Speech Therapists in Private Practice — Tax Guide
More speech and language therapists than ever are moving into private practice. Whether you've left the NHS entirely or you're supplementing your employed role with private clients, the flexibility of self-employment is hugely appealing. You can choose your caseload, set your hours, and build a practice around the work you find most rewarding.
But self-employment comes with its own set of responsibilities — particularly around tax. The good news is that once you understand the basics, managing your tax affairs as a private SLT is perfectly manageable. This guide covers everything you need to know, from initial registration through to the specific expenses you can claim.
Getting Started: Registration and Setup
When you start working as a self-employed speech therapist, your first step is registering with HMRC. You need to do this by 5 October following the end of the tax year in which you started, but registering as soon as you begin trading is the smart approach.
You can register online through the HMRC website, and you'll receive a Unique Taxpayer Reference (UTR) number. This is your identifier for all tax dealings.
Our guide on how to register as self-employed with HMRC walks you through the process step by step.
Beyond HMRC, there are other registrations to consider:
HCPC registration. You must be registered with the Health and Care Professions Council to practise as a speech and language therapist in the UK. Your annual registration fee is a tax-deductible expense.
RCSLT membership. Membership of the Royal College of Speech and Language Therapists is voluntary but highly recommended. It provides access to CPD resources, professional support, and networking opportunities — and the fees are tax-deductible.
DBS check. If you work with children or vulnerable adults, you'll need an enhanced DBS check. The cost is deductible.
Professional indemnity insurance. Essential for private practice. Most SLTs use specialist providers, and the premiums are fully deductible.
ICO registration. If you hold client data (which you almost certainly will), you need to register with the Information Commissioner's Office under data protection legislation. The annual fee is small but it is a legal requirement.
VAT: The Healthcare Exemption
Here's something that catches many healthcare professionals by surprise: most speech therapy services are exempt from VAT under the health exemption.
HMRC's rules state that healthcare services provided by a registered health professional are exempt from VAT, provided the primary purpose is the protection, maintenance, or restoration of health. Since speech and language therapy clearly falls within this definition, and you're registered with the HCPC, your clinical services are VAT-exempt.
This means:
- You don't charge VAT on your therapy fees
- You don't need to register for VAT (even if your turnover exceeds £90,000)
- You can't reclaim VAT on your business purchases
The last point is important. Because you're making exempt supplies, you can't recover the VAT you pay on things like equipment, software, and professional services. It's simply a cost of doing business.
However, if you also provide non-clinical services — training courses, consultancy, expert witness work — these may not be exempt. If a significant portion of your income comes from non-clinical work, it's worth taking professional advice on your VAT position.
What Tax You'll Pay
As a self-employed speech therapist, you'll pay:
Income Tax on your profits (your fee income minus allowable expenses). The 2025/26 rates are:
- 0% on the first £12,570 (Personal Allowance)
- 20% on profits between £12,570 and £50,270
- 40% on profits between £50,270 and £125,140
- 45% on profits above £125,140
Class 2 National Insurance at £3.45 per week if your profits exceed £6,725.
Class 4 National Insurance at 6% on profits between £12,570 and £50,270, and 2% above £50,270.
Your tax return is due by 31 January following the end of the tax year. For the 2025/26 tax year (ending 5 April 2026), your return must be filed by 31 January 2027.
Expenses You Can Claim
Your allowable expenses reduce your taxable profit, which means less tax to pay. Here are the key categories for speech therapists in private practice:
Clinical Supplies and Resources
- Assessment materials and standardised tests (these can be expensive — CELF, BPVS, and similar tools are fully deductible)
- Therapy resources, books, and materials
- Toys, games, and activities used in sessions
- Printing and photocopying costs for worksheets and reports
Professional Fees and Memberships
- HCPC registration fees
- RCSLT membership
- Professional indemnity insurance
- DBS checks and renewals
- CPD courses, conferences, and training events (including travel and accommodation for CPD)
- Clinical supervision fees (if you pay for external supervision)
Clinic or Workspace Costs
If you rent clinic space, the rent and associated costs (utilities, cleaning, business rates) are fully deductible. Many SLTs rent rooms on an hourly or sessional basis from other clinics, GP surgeries, or therapy centres — these costs are deductible too.
