Is a company still worth it for a locum after the 2026 dividend rise?

For some, and less often than before. Two percentage points on the basic and higher dividend rates narrows the gap against sole trader status, and if most of your engagements are caught by the off-payroll rules the gap closes altogether. It is arithmetic on your actual figures rather than a rule of thumb.

Can I pay my spouse a salary from the company?

Only for work genuinely done, at a rate that would be paid to somebody at arm's length, and it has to run through payroll. A salary that fails those tests is disallowed, and it is one of the first things looked at in an enquiry.

What happens if the trust determines me inside the off-payroll rules?

Tax and National Insurance are deducted before the money reaches your company, so the company receives a net amount that has already been taxed. That has to be recorded properly to avoid it being taxed a second time when you take it out, which is a common and expensive error.

Limited Company Accounts for Doctors

Written and reviewed by the Medical Accountants editorial team. Last reviewed 24 July 2026.

A company is a second set of obligations bolted onto your personal ones: statutory accounts at Companies House, a corporation tax return, payroll if anyone is paid a salary, and a dividend record that has to exist before the money moves rather than after. None of it is hard, and all of it has a deadline.

We run the company side and your personal return together, because the decision that matters, which is how profit comes out, only makes sense when both are on the same page.

Company Accounts and Corporation Tax

Statutory accounts prepared and filed, the corporation tax return prepared and filed, and the tax itself calculated with the rate that actually applies. Profits up to £50,000 are taxed at 19% and profits over £250,000 at 25%, with marginal relief in between, and both limits are divided by the number of associated companies.

That last point catches doctors more than most, because a second company for an unrelated venture, or a spouse's company under common control, can drag the whole thing into a higher effective rate.

Salary, Dividends and the 2026 Rates

The dividend allowance is £500. Above it, dividends are taxed at 10.75% in the basic rate band, 35.75% in the higher rate band and 39.35% above that. The basic and higher rates each rose by two percentage points on 6 April 2026, which means most published salary against dividend comparisons written before that date now give the wrong answer.

We run the split on current rates against your actual total income, including the NHS salary, because a doctor with a consultant post is usually already in the higher or additional band before the company pays anything at all.

Off-Payroll Working With NHS Clients

NHS trusts, foundation trusts, integrated care boards and NHS England are public authorities, so where one of them is your client it decides your status and issues a Status Determination Statement. Where the client is a small private company, judged on turnover over £10.2 million, balance sheet over £5.1 million and more than 50 employees, the decision falls back to your own company instead.

If you disagree with a determination, the client has 45 days to respond to a challenge, and missing that deadline moves the tax liability onto them. We check determinations, put the challenge in writing and keep the correspondence, because the record is what protects you later.

Fees for Company Work

A fixed monthly or annual fee covering the accounts, the corporation tax return, payroll for the director and the confirmation statement. Quoted before work starts and not linked to company turnover.

Where a company is not earning its keep, we will say so. Closing one down properly is cheaper than running one for another three years out of inertia.