Speech Therapist
Tax & MTD Guide
Allowable expenses, mileage to clients, HCPC and indemnity fees, NIC, VAT and MTD explained for UK self-employed speech and language therapists.
Estimate your tax as a self-employed speech therapist
Adjust the figures to see your estimated Income Tax and Class 4 National Insurance for the year.
Total turnover before expenses
Under £1,000 we use the trading allowance automatically
Estimated tax bill
£5,832
13.9% effective rate for 2026/27
- Income tax
- £4,486
- Class 4 NI
- £1,346
Take-home pay
£29,168
after tax, NI and expenses
This is an estimate using HMRC-confirmed rates for 2026/27, not your official tax calculation. TapTax is MTD-compatible, so you can connect to HMRC and file the real figures in a couple of taps.
- You pay Income Tax and National Insurance on your profit, which is private therapy income minus allowable expenses, and this is separate from any PAYE salary from the NHS or an agency.
- If your gross private income tops £1,000 you must register for Self Assessment; below that the trading allowance covers you tax-free.
- Mileage to clients homes, schools, nurseries and care homes is one of the biggest deductions for a peripatetic SLT, claimable at 45p per mile for the first 10,000 miles.
- Clinical speech and language therapy is usually VAT-exempt as healthcare, so the £90,000 registration threshold rarely bites, but mixed practices with training or products should check each stream.
- MTD for Income Tax applies from April 2026 above £50,000, April 2027 above £30,000, and April 2028 above £20,000, tested on gross income not profit.
For a self-employed speech and language therapist, the tax is rarely complicated by the income side. Most private SLTs charge a clear hourly or per-session fee, sometimes a block-booked assessment package, occasionally a school or nursery contract. The real money is in the expenses, because this is a job that runs on travel, resources and professional registration. A therapist who drives between three schools and two family homes in a week, carrying a boot full of flashcards, mirrors, picture cards and assessment kits, is racking up deductible costs constantly, and the ones who lose money at Self Assessment are almost always the ones who failed to log their mileage and resource spend as it happened.
This guide is built around how a clinical therapist actually works: a peripatetic, resource-heavy practice with mandatory professional costs, frequently combined with an NHS or agency PAYE job. Get the mileage log and the receipts right through the year and your annual return becomes a tidy formality rather than a January scramble.
How Tax Works for a Self-Employed Speech Therapist
As a sole trader you pay Income Tax on profit, which is your total private therapy income minus allowable expenses. For 2026/27 the personal allowance covers the first £12,570, then you pay 20% to £50,270, 40% to £125,140 and 45% above, with the personal allowance tapering away between £100,000 and £125,140 to create an effective 60% band. Class 4 National Insurance is 6% on profit between £12,570 and £50,270 and 2% above, with Class 2 NIC settled through Self Assessment.
Scottish therapists pay Scottish Income Tax on their profit through six bands (19%, 20%, 21%, 42%, 45% and a 48% top rate) and carry an S-prefixed tax code, while National Insurance stays UK-wide. Welsh therapists have a C-coded tax code at rates currently matching the rest of the UK. Many SLTs hold an NHS or agency salary alongside their private list, and that PAYE job usually already uses your personal allowance, which can distort your code. If your code looks wrong, run it through the tax code checker.
NHS Job Plus Private Practice: The Common Pattern
A great many private SLTs build their list around an existing NHS post or agency work. That salary is taxed under PAYE at source and is entirely separate from your self-employed trade. The mistake is assuming the first slice of private profit is tax-free because of the personal allowance. It almost never is. If your employment already uses your £12,570 allowance, every pound of private profit is taxed from the basic rate up, often straight into the 40% band if the salary is high. Set aside a realistic 20 to 30 percent of private profit, and use the multiple-income tax calculator to see how the salary and the private trade stack together.
If your private work is only an occasional sideline, our guide to side hustle income covers when it tips into a taxable trade.
The Trading Allowance and Starting Out
Many therapists test private work cautiously, taking a handful of paying families while still employed. The £1,000 trading allowance is built for that. If your gross self-employed therapy income is £1,000 or less in a tax year it is tax-free and you do not need to register for Self Assessment for it. Cross £1,000 and you must register and report the full amount.
