Our expertise

Health and Wellbeing Accountants York

Accounts Team Meeting with Client Change Accountants 5

There’s a lot going on in the finances of a health and wellbeing business that won’t necessarily show up in the annual accounts. Take VAT for example, some of what you do might be exempt and some standard-rated, and getting that split wrong is an expensive mistake to unwind later. Then there’s the practitioner working employed hours for the NHS or another employer alongside a private practice, with both incomes needing to land correctly on one tax return. Booth and chair rental arrangements in salons and therapy centres need the right treatment on both sides of the arrangement. And as income grows, the question of whether to incorporate arrives earlier than most people expect.

We look after health and wellbeing businesses across York, Yorkshire and the UK: physiotherapists, osteopaths, chiropractors, nutritionists, personal trainers, yoga instructors, counsellors and therapists working alone, through to gym owners, massage therapists and beauty therapists with staff and premises to run. We understand how the VAT and employment status questions shift across those specialisms, and what it takes to get the numbers right for each one.

In a nutshell: we’ll handle your annual accounts and tax, and the parts of health and wellbeing accounting that take time to get right: VAT status across different income streams, employed and self-employed income reported correctly on one return, booth and chair rental arrangements treated properly on both sides, and the structure conversation handled with real numbers once your income grows to the point where it matters. Fixed fee, agreed upfront. Plain English at every step.

Why health and wellbeing professionals need a specialist accountant

A generalist accountant can do the basics. Where health and wellbeing businesses catch them out is in the combination of VAT complexity, mixed employment status and structural decisions that arrive earlier than expected.

VAT status varies by income stream, and getting it wrong is costly. Regulated healthcare provided by registered practitioners, physiotherapy, osteopathy, chiropractic, and counselling by registered therapists, is VAT-exempt under HMRC’s rules for health professionals. Gym membership, personal training, beauty treatments and non-regulated wellness services are standard-rated. Many businesses in this sector have both types of income, which affects whether VAT registration is needed, how input VAT reclaims work, and how partial exemption rules apply. Getting the VAT status of each income stream right from the start avoids a correction that’s expensive and retrospective. We’ll work through the exemption position for each of your income streams and keep it under review as the business changes.

Employed and self-employed income on the same return needs handling correctly. Many practitioners in this sector work part-time employed hours (perhaps for the NHS, a hospital, or another employer) alongside running their own self-employed practice. Both streams feed a single Self Assessment return and both need reporting accurately. The employed income comes through on a P60; the self-employed income needs proper bookkeeping behind it. We handle both, and make sure the overall tax position is calculated correctly across the combined picture.

Booth and chair rental arrangements need the right accounting treatment. In salons and therapy centres, booth rent and chair rental are common. Whether you’re the practice owner collecting rent from therapists who operate as self-employed tenants, or the therapist paying rent for your space, the accounting treatment is specific. Rental income for the landlord, rental expense for the tenant, but the employment status question also needs looking at, because HMRC has challenged arrangements where the reality of the working relationship doesn’t match the structure on paper. We look at both sides of the arrangement.

The sole trader to limited company question arrives earlier than most people expect. As a practice grows and income rises, the structure question becomes worth examining properly. A limited company can be more tax-efficient above a certain profit level, but the answer isn’t the same for a counsellor seeing clients privately two days a week and a gym owner employing three full-time staff. We run the numbers for your specific situation and explain the trade-offs clearly before you decide anything.

Sector-specific expenses are easy to miss, or to overclaim. CPD, specialist equipment, treatment room rent, professional memberships and work clothing (limited claims, depending on what’s involved) are all allowable in the right circumstances. Uniform and work clothing claims are a common area of confusion: HMRC allows claims for clothing that is distinctly a uniform or protective clothing, but not for clothes you could reasonably wear outside work. We handle the categorisation correctly so nothing allowable gets missed and nothing impermissible gets claimed.

Here’s how we help

The services health and wellbeing businesses call on most, each with the full detail on its own page:

This page talks about why having a specialist is important. The individual service pages show how each bit of the work gets done.

