Medical.Accountants
Regulated by ICAEW
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Regulated & AML supervision
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Nursing & midwifery

Midwife Accountants

Specialist accountants for midwives. Refunds and private midwifery tax. Fixed fees, ICAEW-regulated. Free quote.

What does an accountant for midwives do?

An accountant for midwives 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
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

  • Allowable costs include HMRC-approved professional registrations and subscriptions, indemnity where you pay it, business mileage between workplaces and equipment used for work.
  • 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 nurses, midwives and healthcare assistants

  • "I can't decide between umbrella, limited company or self-employed agency work."
  • "My bank shifts are on emergency tax."
  • "I've never claimed my NMC fees, uniform or mileage."
  • "I work for several employers and my tax codes are a mess."
  • "I do aesthetic work and don't know about VAT."

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

Refund claims

We check what you've overpaid and claim it back from HMRC.

Agency structure advice

A clear comparison of the ways you can be paid.

Self Assessment

Your return filed correctly, with every allowable expense.

Aesthetic VAT check

We confirm whether your treatments are exempt or standard-rated.

How we help

01

Accounts and tax returns

Year-end accounts and Self Assessment or company returns for midwives, 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

Uniform and NMC fee refunds

Allowable costs include HMRC-approved professional registrations and subscriptions, indemnity where you pay it, business mileage between workplaces and equipment used for work. Ordinary commuting and personal costs are not allowable. Employees claim through HMRC; the self-employed deduct costs in their accounts.

Tax Refunds for Doctors & Healthcare Professionals

Independent/private practice

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

Agency work

This is one of the questions we work through with midwives 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

Can nurses claim tax back on NMC registration fees?

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.

Check the official guidance · www.gov.ukWant us to check this for you? Get a free review →

How much is the uniform tax rebate for nurses?

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.

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How far back can healthcare workers claim tax refunds?

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: Tax Refunds for Doctors & Healthcare Professionals

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Should agency nurses use an umbrella company?

An umbrella company employs you and runs your pay through PAYE, so income tax, employee and employer National Insurance and its margin all come out of the assignment rate. It suits short-term or inside-IR35 work. A limited company can be more efficient for genuinely outside-IR35 work, but has more admin. We compare both on your actual rates.

Help with this question: IR35 Reviews for Doctors & Healthcare Professionals

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Are agency nurses self-employed or employed?

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.

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Can community nurses claim mileage?

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.

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Why do I pay more tax on bank shifts?

Midwives pay income tax on taxable profit at 20%, 40% and 45%, plus Class 4 National Insurance on self-employed profit. Payments on account mean your first bill can include half of next year's tax too. Where income also comes from overseas, residence status and split year treatment decide what the UK taxes.

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

Do I need a tax return if I have two NHS jobs?

Many midwives must file a Self Assessment return: you need one if you have untaxed income such as private, locum or self-employed work. A high PAYE salary alone does not require Self Assessment for 2026/27; check HMRC's current criteria and any notice to file. The online filing and payment deadline is 31 January after the tax year ends. Under the non-MTD rules, late filing normally triggers an initial £100 penalty, with further penalties for longer delays. A different regime applies from the tax year you join MTD for Income Tax.

Check the official guidance · www.gov.uk

Help with this question: Self Assessment Tax Returns for Doctors & Healthcare Professionals

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

Do aesthetic nurses need to charge VAT?

Treatment by a registered health professional is VAT exempt only where its main purpose is to protect, maintain or restore health. Purely cosmetic treatments, including most injectables and many skin or hair procedures, are standard-rated, as the Upper Tribunal confirmed in Illuminate Skin Clinics v HMRC in 2025. Each treatment line needs its own assessment.

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 →

Is a limited company worth it for a nurse?

A limited company can suit midwives with substantial private or outside-IR35 income that is not all needed to live on, because profit is taxed at corporation tax rates and can be paid out over time. It brings extra accounts, payroll and filing costs, and NHS employment income cannot move into it. We model sole trader against limited company on your real figures first.

Help with this question: Limited Company Accounts & Corporation Tax for Doctors & Healthcare Professionals

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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 midwives

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 midwives 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 midwives 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 midwives

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 midwives

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.

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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 nurse expenses checklist free

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

Your questions, answered

What does an accountant for midwives do?
An accountant for midwives 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 midwives claim tax back?
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 are independent midwives taxed?
Midwives pay income tax on taxable profit at 20%, 40% and 45%, plus Class 4 National Insurance on self-employed profit. Payments on account mean your first bill can include half of next year's tax too. Where income also comes from overseas, residence status and split year treatment decide what the UK taxes.
How much does an accountant for midwives cost?
Our packages for midwives 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 midwives 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. Midwives 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.

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Related healthcare expertise

Tax Refunds for Doctors & Healthcare ProfessionalsIR35 Reviews for Doctors & Healthcare ProfessionalsVAT Registration & Returns for Doctors & Healthcare ProfessionalsAccountants for NursesIR35 for Locum Doctors & NursesTax-Deductible Expenses for Doctors
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: HMRC uniform and flat rate expenses (GOV.UK); NMC fee tax relief (HMRC List 3); HMRC umbrella company guidance; HMRC P87.

Official guidance

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