Medical.Accountants
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Tax guides

Medical Accountant vs General Accountant

Why specialist knowledge pays for itself. Expert UK guide for doctors from ICAEW-regulated accountants. Updated for 2026/27.

Is a specialist medical accountant worth it?

A specialist medical accountant understands NHS pay, the NHS Pension Scheme, locum IR35 rules and the VAT treatment of health services. That means fewer errors and earlier warnings, such as an annual allowance charge or a Making Tax Digital deadline, than a general accountant would usually give.

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

  • For 2026/27 the standard annual allowance is £60,000.
  • 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 self-employed healthcare professionals

  • "My tax return is late and I'm worried about HMRC penalties."
  • "I got a tax bill I didn't expect and don't know why."
  • "HMRC has opened an enquiry and I don't know what to send."
  • "My mortgage lender wants SA302s and tax year overviews."
  • "My current accountant doesn't understand the NHS."
  • "I have a buy-to-let alongside my clinical income."

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

Urgent catch-up

We bring overdue returns up to date and talk to HMRC on your behalf.

Tax reserve plan

We tell you what to set aside each month so January holds no surprises.

Enquiry support

We handle HMRC correspondence and prepare the records they ask for.

Simple switching

We contact your old accountant and move your records for you.

How we help

01

Accounts and tax returns

Year-end accounts and Self Assessment or company returns for medical accountant vs general accountant, filed on time.

02

Fixed-fee advice through the year

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

03

Making Tax Digital

Compatible software set up and quarterly updates filed where MTD applies.

04

NHS pension tax

Annual allowance and taper calculations, with Scheme Pays guidance where a charge arises.

What to know before you decide

NHS pension

For 2026/27 the standard annual allowance is £60,000. It tapers where threshold income exceeds £200,000 and adjusted income exceeds £260,000, by £1 for every £2, to a minimum of £10,000. NHS pension growth is measured as a defined benefit input, so a pay rise or promotion can trigger a charge without any extra contributions. We run the calculation before the year ends and explain Scheme Pays where a charge arises.

NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

Locum forms

This is one of the questions we work through with medical accountant vs general accountant 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 exemptions

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

Benchmarking

This is one of the questions we work through with medical accountant vs general accountant 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

What does a specialist medical accountant do?

A specialist medical accountant understands NHS pay, the NHS Pension Scheme, locum IR35 rules and the VAT treatment of health services. That means fewer errors and earlier warnings, such as an annual allowance charge or a Making Tax Digital deadline, than a general accountant would usually give.

Want us to check this for you? Get a free review →

How much does a medical accountant cost?

Our packages for medical accountant vs general accountant 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.

Want us to check this for you? Get a free review →

What qualifications should a medical accountant have?

A specialist medical accountant should hold a recognised UK chartership, such as ACA or ACCA. These qualifications ensure they adhere to strict professional and ethical standards. At Medical.Accountants by ACCOTAX, our professionals are fully qualified to handle complex healthcare tax issues. Specialized knowledge in NHS pensions and medical VAT is also essential.

Want us to check this for you? Get a free review →

Why use a specialist rather than a general accountant?

A specialist medical accountant understands NHS pay, the NHS Pension Scheme, locum IR35 rules and the VAT treatment of health services. That means fewer errors and earlier warnings, such as an annual allowance charge or a Making Tax Digital deadline, than a general accountant would usually give.

Want us to check this for you? Get a free review →

How easy is it to switch accountants?

Switching takes minutes on your side. You sign our engagement letter, we contact your previous accountant for professional clearance and records, and we take over HMRC and Companies House authorisations. You can switch mid-year; we pick up from the last filed return.

Want us to check this for you? Get a free review →

What questions should I ask before appointing an accountant?

You should ask if they offer fixed fees agreed in writing and if they specialise in the healthcare sector. Confirm if they provide a remote UK-wide service and how quickly they can onboard new clients. Medical.Accountants typically completes onboarding within 48 hours. Ensure they have experience handling specific NHS pension and superannuation complexities.

Want us to check this for you? Get a free review →

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 deadline calendar free

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

Your questions, answered

Is a specialist medical accountant worth it?
A specialist medical accountant understands NHS pay, the NHS Pension Scheme, locum IR35 rules and the VAT treatment of health services. That means fewer errors and earlier warnings, such as an annual allowance charge or a Making Tax Digital deadline, than a general accountant would usually give.
What does a medical accountant know that others don't?
An accountant for medical accountant vs general accountant 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.
How much does an accountant for doctors cost?
Our packages for medical accountant vs general accountant 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 doctors 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. Medical accountant vs general accountant 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.
How do I switch to Medical.Accountants?
Switching takes minutes on your side. You sign our engagement letter, we contact your previous accountant for professional clearance and records, and we take over HMRC and Companies House authorisations. You can switch mid-year; we pick up from the last filed return.

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

NHS Pension Tax & Annual Allowance for Doctors & Healthcare ProfessionalsVAT Registration & Returns for Doctors & Healthcare ProfessionalsAccountants for doctors and GPs in the UKLocum doctor accountants: tax, IR35 and NHS pensions
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: ICAEW and ACCA practising certificate registers; AISMA (Association of Independent Specialist Medical Accountants).

Official guidance

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