Bookkeeping & Making Tax Digital for Private Doctors

What is Making Tax Digital for Income Tax?

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. Private doctors 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.

When do I need to start MTD?

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. Private doctors 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.

What software do I need?

Making Tax Digital (MTD) requirements mean many professionals will need MTD-compatible accounting software. From April 2026, this applies to individuals with qualifying income over £50,000. Medical.Accountants works with major cloud-based platforms to streamline your bookkeeping. We recommend the most suitable software based on your practice size and complexity.

What are quarterly updates?

Quarterly updates are digital submissions of income and expenses required under Making Tax Digital for Income Tax. These will be mandatory for qualifying individuals from 6 April 2026. They provide HMRC with a regular summary of your business performance. Medical.Accountants will manage these submissions to ensure your practice remains compliant.

Can my accountant submit MTD updates for me?

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. Private doctors 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.

What records must I keep?

You must keep records of all sales, business expenses, bank statements, and relevant tax documents. Digital record-keeping is increasingly necessary to satisfy MTD requirements. Records should generally be retained for at least six years. Medical.Accountants advises you on the best methods to capture and store these documents efficiently.

How much does MTD bookkeeping cost?

Our packages for private doctors 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 happens if I miss a quarterly update?

MTD for Income Tax uses a points-based late-submission regime. HMRC will not award points for missed quarterly updates in the 2026/27 tax year, but you must still submit the updates before submitting your tax return. Later years have different rules. Check the HMRC guidance for your start year; tax return and payment obligations remain.

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.

Help with this question: VAT Registration & Returns for Private Doctors

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.

Help with this question: VAT Registration & Returns for Private Doctors

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.

Help with this question: VAT Registration & Returns for Private Doctors

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 Private Doctors

Help with this question: Payroll & Pensions for Private Doctors

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.