Medical.Accountants
Regulated by ICAEW
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Regulated & AML supervision
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Healthcare businesses

Out-of-Hours & Urgent Care Provider Accountants

Specialist accountants for out-of-hours and urgent care providers. Sessional clinicians, IR35 and NHS contracts. Fixed fees, ICAEW-regulated. Free quote.

What does an accountant for out-of-hours and urgent care providers do?

An accountant for out-of-hours and urgent care providers 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

  • NHS bodies must issue a Status Determination Statement for each off-payroll engagement.
  • Care and staffing businesses depend on accurate payroll, minimum wage compliance including travel time, auto-enrolment and VAT exemption conditions that hinge on regulation.

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 out-of-hours and urgent care providers, 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

Sessional GP engagement

This is one of the questions we work through with out-of-hours and urgent care providers 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.

IR35

NHS bodies must issue a Status Determination Statement for each off-payroll engagement. The decision turns on control, substitution and mutuality of obligation. Inside IR35 work is taxed like employment; outside work can be invoiced through a company. We review contracts, determinations and the effect on take-home pay.

IR35 Reviews for Doctors & Healthcare Professionals

Contract income

This is one of the questions we work through with out-of-hours and urgent care providers 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.

Payroll

Care and staffing businesses depend on accurate payroll, minimum wage compliance including travel time, auto-enrolment and VAT exemption conditions that hinge on regulation. Monthly management accounts show occupancy, staff cost ratios and cash flow early enough to act.

Payroll & Pensions for Doctors & Healthcare Professionals

Your questions answered

How are GP partners taxed on their profit share?

Out-of-hours and urgent care providers 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.

Help with this question: Partnership Accounts for Doctors & Healthcare Professionals

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What is a Type 1 pension certificate and when is it due?

GP partners report NHS pensionable profit to the scheme each year on a certificate based on the practice accounts; locum GPs use the locum A and B forms to pay contributions on each piece of pensionable work. Late or wrong forms cause missing service and incorrect pension records. We prepare the figures and check them against the accounts before submission.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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

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How much should GP partners set aside for tax from drawings?

GP partners should generally set aside a significant portion of their monthly drawings to cover future tax liabilities. Payments on account are due on 31 January and 31 July each year. Your specific percentage depends on your total earnings and other income sources. We calculate these liabilities in advance to help you manage cash flow.

Help with this question: Partnership Accounts for Doctors & Healthcare Professionals

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

Do GP practices need to register for 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

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What is the difference between drawings and taxable profit?

Taxable profit is the total income minus allowable business expenses, regardless of what you took out. Drawings are the actual cash sums you withdraw from the business for personal use. You are taxed on the profit earned, not the amount of drawings taken. If drawings exceed profit, you are essentially withdrawing your own capital.

Help with this question: Partnership Accounts for Doctors & Healthcare Professionals

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How are superannuation adjustments shown in GP accounts?

GP accounts should reconcile estimated NHS pension contributions with the final certified position and show how adjustments affect each partner’s account. Partner pension contributions generally belong in the partner’s personal tax relief calculation, not as a deduction from partnership trading profit. Treatment depends on the contributor and transaction, so reconcile accounts, certificates and returns together.

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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How should PCN and ARRS income be accounted for?

NHS contract income, including PCN, ARRS and UDA or orthodontic contract payments, must be accounted for in the period it is earned, with clawbacks provided for. Partners' profit shares and drawings are kept separate. Accurate accounts also drive the pension certificates each partner submits.

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

What happens to tax when a GP partner joins or leaves?

When a partner joins or leaves, the partnership must calculate the profit share for the specific period they were active. This usually involves a cessation or commencement adjustment for that individual's tax return. The partnership tax return must reflect the changes in profit allocation. Stamp duty land tax may also apply if property interests are transferred.

Help with this question: Partnership Accounts for Doctors & Healthcare Professionals

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

How is the NHS Pension annual allowance calculated for GP partners?

The annual allowance is the amount of pension growth you can have each tax year before a tax charge, £60,000 for 2026/27. For high earners it tapers: if threshold income exceeds £200,000 and adjusted income exceeds £260,000, the allowance falls by £1 for every £2 above £260,000, down to £10,000. NHS pension growth is measured as a defined benefit input, not your contributions.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

Help with this question: Partnership Accounts for Doctors & Healthcare Professionals

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

Can a GP practice incorporate?

A limited company can suit out-of-hours and urgent care providers 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.

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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 care providers

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 care providers 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 care providers 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 care providers

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 care providers

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

What does an accountant for out-of-hours and urgent care providers do?
An accountant for out-of-hours and urgent care providers 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.
Are out-of-hours GPs self-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.
How are NHS urgent care contracts accounted for?
NHS contract income, including PCN, ARRS and UDA or orthodontic contract payments, must be accounted for in the period it is earned, with clawbacks provided for. Partners' profit shares and drawings are kept separate. Accurate accounts also drive the pension certificates each partner submits.
How much does an accountant for out-of-hours and urgent care providers cost?
Our packages for out-of-hours and urgent care providers 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 out-of-hours and urgent care providers 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. Out-of-hours and urgent care providers 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

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Related healthcare expertise

IR35 Reviews for Doctors & Healthcare ProfessionalsNHS Pension Tax & Annual Allowance for Doctors & Healthcare ProfessionalsVAT Registration & Returns for Doctors & Healthcare ProfessionalsHealthcare Accountants for Professionals, Practices & Care ProvidersVAT on Medical & Healthcare ServicesHealthcare Payroll Services Accountants
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: NHSBSA: GP pension certificates (Type 1/Type 2); HMRC partnership guidance (SA800); BMA GP finance guidance; NHS England PCN/ARRS guidance.

Official guidance

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