Allowable expenses, mileage to clients, HCPC and indemnity fees, NIC, VAT and MTD explained for UK self-employed speech and language therapists.
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.
As a sole trader you pay Income Tax on profit, which is your total private therapy income minus allowable expenses. For 2025/26 the personal allowance covers the first GBP 12,570, then you pay 20% to GBP 50,270, 40% to GBP 125,140 and 45% above, with the personal allowance tapering away between GBP 100,000 and GBP 125,140 to create an effective 60% band. Class 4 National Insurance is 6% on profit between GBP 12,570 and GBP 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.
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 GBP 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.
Many therapists test private work cautiously, taking a handful of paying families while still employed. The GBP 1,000 trading allowance is built for that. If your gross self-employed therapy income is GBP 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 GBP 1,000 and you must register and report the full amount.
Once over the threshold you choose each year. You can deduct the flat GBP 1,000 trading allowance instead of working out actual expenses, or deduct your real allowable costs if they come to more than GBP 1,000. You cannot do both. For a peripatetic SLT with serious mileage, resources and registration fees, actual expenses almost always beat the GBP 1,000, so total your costs and claim the larger figure.
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 |
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.
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.
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.
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 GBP 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.
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.
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.
Take a therapist running a private list alongside reduced NHS hours, with GBP 42,000 of private income for the year and a busy visiting schedule.
Income: GBP 42,000 (assessments and sessions GBP 33,000, two school contracts GBP 9,000)
Allowable expenses:
Taxable profit: GBP 42,000 minus GBP 9,500 = GBP 32,500
Income Tax (assuming the personal allowance is used by NHS PAYE): GBP 32,500 at 20% = GBP 6,500 (if the allowance were free, it would be GBP 19,930 at 20% = GBP 3,986)
Class 4 NIC: GBP 19,930 of the profit above GBP 12,570 at 6% = GBP 1,196
The big lever here is the mileage: at 9,000 miles it alone removes over GBP 4,000 of profit. Sanity-check your own figures with the sole trader tax calculator.
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:
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.
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 GBP 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 GBP 1,000 trigger. Once gross private income tops GBP 1,000 you must register for Self Assessment, even if the NHS job is your main work.
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