Tax Tips for Consultant Surgeons in the UK: PSCs, IR35 & Expense Claims
Consultant surgeons in the UK often find themselves navigating a complex mix of public and private work, frequently across different legal and tax structures. Whether you’re splitting your time between the NHS and private practice, or running your affairs through a limited company, getting your tax position right can make a significant difference — not only to your compliance but also to your take-home pay.
So, what do you really need to know? Here are some essential tax tips for Consultant Surgeons in the UK to keep in mind for the 2025–26 tax year.
Consider your structure carefully: Are you using a PSC?
Many consultant surgeons choose to operate through a personal service company (PSC), particularly for private practice. This structure offers flexibility, some tax planning opportunities, and the protection of limited liability. However, it also comes with added responsibilities, including payroll, corporation tax, and dividend management.
It’s important to understand how a PSC changes your tax profile. Rather than paying Income Tax and National Insurance Contributions (NICs) as an employee, you’ll be dealing with Corporation Tax (25% for most companies in 2025–26), dividend tax, and employer responsibilities. When managed well, the savings can be worthwhile — but a careless approach can trigger penalties or IR35 issues.
Speaking of IR35: Are your contracts compliant?
IR35 remains a critical consideration for consultant surgeons working via a limited company. The legislation determines whether you’re genuinely self-employed or a ‘disguised employee’ — someone who works in a way that mimics employment, but is paid through a company to reduce tax.
For public sector work, like NHS contracts, the engager (hospital trust) is responsible for determining your IR35 status. If you fall inside IR35, your income is taxed at source through PAYE, removing the tax advantages of your company. For private sector clients, you may still be responsible for the assessment, depending on the size of the organisation.
If you’re regularly working through a PSC and haven’t reviewed your contracts, now is the time. An independent IR35 assessment can help identify if your working practices or terms might put you at risk.
Make the most of allowable expenses
One of the benefits of being self-employed or running a PSC is the ability to claim business expenses. However, this is only beneficial if you understand what’s genuinely allowable — and what might raise red flags with HMRC.
Common claims for consultant surgeons include:
- Professional memberships and subscriptions (e.g. GMC, Royal College of Surgeons)
- Indemnity insurance
- CPD courses and training relevant to current practice
- Medical equipment and IT tools
- Travel between work sites (not including normal commuting)
- Use of home office space for administrative tasks
The key here is to ensure all claims are “wholly and exclusively” for business use, as required by HMRC. This isn’t about pushing boundaries — it’s about being confident, accurate, and well-documented.
Plan for tax: Don’t forget payments on account
Surgeons with self-employed income or operating through a PSC often face unexpected cash flow problems simply due to poor planning for tax. If your tax bill is over £1,000, HMRC will likely ask for payments on account — advance payments towards the following year’s tax.
This means that in January 2026, for example, you could owe not just your 2025–26 tax, but also half of what HMRC expects for 2026–27. And then another chunk in July. Failing to budget for this can cause avoidable stress.
Keeping regular tabs on your income and setting aside funds each month is a good habit — especially when private income can fluctuate.
Consider professional help for year-round planning
With so many moving parts — IR35, pensions, expense claims, dividend timing — getting tax right as a consultant surgeon often requires more than an annual spreadsheet. A specialist accountant who understands the medical field can help you make strategic decisions throughout the year, not just at tax return time.
From advising on efficient salary and dividend combinations, to checking pension thresholds or navigating VAT if your income grows, their input can save time, stress, and potentially thousands of pounds.
If you’re looking to get a firmer grip on your tax position or thinking about switching to a limited company, it’s worth having a conversation sooner rather than later. Early planning allows you to avoid IR35 surprises, stay compliant, and take advantage of the opportunities available under the 2025–26 legislation.
For more tax tips for Consultant Surgeons in the UK, get more detailed PSC guidance directly from HMRC here.
Get in touch with us at IN Accountancy if you wish to discuss this further and see where we can help.
