What to know before you decide
The annual cost, without rounding away the pennies
Twelve payments of £45.83 total £549.96 before VAT. This is arithmetic at the starting monthly rate, not a discounted annual offer. Add government filing fees and any separately agreed work. Check the written engagement for the final scope and payment terms.
When a general accountant may be enough
If your affairs are straightforward and your accountant understands the relevant rules, there may be no reason to change. Ask whether they can cover your actual income sources, explain the work clearly and respond when you need them. A specialist label alone does not prove better service.
When to consider a medical specialist
Consider a specialist when NHS pension tax, locum status or NHS and private income create questions your current accountant cannot answer confidently. Ask for relevant experience and a scoped quote. The comparison is about the work and knowledge you receive, not an unsupported promise that a specialist always saves money.
What may cost extra
Check catch-up bookkeeping, additional director returns, personal income outside the included director scope, technical tax advice, HMRC correspondence, software and government filing fees. Ask each accountant to separate included work from extras and confirm how scope changes are priced.