Medical.Accountants
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Regulated & AML supervision
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Care & transport

Care Sector Accountants

Care homes, home care, ambulance and clinic accounting. Specialist UK accountants for care homes, home care agencies and healthcare businesses. Free quote.

What does an accountant for care homes, home care agencies and healthcare businesses do?

An accountant for care homes, home care agencies and healthcare businesses prepares your accounts and tax returns, keeps you compliant with HMRC deadlines and advises on the decisions specific to your work: how income is structured, which expenses are allowable, VAT where it applies and, for NHS scheme members, pension tax. At Medical.Accountants the work is quoted as a fixed monthly fee, agreed in writing before we start.

Fixed fees, specialist healthcare accountants, and every HMRC and NHS Pensions deadline handled.

  • Fixed monthly fee — no surprises
  • Specialist in NHS pension and healthcare tax
  • Onboarding within 48 hours
Get my fixed-fee quoteBook a free 15-min tax review
  • ICAEW & ACCA regulated
  • 5,000+ clients served by ACCOTAX
  • Specialist healthcare accountants

Reviewed by Waqas Sagar ACA FCCA FMAAT, Founder of ACCOTAX, 18+ years' experience · Last reviewed: 8 October 2026 · Updated for the 2026/27 tax year

Medical.Accountants by ACCOTAX, ICAEW/ACCA-regulated chartered accountants, London, serving clients across the UK. Over 5,000 clients served.

Key takeaways

  • Care and staffing businesses depend on accurate payroll, minimum wage compliance including travel time, auto-enrolment and VAT exemption conditions that hinge on regulation.
  • Health care by registered professionals is generally VAT exempt where its main purpose is protecting or restoring health.

Which accountancy support fits your income?

Start with how you are paid. Different income sources can need different accounts, returns and expense checks.

How you workWhat we checkSupport to explore
Employed or umbrella (PAYE)Tax codes, eligible employment expenses and whether a tax return is needed.Healthcare tax refund support
Genuinely self-employedBusiness income and expenses, Self Assessment and MTD eligibility.Healthcare Self Assessment service
Your own limited companyCompany accounts, Corporation Tax, director income and off-payroll status where relevant.Healthcare limited company accounts
PartnershipPractice accounts, allocated profit and each partner’s personal tax position.Healthcare partnership accounts

Sound familiar?

Problems we fix for care providers

  • "National Living Wage and employer NIC rises are squeezing us."
  • "Travel time and sleep-in pay compliance worries me."
  • "I'm unsure about VAT on welfare services versus staff supply."
  • "Local authority payments are always late."
  • "CQC or Ofsted want financial viability evidence."

What it's costing you

Leaving it unfixed is rarely free

Overpaid tax
Unclaimed expenses and wrong tax codes mean paying more than you owe, year after year.
HMRC penalties and interest
Late returns attract automatic penalties, plus interest on tax paid late.
Lost evenings
Hours spent on forms, invoices and spreadsheets after a long shift.

General examples — your position depends on your own figures.

How we solve it

What we actually do for you

Care payroll

Payroll that handles travel time and sleep-ins correctly.

Cash-flow forecasting

Forecasts that plan around late local authority payments.

VAT review

A clear view of which services are exempt.

Viability statements

Financial evidence prepared for CQC or Ofsted.

How we help

01

Accounts and tax returns

Year-end accounts and Self Assessment or company returns for care homes, home care agencies and healthcare businesses, filed on time.

02

Fixed-fee advice through the year

Questions answered by your named accountant, without the clock running.

03

VAT and payroll

VAT treatment reviewed line by line and payroll run with minimum-wage checks.

04

Planning before deadlines

Payments on account, structure and pension checks reviewed ahead of 31 January.

What to know before you decide

Payroll and National Living Wage

Care and staffing businesses depend on accurate payroll, minimum wage compliance including travel time, auto-enrolment and VAT exemption conditions that hinge on regulation. Monthly management accounts show occupancy, staff cost ratios and cash flow early enough to act.

Payroll & Pensions for Doctors & Healthcare Professionals

Employer NIC changes

This is one of the questions we work through with care homes, home care agencies and healthcare businesses at the start of every engagement. We look at your real income, contracts and records, set out the options in plain English and confirm the work and fee in writing.

VAT on welfare services

Health care by registered professionals is generally VAT exempt where its main purpose is protecting or restoring health. Cosmetic treatments, medicolegal reports and sales of goods are usually standard-rated. Mixed businesses need each income stream assessed, and the registration threshold applies to taxable sales only.

VAT Registration & Returns for Doctors & Healthcare Professionals

Local authority contract cash flow

This is one of the questions we work through with care homes, home care agencies and healthcare businesses at the start of every engagement. We look at your real income, contracts and records, set out the options in plain English and confirm the work and fee in writing.

Your questions answered

How can care providers manage the employer NIC increase?