How we work with health and wellbeing professionals

No two practitioners need the same mix of services. A sole-practitioner physiotherapist with a single income stream needs different support to a gym owner with a payroll to run, a mixed VAT position, and a limited company structure. We’ll tailor what we handle for you to where you are now, and adjust as the practice develops.

Staying in regular contact through the year will keep things moving. Whatever we’re looking after, you’ll have a specialist team on hand whenever something specific comes up: a question about whether a new service you’re adding changes your VAT position, a booth rental arrangement you want to set up correctly from the start, or a query about how much of your income needs to sit on which side of the employed and self-employed line. If HMRC writes to you about anything, forward it on and we’ll either explain it or tell you to ignore it.

Records come through ShareFile, and we work with Xero, FreeAgent and Dext for clients on cloud bookkeeping. When your bookkeeping separates out exempt and standard-rated income as it happens, your VAT return stops being a guessing game at quarter-end.

The year-end meeting is where we’re most useful. We’ll walk through the year just gone, plan the next one, and shape your accounts and tax around what’s actually relevant to your practice: the VAT position across your income streams, whether the combined employed and self-employed picture is being reported correctly, and whether the structure still suits where your income now sits.

If you’re already working with another accountant, moving over is more straightforward than most people expect, and our guide on how to change accountants walks you through it.

Fixed fees, no surprises

You’ll know what you’re paying before we start, and the fee won’t change unless the work does. A sole-trader therapist with a single income stream is a different job to a salon owner with four employed stylists, booth rental income, and a VAT return to file every quarter, so the right number for you comes from a short conversation, not a price list.

Ask for a fixed fee for your health and wellbeing business

A couple of minutes on our online form, and we’ll come back to you as soon as we can.

Frequently asked questions

Is my health practice VAT-exempt?

It depends on what you do and whether you’re a registered practitioner. Regulated healthcare provided by practitioners registered with the relevant statutory body (such as the HCPC, GOsC or BACP) is VAT-exempt under HMRC’s guidance. Personal training, gym membership and beauty treatments are standard-rated. If your business spans both types of income, the position needs working through properly and we do that with you before any registration decision is made.

I work employed hours as well as running my own practice. How does that affect my tax return?

Both income streams need reporting on a Self Assessment return. Your employed income will come through on a P60 from your employer; your self-employed income needs proper bookkeeping records behind it. We handle both, calculate the overall tax position accurately, and make sure any allowances or reliefs are applied correctly across the full picture.

Can I claim my CPD and professional membership costs?

Yes. CPD costs, professional membership fees, specialist equipment and treatment room rent are all allowable business expenses, provided they’re incurred wholly and exclusively for the purposes of the business. We make sure these are recorded correctly through the year and claimed in full on your return.

Should I incorporate my practice?

It depends on your income level, your costs, and what you want from the structure. A limited company can be more tax-efficient above a certain profit level, but it also brings more compliance obligations: annual accounts, a corporation tax return, and directors’ Self Assessments at minimum. For practitioners with modest profits, sole trader is often the more sensible structure. When the numbers start to move, we look at both positions with your specific figures before recommending anything.

How do booth rental arrangements work from a tax perspective?

If you’re the practice owner receiving booth or chair rent, that income is taxable. If you’re the therapist paying booth rent, it’s a business expense. The key question on both sides is whether the arrangement is genuinely a rental, rather than an employment relationship in disguise. HMRC looks at how the arrangement actually works in practice, not just what the contract says. We review the arrangement before it’s set up to make sure it’s structured correctly.

We work with health and wellbeing practices across Yorkshire and the UK. The first conversation is about your practice: what you do, how it’s structured, and what you’d like an accountant to take off your plate.

Why clients stay with us

We’ve been working with health and wellbeing businesses across Yorkshire since Stacey McVeighty FCCA started the practice in 2014. Today we look after around 800 clients from our York office. We’re ACCA-accredited, and we hold 38 five-star reviews on Google, rated 5.0, most from clients who’ve been with us for years.

Fixed fees. Plain English. The same team next year, and the year after that.

Ready to find an accountant who understands health and wellbeing?

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