Accountants for Dentists

Midlands Accountancy is a Birmingham firm that acts as accountant for dentists across the West Midlands: practice accounts, bookkeeping, payroll and Self Assessment for practice owners, associates, hygienists and therapists. Dentistry splits into two financial worlds: owning a practice and working in one. The accounts, the records and the tax position look different in each, and plenty of dentists live in both at once. This page covers what we do for each, and what a quote needs.

Practice owners and associates have different problems

A practice owner runs a business with premises, staff, equipment and a patient list, and needs business accounts, payroll and tax compliance to match. An associate is usually self-employed, paid under an agreement with the practice, and needs clean personal records and a well prepared Self Assessment return. Hygienists and therapists working self-employed sit in a similar position. We act for all three from our Birmingham office, across the West Midlands conurbation and beyond, and because practice life does not pause for meetings most of the routine work runs through shared cloud records and scheduled calls, with in person reviews when needed. This page belongs to our wider healthcare accountants hub alongside doctors, pharmacists and other clinicians.

Choosing and running the right structure

Associates commonly work as self-employed sole traders, though incorporation questions come up regularly. We treat that as an advice conversation, not a default, because for an associate the NHS pension position usually matters more to the answer than the tax saving does. Practices are variously run as sole proprietorships, partnerships, expense-sharing arrangements between principals, or limited companies. Each brings its own filing obligations, and expense-sharing arrangements in particular need careful bookkeeping so each principal’s position stays clean.

NHS, private and everything between

Dental income rarely comes from one place. A practice may hold an NHS contract paid against activity targets, alongside private fee income, plan income from patient membership schemes, and sundry cosmetic income. The NHS and private streams behave differently: NHS contract payments arrive on a schedule with later adjustments for activity delivered, while private income tracks the appointment book. Records need to keep these streams separate so you can see what each part of the practice actually earns, and so year end adjustments for contract clawback or underperformance land in the right place.

What an associate should keep, and why it matters

Self-employed associates need their own records regardless of what the practice keeps: monthly pay statements from each practice worked at, records of laboratory deductions and other charges taken at source, professional fees such as indemnity and registration, training costs, travel between sites where the facts support it, and bank statements. GOV.UK sets out the record keeping duties of the self-employed. The recurring problem we fix is associates who rely entirely on the practice’s schedules and cannot evidence their own position when the return is prepared. Our guide to accounting records for associate dentists lists exactly what to keep, and our dental practice accounting records checklist covers the record set at practice level.

Bookkeeping in a dental practice

Practice bookkeeping has sector-specific wrinkles: reconciling NHS schedules against receipts, tracking patient plan income from the scheme provider, handling laboratory and material costs against the associates they relate to, and accounting properly for associate pay deductions. Done well, the monthly figures tell you chair-by-chair and stream-by-stream what is happening. Our bookkeeping service handles this routinely.

Accounts, tax returns and the filing calendar

Incorporated practices need statutory accounts and a Company Tax Return, which our company accounts service prepares; sole traders and partners report through Self Assessment, as do associates. Most dentists file under Self Assessment in some capacity, whether for practice profits, associate income or both. Deadlines and current thresholds are on GOV.UK. Where NHS pension considerations sit alongside, we prepare figures that keep the tax and pension pictures consistent and flag where regulated pension advice is needed.

Staff, payroll and pensions at practice level

Practices employ nurses, receptionists and managers, which means payroll, workplace pension duties and the associated reporting. Getting associate status right also matters here: associates are usually self-employed rather than employees, but that rests on how the arrangement works in practice. What we look at is who sets the surgery hours, whether the associate can send a locum in their place, who carries the cost of remedial work, and whether the associate has any say over fees and patient list. Misclassification is expensive when it goes wrong, so we run practice payroll through our payroll service and say plainly when an arrangement needs a second look. Most dental services are exempt from VAT; if your cosmetic or retail takings have grown, send us a breakdown of the last twelve months by treatment type and we will review the position properly.

Reading the practice numbers during the year

For owners, the useful management figures are stream-level income against the same period last year, staff costs as a share of income, laboratory and material costs against the work billed, and NHS contract performance against target while there is time to correct course. Waiting for the annual accounts to discover underperformance is the expensive way to find out.

Traps that catch dental businesses

Five problems account for most of the tidying up we do when a dental client joins us. Associates keep no records of their own and rely entirely on the practice’s schedules. NHS receipts are never reconciled against the schedules, so a clawback arrives as a surprise. Equipment gets bought late in a year without anyone checking how it lands for tax. Expense-sharing arrangements run for years with no written basis and books to match. And practice owners draw money informally, which turns the year end into a reconstruction exercise.

Where an accountant for dentists stops and other advisers start

We prepare accounts, run bookkeeping and payroll, file tax returns and provide management figures and business advice grounded in them. We do not give regulated financial advice on pensions or investments, do not value practices for sale (though we prepare the financial information a valuer needs), and do not advise on clinical regulation or CQC matters. Where a question crosses those lines we say so and help you brief the right adviser.

Starting with us

An engagement starts with a short conversation about your role, structure and income streams. For a quote we need to know whether you own, associate or both, your structure, the income streams and staff involved, and how your records are kept.

Frequently asked questions

I am an associate. Am I definitely self-employed?

Usually, but not automatically. The label on the agreement matters less than the reality of the working arrangement. We review the facts, because getting it wrong affects both you and the practice.

Should an associate work through a limited company?

Sometimes yes, often no. Income level, NHS pension implications, contract terms and personal circumstances all pull on it, and the pension side is what most often decides against. We run the calculation on your actual numbers before anyone incorporates anything.

What is different about accounting for NHS income?

Timing and adjustment. Contract payments arrive on a schedule that does not match activity month by month, and end of year reconciliation can add or claw back amounts. The accounts need to reflect what was earned, not just what was received.

Can you take over from our current accountant mid year?

Yes. Professional handover between firms is a standard process: we request what we need from the outgoing accountant and pick up wherever the records stand, including part-finished years.

Do you act for dental practices buying or selling?

We support the financial side, preparing the figures and explaining what the accounts show, while your solicitor and valuer handle the legal and valuation work.

If that sounds like the support your practice or associate work needs, request a quote with a note on your situation and we will come back with a specific scope and price.