Care providers can mitigate rising payroll costs by ensuring they fully utilise the Employment Allowance, which is £10,500. Reviewing staffing structures and salary sacrifice arrangements may also provide efficiencies. Efficient tax planning helps maintain margins while meeting legislative obligations. We work with healthcare businesses to model the impact of National Insurance changes on their profitability.

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How do care agencies pay National Minimum Wage for travel time?

You can claim tax relief on costs incurred wholly and exclusively for your work: HMRC-approved professional fees such as GMC, NMC, GDC or HCPC registration and approved royal college and union subscriptions, uniform laundering, and business mileage between workplaces. Ordinary commuting and most exam or training costs for new qualifications are not allowable. Employees can claim back up to four tax years.

Help with this question: Payroll & Pensions for Doctors & Healthcare Professionals

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Do introductory care agencies charge VAT?

Welfare services such as residential and domiciliary care are VAT exempt when supplied by a provider regulated by the relevant state regulator, such as CQC in England or Ofsted for children's homes. Unregulated elements, introductory agency fees and some supported living services can be standard-rated. HMRC Notice 701/2 explains the conditions.

Check the official guidance · www.gov.uk

Help with this question: VAT Registration & Returns for Doctors & Healthcare Professionals

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How should sleep-in shifts be paid?

Where a worker is expected to sleep and suitable sleeping facilities are provided, only time spent awake for the purpose of working normally counts for minimum wage purposes. If the worker is expected to work for most of the shift, the whole shift can count. Contractual pay rights and the actual arrangements also need checking.

Check the official guidance · www.gov.ukWant us to check this for you? Get a free review →

Can a care business claim the Employment Allowance?

You can claim tax relief on costs incurred wholly and exclusively for your work: HMRC-approved professional fees such as GMC, NMC, GDC or HCPC registration and approved royal college and union subscriptions, uniform laundering, and business mileage between workplaces. Ordinary commuting and most exam or training costs for new qualifications are not allowable. Employees can claim back up to four tax years.

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How can care providers manage local authority payment delays?

Care providers can manage delays by implementing robust credit control procedures and clear payment terms. Regularly reviewing aged debtors helps identify issues early. Utilising efficient accounting software allows for better cash flow forecasting during lean periods. Medical.Accountants provides ongoing support to help healthcare businesses navigate these financial challenges with fixed fees.

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What is a CQC financial viability statement?

A CQC financial viability statement is a required document proving a provider has sufficient resources to maintain safe services. It often requires verification from a qualified accountant or financial professional. The statement must demonstrate that the business is a going concern for the foreseeable future. This is a critical component of the registration process.

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How are care homes and care agencies valued?

Healthcare businesses such as pharmacies, dental practices and care homes are usually valued on a multiple of sustainable profit (EBITDA), adjusted for property, contracts, regulatory rating and goodwill. Clean, consistent accounts support a stronger price. We prepare normalised figures for sales or acquisitions.

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What tax is due when selling a care business?

Selling a care business typically triggers Capital Gains Tax on the increase in value of the assets. If the business is incorporated, Corporation Tax may apply to the company's gains before dividends are paid. You may be eligible for specific reliefs that reduce the effective rate of tax. Timely professional advice is recommended before completion.

Help with this question: Practice Purchase, Sale & Valuation for Doctors & Healthcare Professionals

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Quick quote

See what you could save — get a fixed fee in one working day

Three fields. No obligation. A specialist replies, not a sales team.

Packages for your working life

Accountancy packages for healthcare professionals

Self-employed income, a limited company, PAYE or a mixture: start with the support that matches how you actually work. We check your status and agree the scope and fee before starting.

Self-employed accountants for healthcare professionals packages

For genuine sole-trader income. We prepare your business accounts and Self Assessment, review allowable expenses and explain payments on account.

  • Sole-trader accounts and personal tax return
  • Allowable business expenses reviewed
  • Tax reserve and payment deadline guidance
  • MTD support scoped separately where required

Fixed fee quoted after a review

Discuss this package

Limited company accountants for healthcare professionals packages

For clinicians working through their own company. Choose Essential/Compliance, Core/Complete or Growth according to your accounts, bookkeeping and payroll needs.

  • Statutory accounts and Corporation Tax return
  • One director return for salary and dividends from the same company
  • Confirmation statement support; filing fee extra
  • Bookkeeping, VAT and payroll according to your chosen plan

Company packages from £45.83 + VAT / month

Compare company packages

Personal tax return packages for healthcare professionals

For employed clinicians, partners and people with mixed income who need a return. We check whether Self Assessment is required and reconcile the relevant income, expenses and pension tax information.

  • Self Assessment requirement checked
  • PAYE and other income reconciled
  • Eligible employment expenses reviewed
  • Pension tax work agreed separately where needed

Fixed fee quoted after a review

Discuss this package

Employment status is determined by the facts, not the package you choose. PAYE, umbrella and partnership arrangements may also apply. A limited company does not override IR35 or off-payroll rules, and not every employed clinician needs a tax return.

Overpaid tax?

