If you went into private practice to sit with clients, not spreadsheets, Making Tax Digital probably sounds like an unwelcome intrusion into a profession built on confidentiality. The good news: MTD only ever touches your financial records, never your clinical notes. Here's exactly what changes, what stays completely untouched, and how irregular session income actually gets reported.
This is the anxiety worth putting to rest first. Making Tax Digital requires digital records of your business income and expenses, what you were paid, by whom, when, and what you spent running your practice. It has nothing to do with session notes, case formulations, or anything covered by your professional confidentiality obligations. Those stay exactly as your professional body already requires, entirely separate from your tax software.
Many therapists work across several referral routes at once: word-of-mouth private clients, an Employee Assistance Programme contract, and perhaps an insurer panel like Aviva or WPA. For MTD purposes, this is normally all one self-employment business, so all of it is added together as a single gross income figure when checking against the threshold, even though the fee structures and payment timing differ wildly between each source.
Clinical supervision, a mandatory requirement for most practising therapists, is normally an allowable business expense. So is CPD training relevant to your practice, professional indemnity insurance, and room rental if you see clients somewhere other than home. Your own personal therapy sits in a different category.
Marcus's three income streams combine into one self-employment total. £44,400 sits under the current £50,000 threshold, but above the £30,000 threshold arriving April 2027, so he'll need to prepare based on this year's figures.
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No. MTD digital record-keeping only applies to your financial records — what you were paid, when, and your business expenses. Clinical case notes are a separate professional and confidentiality requirement, kept under entirely different rules, and are never part of your MTD obligations.
No, if you're self-employed. Fees from Employee Assistance Programmes, insurer panels and private clients are normally all the same self-employment business for tax purposes, so the gross income from all of them is added together when checking against the MTD threshold.
Usually not, even though many training courses required it. HMRC applies a "duality of purpose" test — personal therapy serves your own wellbeing as well as your practice, so it typically fails the wholly-and-exclusively rule. Clinical supervision, which is a mandatory professional requirement, is normally allowable.
Once your gross self-employment income from private practice exceeds £1,000 in a tax year, you need to register for Self Assessment, even if it's a small part-time practice alongside employed work. Whether you reach the MTD threshold itself is a separate, higher bar.
Yes. Annual membership and registration fees for professional bodies relevant to your practice, along with required CPD training and clinical supervision, are normally allowable business expenses against your self-employment income.