As accountants for healthcare professionals, we know healthcare practices rarely have straightforward finances. Mixed income streams — NHS contracts, private fees and exempt versus standard-rated VAT — sit alongside payroll for both clinical and administrative staff. On top of that, equipment and premises costs and compliance obligations extend beyond HMRC into CQC and professional regulation where relevant. We provide dedicated accounting support for doctors, clinics, pharmacies, dentists, opticians and locum professionals, so your finances are managed accurately and in full compliance while you focus on patient care. If you are looking for a specific healthcare speciality, see our dedicated pages for pharmacies, dentists, doctors, locums and opticians.
We cover all the financial and compliance work a healthcare practice needs to keep its numbers accurate and its cash flow predictable.
We track all your income including NHS or contract payments, private fees and ancillary sales, and match it against your costs each month so you always know where you stand financially.
Healthcare income is often a mix of VAT-exempt and standard-rated supplies. We calculate your VAT position correctly and file on time every quarter, so you are never overpaying or underpaying.
From clinical staff and admin teams to locum cover, we run payroll accurately each month and handle every HMRC submission on time.
We prepare your annual accounts and tax return, make sure all allowable costs and reliefs are claimed, and keep your tax bill as low as it legitimately can be.
From clinical equipment and premises costs to professional subscriptions and indemnity insurance, we make sure every legitimate expense is recorded and reduces your tax bill.
We manage all your deadlines and make sure every submission is accurate and on time. You will never face a late filing penalty because something was overlooked.
A clear view of profitability across NHS, private and ancillary income, not just a total turnover figure
Cash flow forecasts that account for contract payment timing, locum costs and seasonal patient demand
Correct VAT treatment of mixed exempt and taxable income, so nothing is miscalculated
Someone to call when a payroll, compliance or contract income question comes up
We work with you throughout the year, not just when a deadline is due.
Between NHS or contract income, private fee income, and VAT-exempt medical supplies sitting alongside standard-rated retail or ancillary sales, healthcare practices deal with a mix of income treatments that most generalist accountants rarely see. Add in payroll spanning clinical staff, administrative teams and locum cover, plus equipment and premises costs, and the bookkeeping quickly becomes more involved than it looks from the outside.
We help healthcare practices see past the headline turnover figure to what is actually happening across each income stream and cost category. That means separating NHS or contract payments from private fees, applying the correct VAT treatment to exempt and taxable supplies, and giving you a realistic monthly view of profitability.
Something we see regularly: practices that look financially healthy on paper but have never had their income streams broken down clearly enough to know which parts of the business are actually driving profit. In other cases, compliance requirements — HMRC, and CQC where relevant — are being met by habit rather than by design.
Getting this structured properly from the start means fewer surprises at year end, and a much clearer picture for decisions about staffing, equipment and growth.
Beyond bookkeeping and VAT, this is where a specialist accountant earns their fee.
Support structuring locum and contractor payments correctly, including IR35 considerations where they apply.
Guidance on VAT partial exemption and the correct treatment of mixed clinical and retail income.
Advice on practice structure — sole trader, partnership or limited company — as your healthcare business grows.
Cash flow forecasting that accounts for contract payment timing, seasonal demand and locum or agency staffing costs.
Record-keeping and reporting support that keeps you ready for CQC or professional body reviews as well as HMRC.
Our healthcare packages start at £175/month for a sole practitioner or small practice doing up to £250k turnover, including year-end accounts, tax return, quarterly VAT and monthly bookkeeping. Practices with mixed NHS and private income, multiple staff, or locum cover typically sit in the £300–£800/month range. Fixed fee, no hourly surprises.
Yes. Healthcare is a broad area, so we also have dedicated support and pages for pharmacies, dentists, doctors, locums and opticians, each covering the specific income, VAT and compliance issues that speciality deals with.
Yes. Most healthcare practices have some combination of VAT-exempt medical supplies and standard-rated retail or private income. We make sure your VAT return reflects the correct treatment every quarter.
Xero as the core ledger, integrated with your practice management or booking software where possible. If you’re on spreadsheets and want to modernise, we handle the migration end-to-end, usually within a few weeks.
We handle the whole process, including writing to your current accountant and transferring records, so it takes very little of your time. Most practices are fully switched over within two to four weeks.
Yes. R&R is regulated by the Association of Chartered Certified Accountants (ACCA). All work is signed off by an ACCA-qualified accountant.
Our head office is in Blackburn, and we work with healthcare professionals in Preston, Burnley, Accrington, Chorley, Leyland, Bolton, Wigan, Bury and Manchester. Being cloud-based means location barely matters — most of our healthcare clients never need to set foot in the office — but face-to-face meetings are available at our Blackburn office when you want them.
Related healthcare specialities: Pharmacies · Dentists · Doctors · Locums · Opticians
Related services: VAT returns & MTD · Cloud bookkeeping
Book a free consultation. We’ll review your last VAT return, your income mix and your management accounts, and give you three concrete things to change — whether or not you switch to us. Call 01254 839543 or book online.
Expert Chartered Certified Accountants helping North West businesses protect and grow their income.
Friendly support from a local team that understands your business. Book your free consultation today and take the first step towards financial clarity and peace of mind.
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74 St James Road, Blackburn, BB1 8ET
We work with clients in Blackburn and across the North West, so you can get support wherever you are.
