Accountants for doctors running a medical limited company
You already have the company. Private clinics, medico-legal reports or locum work run through it, and the question is no longer whether to incorporate but how to run it properly. That means four decisions that repeat every year: how much comes out as salary and how much as dividend, whether a locum engagement is inside IR35 and so never really company income at all, what the company costs you in NHS pension accrual, and when the corporation tax is actually due. A fifth arrives once, when the company is closed and the money either leaves as capital or is taxed as income. Each is set out below on 2026/27 rates, because the dividend rates and the loan charge both moved on 6 April 2026.
Note: Statutory figures for the tax year shown. Your own position is what decides the answer.
What we hear
What we hear from doctors running a medical limited company
The questions and concerns that come up most in the first conversation.
How much salary and how much dividend, this year?
The arithmetic changed on 6 April 2026. Dividends are taxed at 10.75%, 35.75% and 39.35% for 2026/27 above a £500 allowance, on profit that has already borne corporation tax: 19% to £50,000, 25% above £250,000, an effective 26.5% between. Salary is deductible, but the company pays employer National Insurance at 15% above a £5,000 secondary threshold, and the £10,500 Employment Allowance is not available to a single-director company. Which way the salary versus dividend comparison falls depends on how much you need to draw.
Is this locum engagement inside IR35?
Company income from locum work is only company income if the engagement is outside IR35. Public bodies including NHS Trusts have decided status since 6 April 2017; medium and large private hirers took it on from 6 April 2021. Each issues a Status Determination Statement, and the fee-payer operates PAYE against it. Only a small private client leaves the decision with your own company. Doctors across several hirers hold inside and outside determinations at once, so the extraction plan rests on the outside-IR35 share alone.
The company costs you NHS pension accrual
Money taken through the company as dividends is not NHS-pensionable, whatever the company is, so NHS work stays where it is and the company takes private and outside-IR35 work. A GMS contract can sit with a company limited by shares, but only one whose shareholders all qualify under the NHS Act 2006 conditions with a medical practitioner among them, which an ordinary personal service company does not. For a consultant only the substantive NHS post is pensionable, so a tax comparison alone flatters the company.
The director's loan account, and the date the charge attaches
A medical company is a close company, so an overdrawn director's loan still outstanding 9 months and 1 day after the period end carries a section 455 charge: 35.75% on loans made on or after 6 April 2026, 33.75% on loans made in 2025/26 or earlier. Date-band by when the loan was made, not when it fell due. Section 458 gives it back once the loan is cleared, but that relief is deferred by another 9 months and 1 day. Worked through in the director's loan account guide.
Two deadlines in the wrong order, and cash that stays put
Corporation tax is payable 9 months and 1 day after the period end; the return is not due for 12 months. Payment first, filing second, and that ordering is what directors get wrong. Late filing costs £200, not the £100 Self Assessment figure. Profit left behind needs its own plan: dividends a UK company receives are normally exempt under Part 9A of the Corporation Tax Act 2009, but the cash is still trapped, and holding investments loses business relief. Options in surplus cash in a medical company.
How it works
How we work with doctors running a medical limited company
- 01
Your extraction mix, modelled before the year end
A specialist reviews expected profit, your other income, the outside-IR35 share and any spouse shareholding, then models salary, dividend and employer pension contribution at your own numbers while they can still change. First pass yourself with the private practice incorporation calculator.
- 02
Year-end accounts and the company tax return prepared
Statutory accounts and the CT600 are prepared, the director's loan account reconciled to the charge date, capital allowances on equipment checked, and the payment figure given to you well before the 9 month and 1 day deadline.
- 03
Each engagement read for IR35 separately
Determinations are reviewed one engagement at a time against personal service, control, mutuality and integration, and a statement you disagree with is assessed before the client-led disagreement process is used. Inside-IR35 income then stays out of the plan.
- 04
Closing the company planned before the first distribution
Whether a final distribution is capital or income turns on the winding-up rule, and for doctors the condition that bites is similar work within two years. That is tested against your intentions before anything is distributed.
Free calculators
Run the numbers before you send anything
Free to use, on 2026/27 rates. We ask once whether a specialist should check your figure, and skipping that still shows it.
- Private Practice Incorporation CalculatorCompare sole trader against limited company take-home on private practice income, and what the company route costs in pension accrual.
Free first call, then a fixed fee in writing
Talk to an accountant about running your company
One conversation with one of our medical accountants about your salary and dividend mix, the IR35 status of your engagements, and the director's loan account or corporation tax deadlines. We set the scope and the fees with you first, and sending an enquiry ties you to nothing.
- Medical work onlyNHS pension, practice accounts and private practice
- Read by a medical accountantYour enquiry goes to our accountants who work with doctors
- One position, not threePractice, pension and personal return read together
No obligation. If our specialists think your position is already right, they will tell you so.
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