Dental work across west Hertfordshire
Plenty of dentists in this part of Hertfordshire work at more than one surgery. An associate might spend three days at a practice in Watford town centre and two days in Bushey or Rickmansworth, each with its own contract and its own way of paying. Some dentists also take hospital sessions, which brings PAYE income into the picture alongside self employed profit.
West Hertfordshire Teaching Hospitals NHS Trust runs Watford General Hospital on Vicarage Road, along with Hemel Hempstead Hospital and St Albans City Hospital, so healthcare is a big part of local working life. What we see most often is not a lack of income but a lack of clear records across several payers. Getting those into one tidy set of figures is usually our first job. It is also why dentists tend to look for accountants for dentists in Watford who already know how NHS dental pay works.
Associates and self assessment
Most associate dentists are self employed. You file a self assessment tax return each year by 31/1 and pay Class 4 National Insurance on your profit. For 2026/27 that is 6% on profits between £12,570 and £50,270 and 2% on profits above that.
Your first year or two can bring a large bill, because HMRC usually asks for payments on account towards the next year on top of the tax already owed. These fall due on 31/1 and 31/7. We forecast them early so you can save as you go.
Costs you can usually claim include your General Dental Council retention fee, indemnity cover and equipment you buy for your work. The British Dental Association subscription is on HMRC's approved list, but relief is limited to 90% of it.
What is included
- Self assessment returns for associates
- Annual accounts for practice owners
- Checking year end pensionable earnings declarations
- Annual allowance and carry forward calculations
- Planning for UDA clawback and NHS contract income
- Payroll for nurses, receptionists and hygienists
- Incorporation and practice purchase reviews
- VAT checks on cosmetic treatments
UDAs, contracts and the year end reconciliation
If you own a practice with an NHS contract, much of your income depends on units of dental activity, known as UDAs. These are the points the NHS uses to measure the courses of treatment your practice delivers. If the practice delivers fewer UDAs than the contract requires, money can be clawed back after the year end reconciliation.
That clawback can land long after the work was done, so we build it into your cash planning rather than waiting for the letter. NHS contracts also have rules about who can hold them, which matters if you plan to bring in a partner or change how the practice is owned.
Your NHS pension and the annual allowance
The NHS Pension Scheme for dentists works on career average pensionable earnings. Your pensionable pay is reported through a year end declaration of your pensionable earnings, which forms part of the year end reconciliation. The figure needs to match your accounts, so we check it against the profit we have worked out for you.
High earning dentists can go over the pension annual allowance, which brings a tax charge. Unused allowance from the three previous years can usually be carried forward, and a taper can cut the allowance for very high incomes. If a charge does arise, Scheme Pays lets the scheme settle it in exchange for a smaller pension later. We work out where you stand before you decide.
VAT on dental and cosmetic work
Dental treatment given by a registered dentist is exempt from VAT, so most practices never need to register. Cosmetic work done purely for appearance can be treated differently, and facial aesthetics is a common example.
If a practice in Watford or St Albans adds a large cosmetic side, the taxable part can push it towards the £90,000 registration threshold. We keep track of that figure each month so there are no surprises.
Practices that sell toothbrushes, whitening kits or other products to patients should also keep those sales separate in the till, because they are not covered by the exemption for treatment.
Accountants for dentists in Watford buying, selling or incorporating
Buying a practice means looking hard at the figures behind the asking price. We review the accounts, the NHS contract value, the private income trend and staff costs, and tell you what the numbers really show.
Some owners move their private work into a limited company, where profits are taxed at 19% up to £50,000 and 25% above £250,000. NHS income earned through a company may not count as pensionable in the same way, so the pension cost has to be weighed against any tax saving. When you sell, gains on goodwill and property can fall into capital gains tax. Business Asset Disposal Relief can bring the rate to 18% if the conditions have been met for at least 2 years before the sale.
Who this suits
- Associate dentists working across several practices
- Principal dentists who own a mixed NHS and private practice
- Dentists with hospital sessions as well as practice work
- Newly qualified dentists filing their first tax return
- Practice owners planning a sale or retirement
Common questions
Can an associate dentist claim the GDC fee and BDA subscription?
Yes. The General Dental Council fee for keeping your name on the register is allowable. The British Dental Association subscription is on HMRC's approved list, with relief limited to 90% of the annual fee.
What is the year end declaration of pensionable earnings?
It is how your NHS pensionable pay is reported for dental work, as part of the year end reconciliation. It should agree with your accounts, so it makes sense for your accountant to check it before it goes in.
I do NHS and private work. Does that change my tax return?
Both types of income go on the same self assessment return as self employed profit. The difference shows up in your NHS pension, because only NHS earnings are pensionable. We keep the two separate in your records so the pension figures are right.
What happens if my practice does not deliver all its UDAs?
The NHS can claw back money for the shortfall after the year end reconciliation. We plan for possible clawback in your cash flow so it does not catch you out.
Should I set up a company for my private dental income?
It can lower tax on profits you leave in the business, but NHS income through a company may not be pensionable in the same way. We compare the tax saving with the pension cost using your own figures before you decide.
Is facial aesthetics work at my practice subject to VAT?
It can be. Dental treatment is exempt, but treatment done purely for cosmetic reasons can be taxable. If that income grows, it counts towards the £90,000 VAT registration threshold.
Can you help me buy a practice in Hertfordshire?
Yes. We review the practice accounts, the NHS contract and the staff costs, and explain what the figures show before you agree a price. We can then set up the accounts and payroll once you take over. As accountants for dentists in Watford, we also work with buyers looking at practices in St Albans, Hemel Hempstead and Harrow.