Tax refund support for healthcare professionals

We review tax codes, eligible professional expenses and overpaid tax, then prepare a claim where you qualify. A refund is not guaranteed; HMRC decides the claim.

£249 + VAT

For refunds up to £5,000, our fee is £249 plus VAT. For refunds above £5,000, add 5% of only the amount above £5,000 to the £249 fee. VAT applies to the total professional fee.

Example: a £6,000 refund means £249 + £50 = £299 plus VAT.

Professional fee, excluding VAT

£249

Ask about a tax refund

This illustrates the fee only, not whether you qualify or how much HMRC will refund. We agree the claim scope and payment terms before work starts.

What's included

Limited company packages — compare what's included

Essential/Compliance

For locums, salaried GPs and dentists with a limited company

from £45.83 + VAT /month

  • FRS 105 or FRS 102 1A statutory accounts
  • Corporation tax return (CT600) and tax computation
  • Confirmation statement preparation and filing support
  • One director Self Assessment return
  • Deadline reminders ahead of every filing date

Core/Complete

For private practice, consultants and associate dentists

from £62.50 + VAT /month

  • Everything in Essential/Compliance
  • Monthly bookkeeping and bank reconciliation
  • Quarterly Making Tax Digital VAT returns
  • Director payroll with RTI filing and pension submissions
  • Quarterly review call on numbers and tax position

Growth

For clinics, dental practices and growing medical teams

from £75.00 + VAT /month

  • Everything in Core/Complete
  • Payroll for up to five employees

Prices exclude VAT. Making Tax Digital quarterly updates available as an add-on. Compare fees

Why clinicians trust us

Chartered accountants who know the NHS

  • ACCOTAX has served over 5,000 clients.
  • Regulated chartered accountants (ICAEW and ACCA).
  • Founded by Waqas Sagar ACA FCCA FMAAT, with 18+ years' experience.

Reviewed by Waqas Sagar ACA FCCA FMAAT

Chartered accountant and founder of ACCOTAX. Last reviewed October 2026.

Get my fixed-fee quote

How it works

  1. 01

    Free call

    A 15-minute chat about your income, structure and deadlines.

  2. 02

    Onboarding in 48 hours

    We set up your records, software and HMRC agent access.

  3. 03

    We handle the rest

    HMRC, NHS Pensions and every deadline, with reminders before each one.

Free resource

Get the care provider cash-flow template free

Tell us where to send it and we'll email it to you.

Your questions, answered

What does an accountant for care homes, home care agencies and healthcare businesses do?
An accountant for care homes, home care agencies and healthcare businesses prepares your accounts and tax returns, keeps you compliant with HMRC deadlines and advises on the decisions specific to your work: how income is structured, which expenses are allowable, VAT where it applies and, for NHS scheme members, pension tax. At Medical.Accountants the work is quoted as a fixed monthly fee, agreed in writing before we start.
Are care services exempt from VAT?
Welfare services such as residential and domiciliary care are VAT exempt when supplied by a provider regulated by the relevant state regulator, such as CQC in England or Ofsted for children's homes. Unregulated elements, introductory agency fees and some supported living services can be standard-rated. HMRC Notice 701/2 explains the conditions.
How can a care business manage payroll costs?
Care staff must be paid at least the National Minimum Wage for all working time, including travel between visits. Averaging pay over a pay period is allowed but must be checked. A clear rota-to-payroll process and pension auto-enrolment checks keep costs predictable.
How much does an accountant for care homes, home care agencies and healthcare businesses cost?
Our packages for care homes, home care agencies and healthcare businesses start at £45.83 + VAT a month, with Core at £62.50 and Growth at £75 + VAT. The right package depends on your income sources, whether you trade through a company and any payroll, VAT or pension work. We confirm the exact fee in writing before any work begins, so there are no surprise invoices.
Do care homes, home care agencies and healthcare businesses need to comply with Making Tax Digital?
Making Tax Digital for Income Tax applies from 6 April 2026 to sole traders and landlords whose qualifying income (gross self-employment plus property income) is over £50,000, falling to £30,000 from April 2027 and £20,000 from April 2028. PAYE salary does not count. Care homes, home care agencies and healthcare businesses trading through a limited company or a partnership are not brought in yet. We set up compatible software and file the quarterly updates for you.

Speak to a specialist today

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Book a free 15-min tax review

Related healthcare expertise

VAT Registration & Returns for Doctors & Healthcare ProfessionalsPayroll & Pensions for Doctors & Healthcare ProfessionalsPractice Purchase, Sale & Valuation for Doctors & Healthcare ProfessionalsVAT on Medical & Healthcare Services
Accountants for healthcare professionalsHealthcare tax questions answered

General information for the 2026/27 tax year, prepared from the official guidance linked below. It is not personalised tax or regulated financial advice. Rules and circumstances can change; confirm your position before acting.

Official sources referred to on this page: HMRC VAT Notice 701/2 (welfare services); GOV.UK National Minimum Wage (travel time, sleep-ins); HMRC Employment Allowance; CQC registration guidance.

Official guidance

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