-shoebox bookkeeping, moving now is far less painful than moving under deadline pressure.
The most common pattern we see: NHS employment through PAYE, with a private clinic, agency shifts or freelance work alongside. Each is taxed differently — and because PAYE has already used your personal allowance and bands, private profits are taxed from your marginal rate upwards.
That changes the planning: pension contributions, timing of equipment purchases and (at higher levels) company structures all work harder for mixed-income professionals than the generic guidance suggests.
Agency and bank work adds another layer — it's usually PAYE under the agency rules even though it feels freelance, and mixing it up with genuine self-employment on the return is a classic error.
Typical allowable expenses against private work include:
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