A practical guide to self-employment, HMRC registration, tax dates, cashflow, expenses, travel, VAT and more for the 2026/27 tax year.
Any paid clinical work outside PAYE = self-employed for that work.
Register with HMRC by 5th October in the second tax year.
File online by 31st January. Pay by 31st January.
Separate your tax money from day one. Set aside a % of every payment.
Deduct anything "wholly and exclusively" for business. Keep receipts for 5+ years.
45p/mile (first 10k). Keep a mileage log. Watch the 24-month rule.
Most clinical work is exempt. Only register if taxable turnover exceeds £90,000.
No employer contributions. Set up a personal pension. Contributions are tax-deductible.
Stay sole trader unless profits consistently exceed £40-50k. Get advice first.
If you see private clients, work as a locum, contract with schools, or do any paid clinical work outside of a PAYE role, you are almost certainly self-employed for that work. Self-employment isn't a choice you make - it's a legal status determined by the nature of your working arrangements.
HMRC considers the overall picture. No single factor is decisive.
| Indicator of Employment (PAYE) | Indicator of Self-Employment |
|---|---|
| The organisation controls when, where, and how you work | You decide how and when to carry out the work |
| You must do the work yourself - no substitutes | You can send a suitably qualified substitute |
| Regular wage regardless of output | You invoice for work done and bear the risk of non-payment |
| Equipment, premises and materials provided | You provide your own equipment, assessments and materials |
| Holiday pay, sick pay, pension | No entitlement to employment benefits |
| Work mainly for one organisation | Free to work for multiple clients |
| "Mutuality of obligation": they must offer work, you must accept | No ongoing obligation - either party can decline |
You are legally required to register with HMRC as self-employed. This is separate from your HCPC or RCSLT registration.
You must register by 5th October in the second tax year after you started self-employed work:
| You started self-employment… | Register by… |
|---|---|
| 6th April 2026 – 5th April 2027 | 5th October 2027 |
| 6th April 2025 – 5th April 2026 | 5th October 2026 |
Once registered, you'll receive a UTR (usually within 10 working days). You need this for every tax return and every HMRC interaction about your self-employment.
Your employer continues to deduct tax through PAYE. Your Self Assessment return declares both incomes, and HMRC calculates any additional tax on the self-employed earnings.
The UK tax year runs 6th April to 5th April. Here's the timeline for the 2026/27 tax year:
A very common financial mistake new self-employed SLTs make is spending everything without setting aside enough for tax.
Open a separate savings account. Every time you receive payment, immediately transfer a percentage. Don't touch it for anything other than tax.
Estimate how much to set aside from each payment you receive.
You can deduct legitimate business expenses from income before calculating tax. The golden rule: an expense must be incurred "wholly and exclusively" for business purposes.
For example: standardised assessments (CELF, ACE, RAPT etc.), therapy materials, picture cards, apps. Deductible in full. Keep receipts.
For example: HCPC registration, RCSLT membership, DBS checks, professional indemnity insurance. All deductible as annual subscriptions.
For example: courses, conferences, webinars, Hanen or Elklan training, clinical supervision fees. Must be relevant to your current practice.
For example: laptop, tablet, printer, therapy software, Zoom/Teams subscriptions. If also used personally, claim only the business proportion.
For example: renting a therapy room by the hour or day, co-working space fees. Deductible in full.
You can use HMRC's simplified flat rates or calculate the actual proportion of household costs:
| Hours/month at home | Flat rate/month |
|---|---|
| 25 to 50 | £10 |
| 51 to 100 | £18 |
| 101+ | £26 |
For example: mobile contract, home broadband (claim the business proportion). Accounting software such as FreeAgent, Xero, or QuickBooks is deductible in full.
For example: website hosting, domain name, business cards, online advertising. Deductible in full.
You can claim business travel but not ordinary commuting. A "permanent workplace" is somewhere you attend regularly. HMRC uses a 24-month rule. If you work at the same location for more than 24 months (or spend 40%+ of your time there), travel to it becomes commuting.
| Scenario | Claimable? | Why |
|---|---|---|
| Home → school, long-term weekly contract (2+ years) | Unlikely | Likely a permanent workplace under the 24-month rule |
| Home → various client homes | Yes | Each home is a temporary workplace |
| One client site → another during the day | Yes | Travel between business locations is always claimable |
| NHS shift → private client's home | Yes | Business journey for the self-employed engagement |
| Home → clinic you own/use as main base | No | Your permanent workplace - this is commuting |
Estimate your annual mileage deduction using HMRC's approved rates.
Short answer: probably not. You must register for VAT only if your taxable turnover exceeds £90,000 in any rolling 12-month period. Most self-employed SLTs are well below this.
Even if you exceed the threshold, most clinical SLT work is VAT-exempt. Health services by an HCPC-registered professional are exempt, provided the primary purpose is the protection, maintenance, or restoration of health.
Some non-clinical income is standard-rated at 20%:
If you've come from the NHS, you may have been contributing to the NHS Pension without giving it much thought. When self-employed, no one arranges a pension for you.
The full new state pension is around £221.20/week for 2026/27. For most people, that won't be enough on its own.
Several pension providers are well-suited to self-employed professionals who want simplicity and flexibility:
Halve your age when you start contributing and use that as a percentage of income. Start at 30 → aim for 15%. Start at 40 → aim for 20%. The earlier you start, the less you need thanks to compound growth.
When you register as self-employed, you're automatically a sole trader. Some therapists set up a limited company instead. Here's the comparison:
| Factor | Sole Trader | Limited Company |
|---|---|---|
| Setup | Free and instant | £12 at Companies House, more paperwork |
| Admin | One Self Assessment return/year | Annual accounts, Corp Tax return, confirmation statement, personal tax return |
| Tax | Income Tax + Class 4 NICs | Corporation Tax (19–25%), then personal tax on salary/dividends |
| Paying yourself | Simply draw money out | Salary + dividends (lower tax rates) |
| Liability | Unlimited personal liability | Limited to company assets (but clinical negligence still attaches to you) |
| Accountancy costs | Lower - many manage their own | Higher - typically £800–£2,000+/year |
If you work through a limited company but your arrangements with a particular client resemble employment, HMRC's IR35 rules may apply, taxing that income as if it were employment income. For most SLTs working with multiple clients on genuinely self-employed terms, this is unlikely to be an issue.