Once over the threshold you choose each year. You can deduct the flat £1,000 trading allowance instead of working out actual expenses, or deduct your real allowable costs if they come to more than £1,000. You cannot do both. For a peripatetic SLT with serious mileage, resources and registration fees, actual expenses almost always beat the £1,000, so total your costs and claim the larger figure.
Allowable Expenses for Speech and Language Therapists
An expense is allowable when incurred wholly and exclusively for the business. The SLT list is dominated by travel, therapy resources and mandatory professional costs.
| Expense | What qualifies | Notes |
|---|---|---|
| Mileage to clients | Driving to homes, schools, nurseries, care homes and clinics | 45p per mile first 10,000, 25p after |
| HCPC registration | Your annual Health and Care Professions Council fee | Mandatory to practise, fully allowable |
| RCSLT membership | Royal College of Speech and Language Therapists subscription | Allowable professional body fee |
| Professional indemnity insurance | Clinical negligence and public liability cover | Essential and fully deductible |
| Therapy resources | Flashcards, picture cards, mirrors, symbol sets, assessment kits, toys and games | Core clinical tools, fully allowable |
| Assessment licences | Standardised test kits and scoring software, per-use licences | Deductible where used in the trade |
| Equipment | Laptop, tablet, printer, lamination, a therapy bag | Usually claimed via Annual Investment Allowance |
| Clinical software | Practice management, note-keeping, teletherapy platforms | Subscriptions fully deductible |
| DBS checks | Enhanced disclosure required for work with children | Allowable running cost |
| CPD and training | Courses updating your existing clinical skills | New-trade training is not allowable |
| Home-office costs | Flat-rate WFH allowance, or a fair share of heat, light and broadband | Choose the larger fair deduction |
| Accountancy and bank fees | Bookkeeping, Self Assessment, business banking | Fully deductible |
Mileage in Detail
For a therapist who visits clients, mileage is usually the single largest deduction. The simplest method is HMRC's flat mileage rate: 45p per mile for the first 10,000 business miles in the tax year and 25p after that. This one rate covers fuel, insurance, road tax, servicing and wear, so you do not claim those separately. The alternative is claiming a business proportion of actual running costs plus capital allowances on the vehicle, which suits a high-mileage therapist with an expensive car but needs far more record-keeping. Whichever you pick, keep a mileage log with the date, destination and miles for every visit. Travel between varying client locations is allowable; ordinary commuting to a single fixed base is not. To model your numbers, run them through the sole trader tax calculator.
Therapy Resources and Equipment
This is a resource-hungry trade. Flashcards, picture exchange symbols, mirrors, oral-motor tools, sand timers, fidget aids, story sacks, board games and the standardised assessment kits you administer are all allowable when used in your clinical work. A therapy bag, a laminator, a portable table or seating you carry to visits, a laptop, tablet and printer typically go through the Annual Investment Allowance and can be claimed in full in the year of purchase. Where an item is used both personally and for the business, only the business proportion is allowable.
What You Cannot Claim
The private share of dual-use broadband, phone and devices must be excluded. Everyday clothing is never allowable, even smart clothes for client meetings, though genuine branded uniform or protective items can be. Toys bought for your own children are not resources. And travel from home to a single regular workplace is ordinary commuting, not business mileage.
VAT for Speech Therapists
Here is the good news that sets SLTs apart from most trades: clinical speech and language therapy delivered by a HCPC-registered therapist is normally exempt from VAT, because it is a supply of healthcare aimed at protecting or restoring the patient's health. That means you do not charge VAT on clinical fees and you do not have to register even if your turnover sails past the £90,000 rolling 12-month threshold. The flip side is that you generally cannot reclaim VAT on your costs either.
The nuance is mixed income. Paid training delivered to other professionals, selling therapy products, writing medico-legal reports or providing non-clinical supervision may be standard-rated rather than exempt. If a meaningful share of your turnover is non-clinical, you may have a partial VAT position to think about, and it is worth getting the classification of each income stream confirmed rather than assuming everything is exempt.
