Accountants for Healthcare & Managed Service Businesses in Hertfordshire
Healthcare businesses and managed service providers operate under some of the most complex financial and regulatory environments in the UK. From NHS pension implications for GPs and hospital doctors to VAT exemptions for medical services, and from IR35 compliance for locums and agency staff to CQC registration and compliance requirements — the financial landscape is uniquely challenging.
CoreAcc provides specialist accounting and tax advice to healthcare professionals, private medical practices, dental practices, pharmacies, locums, and managed service organisations across Hertfordshire and North London. We understand the specific rules that apply to your sector and provide tailored advice that generalist accountants simply can't match.
Who We Serve in Healthcare
- ✓General Practitioners (GPs) — both NHS partnerships and private practices
- ✓Hospital consultants, junior doctors, and locum doctors
- ✓Dentists — NHS and private, both associates and practice owners
- ✓Pharmacists and pharmacy owners
- ✓Opticians and ophthalmologists
- ✓Physiotherapists, osteopaths, and allied health professionals
- ✓Care home operators and domiciliary care agencies
- ✓Healthcare staffing and managed service companies
Key Tax & Financial Issues in Healthcare
NHS Pension Scheme
The NHS Pension Scheme is one of the most valuable — and most complex — pension arrangements in the UK. For GPs and hospital doctors, annual allowance tax charges (triggered when your pension input exceeds the annual allowance, currently £60,000) can result in unexpected and very large tax bills. We advise on:
- ✓Annual allowance calculations and scheme pays elections
- ✓Carry forward of unused annual allowance from previous years
- ✓Interaction between NHS pension growth and personal pension contributions
- ✓Lifetime allowance — now abolished for most purposes following April 2023 changes, but with transition protections for some
VAT Exemption for Medical Services
Most medical services supplied by registered healthcare professionals are exempt from VAT. However, the boundary between exempt medical services and standard-rated non-medical supplies can be complex — particularly for cosmetic procedures, expert witness work, and medico-legal services. We advise on the correct VAT treatment and ensure you're not under or over-accounting for VAT.
IR35 and Locum Arrangements
Locum doctors, dentists, and other healthcare professionals frequently work through personal service companies (PSCs). The off-payroll working rules (IR35) can apply to locums working with NHS bodies (which are medium or large organisations for IR35 purposes) or private hospitals. We advise on the correct IR35 assessment, structure your engagements appropriately, and ensure compliance to avoid HMRC enquiries.
Expense Claims for Healthcare Professionals
Healthcare professionals, particularly those in private practice or working across multiple employers, have significant legitimate expense claims available — including subscriptions to professional bodies (GMC, GDC, GPhC), medical indemnity insurance, Continuing Professional Development (CPD) costs, equipment, and travel to fixed temporary workplaces. We ensure every allowable expense is captured and claimed.
Managed Service Companies & CQC-Registered Businesses
For care home operators, domiciliary care agencies, and managed service providers, we provide:
- ✓Annual accounts preparation and Corporation Tax compliance
- ✓Management accounts and cash flow forecasting — critical in a sector with local authority payment delays
- ✓Payroll and auto-enrolment for care staff — including bank worker and zero-hours contract processing
- ✓CQC registration and financial compliance support
- ✓Business planning for new care home developments or acquisitions
- ✓Advice on the structure of management contracts and service agreements
Frequently Asked Questions
What is an NHS Pension Scheme Pays election?
If you receive an annual allowance tax charge of £2,000 or more, you can elect for the NHS Pension Scheme to pay the charge on your behalf in exchange for a reduction in your future pension benefits. This is known as a Scheme Pays election. The mechanics, deadlines, and long-term implications are complex — we advise clients on whether this is the right approach for their circumstances.
Can I form a limited company as a locum doctor?
Yes — many locums operate through a personal service company (PSC/limited company), which can offer tax advantages through the salary/dividend structure. However, you must carefully assess the IR35 position for each engagement. Working through a limited company does not automatically protect you from IR35 — the deemed employment rules can apply regardless of your company structure if the underlying engagement resembles employment. We advise on IR35 risk at the engagement level.
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