What an accountant actually costs a self-employed locum

A specialist accountant for a UK locum healthcare professional costs £300–£900 per year. The variation is real. Here is what sits inside each band and how to pick.

The fee bands

£250–£450 annually. A basic Self Assessment return and a phone call or two. Usually comes from an accountant with several dozen locum clients and a streamlined process. You send receipts at year-end, they file, you get a summary. Fine if your income is uncomplicated and under £70,000 gross.

£450–£750 annually. Self Assessment plus monthly or quarterly bookkeeping support, a planning meeting early in the tax year, and help with pension submissions. Most medical-specialist firms sit in this band for sole-trader clients.

£750–£1,500 annually. Limited company accounts, confirmation statement, Corporation Tax return, payroll for one or two people, quarterly tax planning. This is where a limited-company locum pays to have the structure managed properly.

Over £1,500. Partnership returns, group structures, complex cross-border work, consultancy businesses with VAT and employees. Most locums never need this.

What you get for the fee

A good medical-specialist accountant earns their fee by:

• Knowing which expenses HMRC will accept for your profession without a raised eyebrow
• Tracking tax-year deadlines so you do not miss them
• Running the limited-company-vs-sole-trader calculation once a year
• Filing NHS pension paperwork for GPs (some firms)
• Being available for a 20-minute call before you make a decision with tax consequences

A bad accountant just files what you send. That is the cheap band, and it is not worth even £300 because you could do the same thing with free software yourself.

Signs of a specialist

Ask before engaging:

• How many clients in my profession do you look after? (If under 20, not a specialist.)
• Do you file NHS Pension Form A and B for GP clients? (If you are a GP, this matters.)
• What does your free-form email support look like? (A reluctance to give straight answers on simple questions is a bad sign.)
• Do you send a tax-planning summary before each year-end? (Should be yes.)

When the fee pays back

Crossover is at roughly £60,000 gross income for most locums. Below that, free HMRC Self Assessment software is usually adequate. Above £60,000 the tax-saving opportunities start to outnumber the cost, pension planning, timing of expenses, capital allowances on equipment, the limited-company decision.

If you have:

• Any private work alongside NHS, or
• A mixed portfolio across practices or sectors, or
• Income that varies by £20,000 or more year to year, or
• Plans to convert income into property investment

… a specialist is almost always worth the fee.

The free alternative

HMRC Self Assessment software is free and works. For a straightforward sole trader with one income stream, the form takes a careful afternoon. Sessional exports every figure you need in the exact format Self Assessment asks for.

What an accountant will not do for you

• Find money you did not earn. Every legitimate tax reduction starts with a real expense or contribution.
• Represent you in an HMRC investigation (some do, specialised insurance usually covers this).
• Make your record-keeping acceptable if you send shoebox receipts. Garbage in, garbage out.

Choosing one

Ask two other locums in your profession who they use. Specialist accountants earn most of their new business through referral because the "does this firm understand healthcare locum work" test is hard to pass without a recommendation.

Sessional keeps your records in a format every accountant recognises so the handover each year is clean. See our sessions and expenses guides for how to structure the year.