What to know before you decide
Going self-employed or Ltd
For paramedics, the choice between sole trader and limited company turns on profit level, how much income you draw, and whether your work is NHS employment, private practice or outside-IR35 locum work. A company can defer tax on retained profit but adds accounts, payroll and filing costs. We compare both on your figures before you decide.
Mixed NHS and private income
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 ProfessionalsRegulator fee relief
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.
MTD from April 2026
Making Tax Digital for Income Tax started on 6 April 2026 for sole traders and landlords with qualifying income above £50,000. The threshold falls to £30,000 in April 2027 and £20,000 in April 2028. Qualifying income is gross self-employment plus property income; NHS salary is excluded. We set up compatible software and file the quarterly updates.
Bookkeeping & Making Tax Digital for Doctors & Healthcare Professionals