If you see clients from home, you can claim a proportion of your household expenses (rent/mortgage interest, council tax, heating, electricity, broadband) based on the proportion of your home used for clinical work and the time spent.
Alternatively, use HMRC's simplified flat rate of £6/week without needing to calculate exact costs.
Travel
If you provide therapy in clients' homes, schools, or care homes, your travel costs are deductible:
- Mileage at 45p/mile for the first 10,000 miles, then 25p/mile
- Public transport fares
- Parking fees
Travel between your home and a regular clinic is generally not deductible (it's considered commuting). But travel from your home to client visits, schools, or ad-hoc locations is allowable.
For a full guide on mileage claims, see our article on how to claim mileage when self-employed.
Technology and Software
- Laptop, tablet, or computer (proportioned if also used personally)
- Clinical software and apps
- Video conferencing tools for online therapy sessions
- Practice management software
- Accounting and bookkeeping software
- Mobile phone costs (business proportion)
Marketing
- Website design, hosting, and maintenance
- Business cards and leaflets
- Online advertising (Google Ads, social media ads)
- Directory listings (specialist SLT directories, local business directories)
- Networking event fees
Insurance
- Professional indemnity insurance
- Public liability insurance
- Business contents insurance (if you have a clinic)
- Cyber insurance (increasingly relevant given the sensitive nature of client data)
For a comprehensive overview, our complete guide to sole trader expenses is a useful reference.
Record-Keeping for Private SLTs
Good record-keeping serves two purposes: it ensures you're tax-compliant, and it ensures you're claiming everything you're entitled to.
At minimum, you should keep:
- A record of all income received, including the date, client (or referrer), and amount
- Receipts or proof of all business expenses
- Bank statements showing business transactions
- Mileage logs for business travel
- Copies of invoices sent to clients
If you use a dedicated bookkeeping tool, much of this is automated. Accounted, for instance, is designed for sole traders and uses an AI assistant called Penny to categorise transactions and match receipts — which is particularly helpful if admin isn't your favourite part of running a practice (and let's be honest, for most SLTs it isn't).
The key habit to build is recording things as they happen, not in a batch at the end of the month (or worse, the end of the year). Five minutes a day is far easier than five hours in January.
Working With Schools and the NHS
Many private SLTs have a mixed income model — some private clients, some school contracts, and perhaps some NHS work via agencies or sub-contracting arrangements.
Each income source has slightly different considerations:
School contracts. If you contract directly with schools, you're typically invoicing for your services and the school pays you as a supplier. This is straightforward self-employment income. However, if you're working through an agency and they control how, when, and where you work, there may be IR35 considerations — essentially, HMRC might argue you're an employee in all but name.
NHS sub-contracting. If you provide services to the NHS as a sub-contractor, similar IR35 considerations apply. The public sector IR35 rules mean the engaging body (the NHS trust or agency) is responsible for determining your employment status.
Agency work. Some SLTs supplement their private practice with agency shifts. The tax treatment depends on how the arrangement is structured — you might be paid through the agency's payroll (as an employee) or invoicing the agency directly (as self-employed). Be clear on which applies.
Our complete guide to IR35 explains the rules in detail if you're unsure about your status.
Making Tax Digital
From April 2026, self-employed individuals with turnover above £50,000 must comply with Making Tax Digital for Income Tax. Those above £30,000 follow from April 2027.
This requires:
- Keeping digital records of income and expenses
- Submitting quarterly updates to HMRC
- Filing an annual End of Period Statement and Final Declaration
If your private practice turnover exceeds these thresholds, you'll need MTD-compatible software. Even if you're below the threshold, moving to digital record-keeping now is sensible preparation.
Common Pitfalls
Not separating business and personal finances. Open a business bank account and use it exclusively for practice income and expenses. It makes bookkeeping dramatically easier.
Under-claiming expenses. Assessment tools, CPD, supervision, professional memberships — these all add up. Don't leave money on the table.
Ignoring payments on account. If your tax bill exceeds £1,000, HMRC will likely require advance payments towards next year's bill. Budget for this from the start.
Not putting money aside for tax. A good rule of thumb is to set aside 25–30% of your net income for tax and National Insurance. Put it in a separate savings account so it's there when you need it.
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