How to Start a Speech Therapy Practice in the UK

Private speech and language therapy is in strong demand, with long NHS waiting lists driving families and adults to seek private services. If you are HCPC-registered and experienced, private practice offers flexibility, clinical autonomy, and the ability to provide timely intervention.

HCPC Registration

Speech and language therapist is a protected title. You must be registered with the HCPC. Annual registration is around £106. You need an HCPC-approved degree in speech and language therapy.

Professional Memberships

• RCSLT (Royal College of Speech and Language Therapists) — the professional body. Provides CPD resources, insurance, and professional support.

Sole Trader or Limited Company?

Most private SLTs operate as sole traders. Simple and suits the business model. A limited company is relevant if you build a larger practice with multiple therapists.

Registering with HMRC

Register for Self Assessment within three months. VAT: speech and language therapy by HCPC-registered practitioners is exempt from VAT.

Insurance

• Professional indemnity — essential. RCSLT membership includes an insurance option.
• Public liability — for clinic and domiciliary visits
• Employers' liability — if you hire staff
• Contents — therapy materials, assessment tools, equipment

Expect £200–£500 per year if not covered by RCSLT membership.

Claimable Expenses

• HCPC registration
• RCSLT membership
• Assessment tools — standardised assessments (CELF, BPVS, ACE, etc.) — these can be expensive
• Therapy materials — games, flashcards, apps, worksheets
• Clinic room hire
• Home office costs — for report writing and admin
• Travel — to schools, homes, clinics, at 45p per mile (SLTs travel extensively)
• CPD and training — specialist courses, conferences
• Software — clinical notes, report templates, telehealth platforms
• DBS check costs
• Marketing — website, professional directories
• Phone and broadband
• Insurance premiums
• Accountancy fees

Accounted tracks all your expenses and keeps records organised.

Pricing

• Initial assessment (60–90 min) — £150–£350
• Therapy session (45–60 min) — £70–£130
• School visit — £250–£500 per day (including travel and report writing)
• Written report — £150–£400
• Specialist assessment (e.g., dysphagia) — £200–£400
• Medico-legal report — £500–£2,000+

Building Your Practice

• GP and paediatrician referrals
• Schools and SENCOs — specialist assessment and therapy
• Parent networks — word of mouth, parenting groups
• Online directories — RCSLT Find a Therapist, private therapy directories
• Health visitor referrals
• Social media — Facebook groups for parents, Instagram for therapy tips
• Local authority contracts — some LAs commission private SLT services

Bookkeeping Tips

• Separate business and personal finances
• Track mileage carefully — school and home visits generate significant travel
• Record assessment tool purchases — they are deductible
• Invoice promptly — especially for school and local authority contracts
• Set aside 25–30% of profits for tax

Accounted connects to your bank and categorises transactions with AI.

Key Deadlines

• 31 January — Self Assessment and payment
• 31 July — second payment on account
• Every 2 years — HCPC renewal

Getting Started

Private speech therapy is rewarding and in strong demand. Ensure your HCPC registration is current, arrange insurance, and keep your finances well-managed from the start.

Ready to give your practice finances a voice? Sign up for Accounted and let Penny handle the bookkeeping while you help your clients communicate.