Clinic ERP Consultant, UK

Associates, lab bills and self-employed clinicians

In many UK dental practices the associate dentists are self-employed and paid a share of the fees they generate, with a corresponding share of laboratory bills deducted. NHS work may be valued differently from private work in the same agreement. Hygienists, therapists, physiotherapists and aesthetic practitioners can be employed, self-employed or paid per session, and the terms often differ from one acquired practice to the next.

The monthly pay sheet is therefore a calculation with many inputs: private fees collected or charged, NHS activity attributed to each clinician, lab invoices matched to the right associate, refunds and remakes, and any agreed adjustments. When this lives in a practice manager's spreadsheet, disputes are hard to settle and the group cannot see clinician cost consistently.

I document each agreement type, decide which figures come from the practice software and which from the ERP, and design a calculation the finance team can review before payment. Lab invoices are recorded against the practice, the associate and, where needed, a case reference that carries no patient identity. Employment status and the wording of associate agreements are matters for your solicitor and accountant; the system simply has to reflect what has been agreed.

NHS contracts, private fees and payment plan income

A mixed dental group can receive money through several routes in one month. NHS contract payments arrive on a schedule set by the contract, and arrangements differ between England, Scotland, Wales and Northern Ireland. Private patients pay at the desk or by card online. Many practices also run monthly dental payment plans, collected by direct debit either directly or through a plan provider that passes on the income after its own fees. Physiotherapy and private GP groups add invoices to private medical insurers and corporate clients.

Each route needs its own path into the ledger. Plan income should be recorded gross, with the provider's fees shown as a cost, and reconciled to the plan provider's statements. NHS contract income needs to be visible against delivered activity, so the group can see shortfalls before year-end reconciliation rather than after. Insurer invoices need aging by insurer and site.

I trace every route from the practice software or statement to the bank and then to the ledger, and write the interface and reconciliation steps. The result is a practice-level profit view that separates NHS, private, plan and insured income, which is usually the first thing owners ask for after an acquisition.

Medical or cosmetic: VAT across one treatment list

The VAT question in UK clinics often sits inside a single treatment list. Care provided by registered health professionals is broadly exempt, but treatments whose main purpose is cosmetic, such as some aesthetic injections or whitening, may be standard-rated, and retail products sold at reception usually are. The same clinician might deliver both kinds of treatment in one afternoon, and the same product might be used clinically or cosmetically.

Getting this right is a question of evidence and advice, not configuration. Your VAT advisor decides how each treatment is treated and what records support it. My part is to make that decision repeatable: a treatment and product master carrying the agreed VAT code, practice software settings aligned with it, and ledger codes that keep exempt, taxable and retail income apart. Where a group is close to the registration threshold or already registered, the advisor will also want to see how input VAT is attributed across activities.

Because many groups file through Making Tax Digital compatible software, I also check how the chosen platform produces VAT records and returns, and how practice software totals reach it. These checks go into UAT so the first quarter on the new system is not the first real test.

Bringing acquired practices onto group systems

When a group buys an independent practice, the deal usually closes before anyone has decided how the practice will run on group systems. Weeks later, the practice is still on its old bookkeeping, buying from its old supplier at its old prices, and paying associates under terms only the previous owner fully understood.

An onboarding pack changes that. I write a standard sequence: map the practice into the group ledger with its own practice code, capture each clinician's pay terms in the agreed format, move ordering to group suppliers and price lists, set up materials stock if the practice holds any of value, connect the practice software to the summary interface, and run the first month-end in parallel. Dental materials, implant components and aesthetic products are tracked with batch and expiry where your clinical lead says it is needed.

Registration with the relevant care regulator, information governance and other compliance duties sit with your registered managers and compliance lead. The onboarding pack points to those owners but does not try to manage regulatory records inside the ERP. Kept this way, the template stays short enough to be used every time.

Platform choice and remote work with UK clinic groups

Most UK clinic groups I hear from run Xero or Sage at practice or group level, with pay sheets in spreadsheets and materials bought through supplier websites. Sometimes a stronger accounting setup with good integrations is enough; sometimes the group needs an ERP with purchasing, stock and multi-practice reporting. Odoo, Zoho, Microsoft Dynamics 365 and ERPNext each get tested against a month from one of your practices, and I say plainly when a lighter option suits you better.

Data protection shapes the design: health data is special category data under UK GDPR, so interfaces carry amounts, practice codes and clinician references, not patient details. Your data protection lead reviews the data flows before build.

Workshops run remotely during the UK working day, with recordings for practice managers who cannot step away from reception. Related reading: ERP for clinics for the general model, the UK healthcare ERP page for hospitals and NHS suppliers, my UK ERP consulting overview, the Zoho Books page for UK businesses and the United Kingdom hub.