Independent dental practices · NHS, mixed and private

Books that know your UDA position before the reconciliation does

Your contract pays twelve equal instalments against one annual target. Your ledger should track what you have earned, not what has landed. Monthly bookkeeping and accounts from a Chartered Management Accountant, from £95 + VAT.

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Regulated byCIMA
Member in Practice
Companies HouseNo. 16943160
Insight Professional Partners Ltd
CoverProfessional
Indemnity Insured
ServingNorthants, Cambs
Beds, Rutland & Lincs
Why the cash and the income are different numbers

Monthly cash tells you nothing about where the contract will land

A dental ledger fails in five places, none of them generic: NHS income on the payment schedule rather than UDAs delivered, the exempt and standard-rated split that forces partial exemption, associate status, the lab-fee split counted twice, and equipment on finance treated as cost rather than asset.

An NHS contract in England pays its annual value in twelve equal instalments against a target number of Units of Dental Activity for the year to 31 March. Payment and delivery are decoupled, so the bank statement is silent on performance. NHS Dental Services reconciles contracted against delivered activity after the year end, finishing by September.

The bands matter more than the trend. Below 96% of target the commissioner claws back, up to the full value of the activity target, with a breach notice possible. Between 96% and 100% the shortfall is tolerated and carried into next year's requirement rather than recovered in cash. Over-delivery to 102% carries forward; above 102% is neither paid for nor carried. UDA value is contract value divided by contracted UDAs, so on 6,000 UDAs at £30, finishing on 5,580 — 93% — is a shortfall worth £12,600, taken from the next year's instalments. Two points higher and you repay nothing.

Which makes it an accounting problem before a cash problem. Revenue belongs in the period it is earned, so once under-delivery is probable and measurable from the activity reports, the expected recovery belongs in the year it arose. Post each instalment straight to income and the books show a profit the reconciliation removes a year later. Northamptonshire, Cambridgeshire and nearby counties in person; remote elsewhere.

Seven places a dental ledger goes wrong

Each one is a posting decision, made once and repeated monthly

01 · NHS

Income against delivery

Each instalment split earned against deferred, using the UDA position in Compass. Below a 96% run rate, the expected recovery is carried as a liability from that month.

02 · VAT

The exempt line, and the line that is not

Exemption rests on medical care: protecting, maintaining or restoring health, by a registered professional. Whitening and veneers purely for appearance, and facial aesthetics, are standard rated. Prostheses are exempt; reception toothpaste is not.

03 · VAT

Partial exemption, calculated

Taxable income alone counts towards the £90,000 rolling threshold — how a mostly exempt practice ends up registered. Input tax then splits three ways: taxable, exempt, residual. Coded at entry.

04 · People

Associates, since the guidance went

HMRC withdrew its associate dentist guidance with effect from 6 April 2023. No automatic self-employed treatment survives it. Being wrong costs PAYE and NIC on fees already paid gross.

05 · Margin

The lab-fee split, counted twice

Most associate agreements share lab fees. Post the laboratory invoice gross to practice costs and also net the associate's share off their self-billed fee, and both lines overstate. Private margin then means nothing.

06 · Capital

Chairs, autoclaves, the CBCT scanner

Hire purchase with an option or obligation to acquire puts the asset on the balance sheet and opens capital allowances once in use. A true operating lease gives rentals and none.

And the knowable fixed costs. Consumables bought in bulk and never counted land wherever the invoice fell. CQC registration is budgetable: for 2026/27 a single-location practice pays £598 for one chair, £747 for two, £846 for three. All on your existing Xero or Sage.
The monthly cycle, and what it costs

What arrives, and the published fee for it

Essentials £95 + VAT a month: bookkeeping and VAT. Essentials + Books £195 + VAT, adding year-end accounts and the CT600. Managed £395 + VAT, with management accounts and commentary. Finance Director £1,250 + VAT. Catch-up on an overdue year, £450 + VAT. Fixed, by Direct Debit, agreed in writing. Full price list.

Excluded deliberately. No statutory or external audit, and no specialist tax advice: incorporation planning, practice sale and goodwill, superannuation, and personal tax beyond basic Self Assessment go to a firm that does that properly. A borderline VAT treatment gets ruled on, not guessed.
Where this fits and where it does not

Owner-run practices, one site or a small group

Structure
Independent and owner-run — wholly NHS, mixed or private
The trigger
A clawback nobody saw coming, a cosmetic line pushing you towards VAT registration, or a new associate
Scale
Two to ten surgeries; SIC 86230
Current state
An accountant who files and nothing between; the ledger kept by the practice manager
Not a fit
Corporate groups, and anyone needing a statutory audit — we do no audit work
Geography
Northamptonshire-based; nearby counties in person, remote UK-wide
Who does the work

Why a management accountant, for this

I'm Peter Edwards, a Chartered Management Accountant (ACMA CGMA) and CIMA Member in Practice, twenty-five years in finance: Head of Finance at a pharmaceutical wholesaler growing from £3m to £10m, at a £13m publishing and media group with an ecommerce arm, and at a £15m software business, plus a spell as Responsible Financial Officer and Deputy Town Clerk at a town council.

Two of those turned on income arriving at one rhythm and being earned at another. A dental practice is that problem in a different coat, and costing something properly is the core of the management accounting discipline — a different trade from year-end compliance.

You deal with me. No junior doing the work, no partner signing it, no statutory audit and no specialist tax advice.

  • Peter Edwards ACMA CGMAChartered Management Accountant, CIMA Member in Practice
  • Pharmaceutical wholesalerHead of Finance, £3m to £10m
  • £13m publishing and media groupHead of Finance, with an ecommerce arm
  • £15m software businessHead of Finance, through a restructuring
  • Town councilResponsible Financial Officer and Deputy Town Clerk
  • Insight Professional Partners LtdCompany No. 16943160, Northamptonshire. PI insured, AML supervised
  • Xero and SageXero Partner practice, plus ten years on Sage 50 and Sage 200
Getting started

Three steps, starting with one you can do alone

01

The Quick Books Check

Seven questions, answered from memory. No logins, no exports, and an honest verdict before we ask you for anything.

02

Thirty minutes and the contract

Free. Bring your UDA position and one associate agreement — most of what needs fixing shows up in those two documents.

03

A fixed fee, then the cycle

Scope and monthly fee in writing before anything starts, from the first complete month. Stop on a month's notice.

What percentage of target are you on today?

If you can answer that and say what it does to this year's income figure, your books are in better shape than most. If not, start with seven questions you can answer from memory.

Run the free Quick Books Check → Or book a 30-minute review