Choosing the right GP accountant in London matters because general-practice finances are unlike almost any other small business. Your income comes from an NHS contract that no generalist accountant ever sees, your pension is a defined-benefit scheme with its own certification machinery, and your tax position spans a partnership, your personal return and, increasingly, private and medico-legal work. This page sets out what a specialist GP accountant in London actually does, the 2026/27 figures that drive the numbers, and how the London context (higher earnings, valuable premises, mixed NHS and private income) changes the planning. It is general information for GPs, partners, salaried doctors and locums, not personal advice.

Why London GPs need a specialist medical accountant

The tax rules are UK-wide, so a London GP is not taxed under a different code. What is different is the profile. London GPs are more likely to cross the pension annual allowance taper, more likely to hold high-value owned surgery premises, and more likely to add private, occupational-health or medico-legal income on top of NHS work. Each of those raises questions a generalist accountant rarely meets.

A specialist GP accountant in London understands how general-practice money actually flows. NHS core funding arrives as the Global Sum, a per-patient payment weighted by the Carr-Hill formula, plus QOF (the Quality and Outcomes Framework), enhanced services and Primary Care Network (PCN) / Network Contract DES funding including the Additional Roles Reimbursement Scheme. GPs do not bill UDAs or dental bands, and there is no single national per-patient value because the figures are weighted and uplifted each year. An accountant who knows that vocabulary is starting from the right place. For the funding mechanics, see our explainer on how GMS funding works and on QOF income in practice accounts.

Getting your role right: partner, salaried GP, locum or consultant

Tax status follows the substance of the working arrangement, not the label, and the four common roles sit very differently:

  • GP partner. Self-employed. The partnership files an SA800 and each partner's profit share flows to the partnership pages of their personal return, taxed as trading income with Class 4 NIC. Partners are taxed on their profit share, not their drawings, so reconciling drawings against actual profit at year-end is central work.
  • Salaried GP. An employee of the practice, taxed under PAYE with Class 1 NIC, and an active NHS pension member.
  • Locum GP. Usually a sole trader (self-assessment), or less commonly through a personal service company. A sole-trader locum has no intermediary so IR35 does not apply; a company changes that picture.
  • Hospital consultant. An NHS employee (PAYE) who may also do private work as a sole trader, partnership or company; only the NHS employment is pensionable.

Getting this mapping right at the outset prevents the most common and expensive errors. If you are weighing a move into partnership, our guides on GP partner versus salaried GP tax and becoming a GP partner go deeper than we can here.

Partnership and practice accounting

Your GP accountant in London should handle the full cycle: bookkeeping, annual accounts, the SA800 partnership return, and the profit allocation between partners under the partnership agreement (prior shares, seniority, sessions and any property element). Many London practices have complex arrangements, multiple sites, federated or PCN working, or dispensing income, and these need an accountant who has seen them before. For the underlying mechanics, see our GP partnership tax guide and profit-sharing and tax planning explainer.

Premises: a bigger feature for London GPs

Surgery premises are a far larger issue for GPs than for most healthcare businesses, and London property values make the stakes higher. Premises are often held in a separate property partnership or LLP outside the medical partnership. Income support comes via notional rent (for owner-occupiers, on a current-market-rent basis assessed by the District Valuer), legacy cost rent (closed to new schemes), or improvement grants, under the NHS (General Medical Services) Premises Costs Directions 2024. These amounts are property-specific, so no accountant should quote a figure without your valuation. A specialist will also flag the last man standing risk, where a single remaining partner is left holding the whole premises lease and liability. See our guides on notional rent versus cost rent, owning versus renting premises and the last man standing premises risk.

NHS pension: where London GPs gain or lose the most

For higher-earning London GPs, the NHS pension is usually where a specialist accountant earns their keep. All active members now accrue in the 2015 CARE section (1/54th of each year's pensionable earnings), with the older 1995 and 2008 final-salary sections held as legacy service. The annual allowance change in April 2023 (the limit rose from £40,000 to £60,000) gave higher earners more room, but London partners and consultants can still breach it.

The key figures for 2025/26: the annual allowance is £60,000, measured for a defined-benefit scheme by the pension input amount (capitalised growth), not the contributions paid. It tapers where threshold income exceeds £200,000 and adjusted income exceeds £260,000, falling by £1 for every £2 of adjusted income above £260,000, down to a floor of £10,000. The money purchase annual allowance is £10,000. The lifetime allowance was abolished from 6 April 2024 and replaced by the Lump Sum Allowance (£268,275) and the Lump Sum and Death Benefit Allowance (£1,073,100). A London GP earning into six figures with strong pension growth needs the input amount monitored each year, because an allowance breach is taxed at marginal rate. Where a charge arises, Scheme Pays can settle it from the pension itself.

