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Management Accounts & Cash Flow for Private Clinics
Management Accounts & Cash Flow for private clinics. No clear view of profit? We fix it: fixed fees, ICAEW-regulated specialists. Free quote.
What does management accounts & cash flow for private clinics involve?
Our management accounts & cash flow service for private clinics covers monthly/quarterly management accounts, kPIs, cash-flow forecast. It solves the problems we see most often — private clinics: No clear view of profit, margins or cash; lender and CQC information requests — on a fixed monthly fee agreed in writing before any work starts.
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
- Problems solved: Private clinics: No clear view of profit, margins or cash; lender and CQC information requests.
- Included: Monthly/quarterly management accounts.
- Included: KPIs.
- Included: cash-flow forecast.
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 work | What we check | Support to explore |
|---|---|---|
| Employed or umbrella (PAYE) | Tax codes, eligible employment expenses and whether a tax return is needed. | Healthcare tax refund support |
| Genuinely self-employed | Business income and expenses, Self Assessment and MTD eligibility. | Healthcare Self Assessment service |
| Your own limited company | Company accounts, Corporation Tax, director income and off-payroll status where relevant. | Healthcare limited company accounts |
| Partnership | Practice 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
Monthly/quarterly management accounts
Part of our management accounts & cash flow service for private clinics, delivered on a fixed fee.
02
KPIs
Part of our management accounts & cash flow service for private clinics, delivered on a fixed fee.
03
cash-flow forecast
Part of our management accounts & cash flow service for private clinics, delivered on a fixed fee.
04
budget vs actual
Part of our management accounts & cash flow service for private clinics, delivered on a fixed fee.
Your questions answered
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 →How often should I get them?
The frequency of management accounts depends on the size and complexity of your healthcare practice. Many clinicians opt for monthly or quarterly reports to maintain tight control over their finances. Regular reporting helps identify trends and potential tax liabilities early. Medical.Accountants provides these reports based on your needs.
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 →What do lenders expect to see?
Lenders typically expect to see historical accounts and detailed financial projections. They require evidence of consistent clinical income and sound debt management. Management accounts and tax returns are standard requirements for healthcare financing. Medical.Accountants prepares professional financial packs to support your lending applications.
Help with this question: Mortgage References & SA302s for Doctors & Healthcare Professionals
Want us to check this for you? Get a free review →Can management accounts support CQC applications?
Management accounts can demonstrate financial viability during the Care Quality Commission registration process. They provide evidence that the provider has sufficient resources to maintain safe and effective services. Accurate financial reporting supports the 'Well-led' domain of the inspection framework. We assist in generating reports that reflect your business stability.
Want us to check this for you? Get a free review →How much do management accounts cost?
The cost for management accounts is determined by the complexity and frequency of the reporting required. Medical.Accountants operates on a fixed-fee basis, which is always agreed in writing before work commences. This ensures full transparency and aids your practice budgeting. Fees are tailored to the specific needs of your healthcare business.
Want us to check this for you? Get a free review →Can you work with Xero or QuickBooks?
We work with doctors, dentists, nurses, pharmacists, allied health professionals, aesthetic practitioners and healthcare businesses including care homes, clinics and agencies across the UK.
Want us to check this for you? Get a free review →Are medical services VAT exempt in the UK?
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.ukHelp with this question: VAT Registration & Returns for Private Clinics
Want us to check this for you? Get a free review →When must a healthcare business register for 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.
Check the official guidance · www.gov.ukHelp with this question: VAT Registration & Returns for Private Clinics
Want us to check this for you? Get a free review →Which healthcare services are standard-rated for 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.
Check the official guidance · www.gov.ukHelp with this question: VAT Registration & Returns for Private Clinics
Want us to check this for you? Get a free review →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.
Check the official guidance · www.gov.ukWant us to check this for you? Get a free review →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.
Check the official guidance · www.gov.ukHelp with this question: VAT Registration & Returns for Private Clinics
Help with this question: Payroll & Pensions for Private Clinics
Want us to check this for you? Get a free review →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.
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 packageLimited 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 packagesPersonal 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 packageEmployment 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
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 quoteHow it works
- 01
Free call
A 15-minute chat about your income, structure and deadlines.
- 02
Onboarding in 48 hours
We set up your records, software and HMRC agent access.
- 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
- Do private clinics need management accounts & cash flow?
- 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.
- What does management accounts & cash flow for private clinics include?
- 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.
- How much does it cost for private clinics?
- Our packages for private clinics 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.
- What are the deadlines for private clinics?
- 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.
- Can I switch to you mid-year?
- Switching takes minutes on your side. You sign our engagement letter, we contact your previous accountant for professional clearance and records, and we take over HMRC and Companies House authorisations. You can switch mid-year; we pick up from the last filed return.
Speak to a specialist today
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Book a free 15-min tax reviewRelated 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 Notice 706 partial exemption; HMRC VAT registration (GOV.UK); HMRC MTD for VAT.