Hospice & Healthcare Charity Accountants

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.

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

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.

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

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.

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.

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.

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.

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.

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

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.

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

Are my services exempt or standard-rated?

Medical care provided by registered health professionals is generally VAT exempt if the primary purpose is protecting health. Purely cosmetic procedures and medicolegal reports are typically standard-rated at the prevailing rate. You must monitor your taxable turnover against the £90,000 registration threshold. Determining the correct liability requires a detailed review of your specific services.

What is partial exemption?

Partial exemption applies when a healthcare business makes both VAT-exempt and taxable supplies. You cannot usually reclaim all input VAT if you have exempt income. A specific calculation determines how much VAT on overheads is recoverable. This is a common requirement for GPs and consultants with mixed income streams.

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

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

What happens if I registered late?

Failure to register for VAT when your taxable turnover exceeds £90,000 may result in financial penalties. HMRC may also charge interest on the VAT that should have been paid from the effective date of registration. You will be liable for the VAT on past sales regardless of whether you charged it. Early disclosure often helps in mitigating these penalties.