This is detailed work, so we keep the full method in dedicated guides: the NHS pension annual allowance guide, the tapered annual allowance explainer, Scheme Pays deadlines, and how to minimise NHS pension tax charges. Your accountant should also handle the certification side: the Type 1 Annual Certificate of Pensionable Profits for partners, the Type 2 self-assessment for salaried GPs, and Locum forms A and B for freelance locums.

Tax returns, expenses and Making Tax Digital

Beyond the accounts, a good GP accountant in London manages each individual's self-assessment and claims the right expenses. Allowable costs include medical indemnity (note that NHS GP clinical negligence is state-indemnified under CNSGP from 1 April 2019, so paid indemnity is now mainly for private and non-clinical work), the GMC retention fee, BMA and relevant Royal College subscriptions on HMRC's List 3, CPD, equipment via capital allowances, and business mileage between sites at 55p per mile for the first 10,000 business miles in 2026/27 (the rate rose from 45p on 6 April 2026) and 25p thereafter. Home-to-first-site travel is non-deductible commuting.

On National Insurance, Class 4 NIC is 6% on profits between £12,570 and £50,270 and 2% above (2025/26), and Class 2 is no longer a required payment from 6 April 2024 for profits at or above the small profits threshold. For expense detail, see our complete GP tax deductions list for 2026 and home-office relief guide.

Making Tax Digital for Income Tax arrives for sole-trader and locum GPs with qualifying income over £50,000 from 6 April 2026 (then £30,000 from 2027 and £20,000 from 2028). GP partnerships are deferred with no confirmed date, and limited companies are outside MTD for ITSA entirely. Most full-time locums and unincorporated private GPs are in scope from April 2026, so a London accountant should be getting you onto compatible software now.

Private work, VAT and incorporation

London concentrates private, occupational-health and medico-legal opportunities, and each has a tax twist. On VAT, genuine medical care by a registered practitioner is exempt, and NHS contract income is outside the scope, so neither counts toward the threshold. But cosmetic-only procedures, medico-legal and expert-witness reports, and some occupational-health services can be standard-rated, and once that taxable (non-exempt) turnover exceeds £90,000 in a rolling 12 months (the threshold since 1 April 2024) registration is required. See our GP VAT registration guide and the wider private practice tax explainer.

On incorporation, the single most important point is that it is a private-work decision only. A limited company cannot hold an NHS GMS or PMS contract, and company income (and the dividends taken from it) is not NHS-pensionable. So any tax saving from a company has to be set against lost NHS pension accrual. The 2026/27 dividend rates (ordinary 10.75%, upper 35.75%, additional 39.35% unchanged, allowance £500, from 6 April 2026) make the headline saving smaller than it once was. For the trade-off, see our guides on the GP limited company decision and incorporation relief on a private practice.

Selling, retiring or restructuring

A point London GPs often misunderstand: you cannot sell the goodwill of an NHS practice. The prohibition has applied since 1 April 2004 (now under SI 2019/251), and it also blocks selling company shares whose value includes that goodwill. A partner entry or exit is therefore about tangible assets, owned premises and the partnership capital account, plus any genuinely private goodwill. Business Asset Disposal Relief can apply only to a private-practice or private-company disposal (never to NHS goodwill), at 18% for a disposal on or after 6 April 2026 (it was 14% from 6 April 2025 to 5 April 2026, and 10% before that), with a £1m lifetime limit. Our guides on whether GP goodwill can be sold and selling a private medical practice cover the detail.

What to look for when choosing a GP accountant in London

  • Genuine medical-sector depth. They should talk fluently about GMS and PMS contracts, Global Sum and Carr-Hill, QOF, PCN and ARRS funding, and the NHS pension certification forms, not just general healthcare.
  • Pension competence. Ask specifically how they monitor the annual allowance and the taper, and how they handle Type 1 certificates, Type 2 self-assessment and locum forms.
  • Premises experience. London premises values make notional rent, property-partnership structuring and last man standing live issues; the accountant should have handled them.
  • Proactive, not just year-end. Tax and pension planning, partner buy-in and buy-out, and MTD readiness all need contact through the year, not a single annual meeting.
  • Modern systems. Cloud accounting that integrates with your practice systems and gives real-time visibility, which matters most for multi-site and federated London practices.

How we help London GPs

We are specialist medical accountants for GPs, partnerships, salaried doctors and locums across London. We prepare partnership and practice accounts, handle every partner's self-assessment, run NHS pension certification and annual-allowance monitoring, advise on premises and partner changes, and keep you ahead of Making Tax Digital. We give general information rather than one-size-fits-all advice, and we tailor the work to your practice.

To talk through your practice or your personal position, see our full range of services or get in touch via our contact page. For a broader overview of the service, our GP accountant services complete guide is a good next read.