- VAT exemption for healthcare
- Services provided by a registered health professional (including HCPC-registered speech and language therapists) that consist of medical care, meaning the protection, maintenance or restoration of a patient's health, are exempt from VAT. Exempt supplies are not counted toward the £90,000 registration threshold and carry no VAT on the fee, but you also cannot reclaim VAT on related costs. Non-clinical activities such as paid training or product sales fall outside the exemption and may be taxable.
Record-Keeping That Makes the Year Easy
The therapist who breezes through Self Assessment is the one who captures things as they happen, not the one who reconstructs a year of visits each January.
- Log mileage at the point of travel. A note on your phone or an app per visit, with date, destination and miles, builds the figure painlessly.
- Photograph receipts immediately. Resource and equipment spend is frequent and small; lost receipts are lost deductions.
- Separate clinical from non-clinical income. Tagging exempt clinical fees apart from any training or product income makes VAT questions trivial.
- Keep your professional fees together. HCPC, RCSLT, indemnity and DBS recur annually and are easy to claim in full once recorded.
- Use a dedicated bank account for the private practice so personal and business money never blur.
For a visiting speech therapist, the mileage you forget to log costs more than any expense you forget to claim. Record every visit as you make it and the return writes itself.
Worked Example: An SLT on £42,000
Take a therapist running a private list alongside reduced NHS hours, with £42,000 of private income for the year and a busy visiting schedule.
Income: £42,000 (assessments and sessions £33,000, two school contracts £9,000)
Allowable expenses:
- Mileage: 9,000 business miles at 45p: £4,050
- HCPC, RCSLT and indemnity insurance: £750
- Therapy resources, assessment kits and toys: £1,400
- Laptop, tablet and printer (AIA, in full): £1,300
- Clinical and note-keeping software: £480
- DBS, CPD and home-office proportion: £1,020
- Accountancy and bank fees: £500
- Total expenses: £9,500
Taxable profit: £42,000 minus £9,500 = £32,500
Income Tax (assuming the personal allowance is used by NHS PAYE): £32,500 at 20% = £6,500 (if the allowance were free, it would be £19,930 at 20% = £3,986)
Class 4 NIC: £19,930 of the profit above £12,570 at 6% = £1,196
The big lever here is the mileage: at 9,000 miles it alone removes over £4,000 of profit. Sanity-check your own figures with the sole trader tax calculator.
MTD for Income Tax: What Changes for Therapists
Making Tax Digital for Income Tax Self Assessment replaces the once-a-year return with quarterly digital submissions and a year-end finalisation. The thresholds are based on gross income from self-employment and property, not profit, and your NHS PAYE salary does not count toward them:
- April 2026: Combined trading and property income over £50,000
- April 2027: Over £30,000
- April 2028: Over £20,000
For a therapist the change is mostly about rhythm. Instead of pulling a year of session invoices, mileage and receipts together each January, you record income and costs digitally as they occur and send HMRC a quarterly summary. For a peripatetic SLT that actually helps, because mileage and resource spend are exactly the things that get forgotten when reconstructed months later. Our guide to MTD for sole traders walks through what the quarterly rhythm looks like in practice.
Common Mistakes Speech Therapists Make
Not logging mileage. This is the biggest single deduction for a visiting therapist and the easiest to lose. No log, no claim.
Assuming the personal allowance covers private profit. If an NHS salary already uses your £12,570 allowance, your private profit is taxed from the basic rate up, often at 40%.
Forgetting professional fees are deductible. HCPC, RCSLT, indemnity and DBS are all allowable and recur every year, yet are routinely missed.
Treating all income as VAT-exempt. Clinical therapy is exempt, but paid training, products and some reports may be standard-rated; a mixed practice should check.
Missing the £1,000 trigger. Once gross private income tops £1,000 you must register for Self Assessment, even if the NHS job is your main work.
People also ask
Quarterly expenses under MTD: the £90,000 rule
If your annual business turnover is £90,000 or less, HMRC lets you report a single consolidated expenses total in each Making Tax Digital quarterly update instead of breaking expenses down into itemised categories. Most self-employed speech therapist businesses are under this threshold, so a quarterly update can be as simple as two figures: total income and total expenses. You still need to keep digital records of each individual expense - the relaxation only changes how much detail goes into the quarterly update itself.
Frequently asked questions
Calculators for speech therapists
Helpful guides
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