Medical.AccountantsMedical.Accountants
ICAEW regulated
ICAEW regulated
ACCA regulated
ACCA regulated
AAT fellow member
AAT fellow member
Certified advisor
Certified advisor
ProAdvisor
ProAdvisor
100+ years' experience
£2m indemnity cover
4.9 · 321 reviews

Practices & businesses

Specialist accountants for Domiciliary Care Business Plan · Fixed fees · Free first call

Domiciliary care business plan: the figures that matter

A home care business plan is only as good as its numbers. Lenders, landlords and local authorities look at your hourly rate, staff costs and how long you can pay wages before income arrives.

What goes into a domiciliary care business plan?

Your service and area, how you will win clients, staffing plan, an hourly rate built from carer pay and on-costs, start-up costs, a 12 to 24 month cash-flow forecast and your break-even point in care hours per week. We prepare the financial sections for a fixed fee.

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
  • 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

  • We set up the company, payroll and bookkeeping; we do not write your CQC or regulator application.
  • Fixed fee for start-up work, agreed in writing before work starts.
  • One named accountant from your first forecast to your first year-end.

Building the financial plan step by step

  1. List one-off start-up costs
  2. Build the hourly rate from pay and on-costs
  3. Forecast hours delivered month by month
  4. Map when councils and private clients pay
  5. Find break-even and the funding needed

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

Company set-up and structure

Sole trader or limited company, shareholders, bank account and registration for VAT, PAYE and Corporation Tax, done before your first client.

02

Business plan figures

Start-up costs, cash-flow forecast and break-even point prepared for your lender, landlord or regulator application.

03

Payroll and year one accounts

Payroll with pension auto-enrolment, bookkeeping set up on Xero or QuickBooks, and your first accounts and tax returns at a fixed fee.

What to know before you decide

Your questions answered

What are the main start-up costs for a home care agency?

Typically company set-up, CQC registration fee, office or software, recruitment, training, insurance, a registered manager's salary before income starts, and working capital for several months of wages. Amounts vary widely, so we cost your own plan rather than quote an average.

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How long until a home care agency breaks even?

It depends on how quickly you win hours and on your margin per hour. The plan should show the weekly care hours needed to cover fixed costs, and the cash needed until you reach them.

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What are management accounts?

Management accounts are financial reports produced regularly to reflect the current performance of your healthcare business. They typically include a profit and loss statement and a balance sheet. These reports differ from statutory accounts by focusing on internal decision-making. They help clinicians monitor their financial health in real-time.

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Which KPIs matter for my healthcare business?

Key Performance Indicators for healthcare businesses often include staff cost ratios and average revenue per patient. Monitoring clinical room utilisation and overhead percentages is also essential for profitability. These metrics provide insights into operational efficiency beyond simple bank balances. We help you identify the most relevant data for your specialty.

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How do cash-flow forecasts help?

Cash-flow forecasts help you predict future bank balances by timing anticipated income against planned expenditure. They are vital for planning large tax payments or equipment upgrades. These projections allow for informed decisions regarding recruitment and expansion. Maintaining accurate forecasts reduces the risk of unexpected liquidity issues.

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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 care providers

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 care providers 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

Medical accountants for care providers: limited company 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 care providers

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 care providers

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.

Speak to a specialist today

Leave your details and we'll call you back, or book a free review straight away.

Book a free 15-min tax review

Related healthcare expertise

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: CQC: Registration; GOV.UK: National Minimum Wage; Homecare Association; Skills for Care.

Official guidance

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Google reviews

What ACCOTAX clients say

4.9 out of 5 from 321 Google reviews

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