Accountants for Doctors in London

Written and reviewed by the Medical Accountants editorial team. Last reviewed 24 July 2026.

London has the densest concentration of private medical practice in the country, and the tax questions follow from that. A consultant here is more likely than one anywhere else to have a private list large enough to change their VAT position, their pension position and the structure they should be trading under.

It is also the place where the annual allowance taper bites most often, because the taper turns on total income and London consultants tend to have more of it from more directions.

Private Practice and the London Taper

The tapered annual allowance needs both threshold income above £200,000 and adjusted income above £260,000. A consultant with an NHS contract, a private list and any property income can pass both without feeling wealthy, and the allowance then falls by £1 for every £2 above the adjusted income limit, down to £10,000.

Once tapered, the mandatory Scheme Pays route may not be available, because that is tested against the standard allowance rather than the tapered one. Voluntary Scheme Pays covers it, on a different set of terms, which is set out in our guide to the NHS pension annual allowance.

GP Practices Across the London Boroughs

London GP work is spread across boroughs from Croydon and Bromley in the south to Romford in the east, and a large proportion of it is salaried or sessional rather than partnership. That matters because the salaried route carries the type 2 end of year certificate, which is the doctor's own obligation and is missed more often in London than anywhere, simply because there are more people doing it.

For partners, the pattern here is more mergers and larger practices than elsewhere, which means more mid-year partner changes and more split-year certificates to get right.

What we do for London business owners

GP Accountants

Tax returns, pension certificates and profit figures for GP partners, salaried GPs and sessional GPs.

Locum Accountants

Bookkeeping, returns and quarterly updates for locum doctors invoicing trusts, agencies and practices.

Private Practice Accounts

Books, VAT and returns for hospital consultants running a private list alongside an NHS contract.

GP Partnership Accounts

Practice-level annual accounts, profit allocation and the partnership return for GP practices.

Doctors' Tax Returns

The annual return, prepared from all your income sources and filed on time, with the January figure given early.

Limited Company Accounts

Statutory accounts, corporation tax, payroll and dividends for doctors trading through a company.

Questions Doctors Ask Us

Do you need to meet in person in London?

No. Everything runs by email and by phone, and none of the filing requires a meeting. If you would rather talk it through, say so in the form and give us a window that fits around clinics.

My private practice is through a company. Does that change the VAT position?

The threshold follows the entity making the supplies, so the question is which of your work is exempt in the first place. Medico-legal reports and purely cosmetic work are standard rated and count towards the £90,000 threshold.