Accountants for doctors, dentists and healthcare professionals

You spent years learning medicine, not tax. Yet somewhere between your NHS payslip, a bit of private work, a pension statement you can’t decode and a Self Assessment return you’re not sure you even need, the financial side quietly became its own specialty. It’s one where the wrong move, or a missed allowance, costs real money. That’s the part we take care of, so your time goes where it should: your patients.

Reviewed July 2026. Medical tax and NHS pension rules are complex and depend on your circumstances. Always check GOV.UK or speak to us before acting.

What’s different about medical tax

Healthcare finances don’t behave like an ordinary business. Your income often comes from several places at once (NHS salary, locum sessions, private practice), which usually means Self Assessment even when you’re mostly employed. Your biggest tax issue is frequently the NHS pension, not your pay. Your professional costs are specific. And your employment status, as a locum or an associate, is not always as settled as it looks. Generalist accountants rarely deal with any of this. We do it every day.

The NHS pension annual allowance

This is the single most misunderstood, and most expensive, issue for senior doctors and dentists. The annual allowance is the limit on how much your pension can grow each year with tax relief (£60,000 for 2026/27, and lower for very high earners under the tapering rules). In the NHS scheme, “growth” isn’t what you pay in; it’s a formula based on how much your promised pension increases. That means you can face a tax charge on pension growth without a penny extra landing in your bank account, which understandably feels bewildering the first time the letter arrives.

The good news is it’s manageable once someone actually works it out for you. We calculate your pension growth, check whether a charge applies, explain the “scheme pays” option (letting the pension settle the charge for you), and factor it into your wider tax planning rather than leaving it as a nasty surprise.

GPs and practices

GP finances have their own rhythm. GP partners share practice profits and need proper partnership accounts, plus the superannuation certificates that tell NHS Pensions your pensionable pay for the year. Salaried GPs are employed, but frequently pick up locum or private work that pulls them into Self Assessment. We handle practice accounts, partners’ Self Assessment, superannuation and profit-share, so the numbers are right and the pension record is accurate.

Locum doctors

As a locum, you’re usually self-employed (or working through your own company or an agency), which means Self Assessment, tracking your expenses, and keeping your NHS pension contributions in order through the correct locum forms. From April 2026, locums with gross self-employed income over £50,000 also come under Making Tax Digital and will report quarterly, which our MTD for Income Tax guide explains. One point worth knowing: income taken through a limited company is not pensionable in the NHS scheme, so we help you weigh that up rather than trip over it.

Dentists: associates and practice owners

Associate dentists are typically self-employed: you keep your NHS and patient fee income, cover your lab costs, and pay the practice a percentage as a licence fee for the chair, facilities and staff. One thing changed in April 2023, when HMRC withdrew its long-standing guidance that treated associates on standard contracts as automatically self-employed. Most associates remain genuinely self-employed, but status now rests on the normal employment tests, so it pays to have the arrangement and paperwork right. Practice owners, meanwhile, run a real business with staff, mixed NHS and private income and their own superannuation, and we look after all of it.

Consultants and private practice

If you’re a hospital consultant with private work, you’re often employed and self-employed at the same time. That raises practical questions: how to structure the private practice, whether a company makes sense, and how to stay efficient across both. We advise on the setup and handle the reporting so nothing slips between the two.

The expenses medics often miss

Claimed correctly, professional costs add up. For most doctors and dentists that includes GMC or GDC registration, royal college and BMA or BDA memberships, medical defence organisation cover (such as the MDU, MDDUS or DDU), exam and course fees for your ongoing role, equipment, and relevant professional journals. We make sure you claim everything you’re entitled to, and nothing you’re not.

What we handle for you

On one fixed monthly fee: Self Assessment for mixed NHS and private income, NHS pension annual allowance calculations and planning, practice and partnership accounts, superannuation certificates, locum and associate tax, private-practice structuring, and full expense claims. You get a dedicated accountant, our 3-hour email promise, and plain-English answers, not more jargon.

Why healthcare professionals choose Xpert

Most medics come to us either baffled by a pension or tax charge nobody explained, or tired of a generalist accountant who doesn’t understand NHS income. We’re proactive and specialist: fixed monthly fees, a real person who knows how medical pay and pensions work, no long tie-ins, and we handle the switch from your current accountant for you.

Doctor, dentist, locum or practice? Take our 2-minute quiz or book a free consultation, and we’ll get your tax and pension position clear.