Accountants for doctors and GPs, including consultants.

Accountants for doctors and GPs separate NHS employment income, NHS pension input, partnership profit share and private practice earnings, then test each against the annual allowance before the tax return is filed. Most medical tax problems are pension problems that surface two years late, once the scheme statement finally arrives.

Doctors, GPs and consultants have some of the most complex tax positions of any professional group. The combination of NHS Pension Scheme (with its annual allowance interactions and lifetime allowance history), private practice income, locum work, consultant fees and education income, often all from one taxpayer, creates real planning complexity. The wrong approach can trigger £40k+ of avoidable tax in a single year.

We work with GP partners (in practices and groups), salaried GPs, locum doctors (limited company or sole trader), consultants in private practice, registrars and SHOs, and consultant-led private medical companies. The scope varies by structure but the core disciplines are the same: clean income capture, NHS Pension reconciliation, annual-allowance modelling, private-fee accounting, and Self-Assessment.

NHS Pension Scheme administration is particularly material. Annual Allowance tapering can affect higher-earning consultants where adjusted income exceeds £260k, with significant tax consequences if not managed. We track NHS pension growth alongside private contributions and model the tax consequences before pension input amounts are crystallised.

The NHS scheme is a defined benefit arrangement, so the amount tested against the annual allowance is not what the doctor paid in. It is the growth in the promised pension, converted to a notional capital figure. A pay rise, a partnership profit spike, or moving between the 1995, 2008 and 2015 sections can push that growth well past the standard 60,000 pound allowance in a single year, and the statement confirming it typically arrives long after the tax return was due. That timing gap, not the rate, is what generates the penalties.

Adjusted income above 260,000 pounds tapers the allowance further, down to a floor of 10,000 pounds, and consultants with private practice on top of a substantive contract cross that line more often than they expect. Where a charge is unavoidable, Scheme Pays lets the pension itself settle it in exchange for a reduction in benefits, but the election has its own deadline and its own arithmetic. We model the charge, the Scheme Pays cost and the alternative of paying personally before the election is made, using the member statement from NHS Pensions rather than an estimate.

Locum and private work brings a second question. Since April 2021 medium and large clients issue the status determination under the off-payroll working rules, which covers most NHS trusts, while smaller private clinics leave the decision with the doctor's own company. VAT is the third: healthcare supplied by a registered practitioner for the protection or restoration of health is exempt, but medico-legal reporting, cosmetic work without a therapeutic purpose and expert witness fees generally are not, and a consultant can drift over the 90,000 pound registration threshold on the taxable slice alone. The personal return itself is handled through our Self-Assessment filing service, and dental principals face a parallel set of issues on our dental practice accountants page. Locum work through a limited company brings the off-payroll rules into play, and our IR35 guide for contractors covers how each engagement should be assessed and documented. Private practice run through a limited company brings statutory filings with it, which sit with our outsourced company secretary service. The full range is listed in our directory of accounting, tax and advisory services.