Medical.Accountants
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Regulated & AML supervision
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Healthcare businesses

Healthtech & Medtech Start-up Accountants

Specialist accountants for healthtech and medtech start-ups. R&D relief, SEIS/EIS and investor-ready accounts. Fixed fees, ICAEW-regulated. Free quote.

What does an accountant for healthtech and medtech start-ups do?

An accountant for healthtech and medtech start-ups 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
  • 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

  • Your actual working arrangements determine the tax treatment; choosing a package does not change your employment status.
  • Keep records for each income source and check the official guidance linked to the questions below.
  • Agree the accounts, returns and advisory work you need before accepting a written fixed-fee quote.

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 healthcare businesses

  • "I'm unsure which of our services are medical and which are cosmetic for VAT."
  • "Are our clinicians employees, contractors or inside IR35?"
  • "Fleet and equipment costs are eating our profit."
  • "Invoice finance is managing our cash flow, not us."
  • "We may qualify for R&D relief or SEIS/EIS."
  • "Investors want proper management accounts."

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

VAT and status review

VAT treatment and clinician status checked together.

Capital allowances

Relief claimed on vehicles and equipment.

R&D claims

Claims prepared where your work qualifies.

Management accounts

Monthly numbers investors and lenders trust.

How we help

01

Accounts and tax returns

Year-end accounts and Self Assessment or company returns for healthtech and medtech start-ups, 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

Planning before deadlines

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

What to know before you decide

Merged R&D scheme [VERIFY]

This is one of the questions we work through with healthtech and medtech start-ups 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.

SEIS/EIS

This is one of the questions we work through with healthtech and medtech start-ups 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.

Grants

This is one of the questions we work through with healthtech and medtech start-ups 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.

MHRA-related costs

This is one of the questions we work through with healthtech and medtech start-ups 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

Do private clinics charge VAT?

Most health care by registered professionals is VAT exempt where the main purpose is protecting or restoring health, so many clinicians never register. VAT becomes relevant when you sell goods, provide cosmetic or medicolegal services, or exceed the registration threshold with taxable income. HMRC Notice 701/57 gives the official guidance.

Check the official guidance · www.gov.uk

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

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

Should clinicians be employed or self-employed in my clinic?

Employment status depends on the real working relationship: who controls the work, whether you can send a substitute, whether you carry financial risk and how integrated you are. A contract label alone does not decide it. HMRC's Check Employment Status for Tax tool and case law set the tests, and getting it wrong can leave the engager owing PAYE.

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

How does VAT partial exemption work for a clinic?

Most health care by registered professionals is VAT exempt where the main purpose is protecting or restoring health, so many clinicians never register. VAT becomes relevant when you sell goods, provide cosmetic or medicolegal services, or exceed the registration threshold with taxable income. HMRC Notice 701/57 gives the official guidance.

Check the official guidance · www.gov.uk

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

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

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

Can healthcare businesses claim capital allowances on equipment?

Equipment, vehicles and many fixtures used in the business normally qualify for capital allowances. The Annual Investment Allowance gives full relief on qualifying spending up to its limit, and cars follow separate rules based on emissions. Keep invoices and record when the asset was first used.

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

Is my healthcare start-up eligible for SEIS or EIS?

Eligibility for SEIS or EIS depends on the nature of your healthcare business and how the capital is used. These schemes offer significant tax reliefs to investors in early-stage companies. The company must meet specific size and trading criteria to qualify. We can review your business structure to determine if an application for advance assurance is appropriate.

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

Is patient transport VAT exempt?

Transport of sick or injured people in vehicles specially designed for that purpose can be zero-rated or exempt, depending on the vehicle and the service. Ordinary passenger transport and event medical cover may be treated differently. We review vehicle specifications and contracts before deciding the VAT position.

Check the official guidance · www.gov.uk

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

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

Do healthcare recruitment agencies charge VAT on staff?

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

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

What management information do lenders and investors expect?

Lenders and investors typically expect up-to-date profit and loss statements, balance sheets, and cash flow forecasts. They use this information to assess the financial health and viability of your healthcare business. Accurate bookkeeping is essential for providing these insights. Medical.Accountants helps clients prepare professional management reports through our UK-wide service.

Help with this question: Mortgage References & SA302s for Doctors & Healthcare Professionals

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

What does it cost to register a clinic with the CQC?

CQC fees depend on the regulated service and the applicable fee scheme. Check the current CQC guidance for your provider category rather than assuming a universal application charge. Also budget separately for premises, professional advice, staffing and compliance work. The requirement to register depends on the activities delivered in England.

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

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.

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

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.

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

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.

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 practice owners

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 practice owners 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 practice owners 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 practice owners

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 practice owners

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 healthcare business finance checklist free

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

Your questions, answered

What does an accountant for healthtech and medtech start-ups do?
An accountant for healthtech and medtech start-ups 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.
Can healthtech start-ups claim R&D tax relief?
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.
Is my medtech start-up eligible for SEIS?
It depends on your circumstances. Our team reviews your income, structure and records and confirms the right approach for healthtech and medtech start-ups in writing as part of your fixed-fee service.
How much does an accountant for healthtech and medtech start-ups cost?
Our packages for healthtech and medtech start-ups 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 healthtech and medtech start-ups 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. Healthtech and medtech start-ups 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

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: HMRC VAT Notice 701/57; HMRC partial exemption (Notice 706); CQC registration; HMRC R&D tax relief (GOV.UK); HMRC SEIS/EIS.

Official guidance

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