Last updated: 19 October 2026
Making Tax Digital (MTD) for Income Tax is now live. Since 6 April 2026, self-employed people and landlords with qualifying income over £50,000 have had to keep digital records and send HMRC quarterly updates through recognised software. Many locum and associate dentists are self-employed and earn well above that level, so MTD already applies to a large share of the profession. This guide explains who is caught, the key dates, what you need to do and how it works alongside your NHS and private work.
What Is Making Tax Digital for Income Tax?
MTD for Income Tax replaces part of the annual Self Assessment process with digital record keeping and four quarterly updates a year. You still submit a final tax return by 31 January after the end of the tax year, but it is filed through your MTD software rather than the old online return.
Does MTD Apply to Locum Dentists?
It applies if you are self-employed (or a landlord) and your qualifying income is above the threshold. Qualifying income is your total gross self-employment and property income before expenses, not your profit. Employed (PAYE) salary, pensions, dividends and savings interest do not count.
| Qualifying income | Tax year HMRC looks at | MTD starts |
|---|---|---|
| Over £50,000 | 2024/25 | 6 April 2026 |
| Over £30,000 | 2025/26 | 6 April 2027 |
| Over £20,000 | 2026/27 | 6 April 2028 |
For example, a locum dentist with £72,000 of gross self-employed fees in 2024/25 should have started MTD on 6 April 2026. A dentist who works mainly as an employee in a hospital and does £18,000 of private locum work would not need to join until their qualifying income goes over £20,000.
Key Dates for 2026/27
- 7 August 2026 – first quarterly update (6 April to 5 July).
- 7 November 2026 – second update (6 April to 5 October).
- 7 February 2027 – third update (6 April to 5 January).
- 7 May 2027 – fourth update (6 April to 5 April).
- 31 January 2028 – final tax return for 2026/27, and payment of any balancing tax.
Your 2025/26 tax return is still filed the old way by 31 January 2027. Each quarterly update is a running total from 6 April, so a later update can catch up a missed one. For a full timeline, see our Making Tax Digital deadlines guide.
What You Need to Do
- Check your qualifying income for 2024/25 and 2025/26 using your tax returns.
- Sign up for MTD on GOV.UK, or ask your accountant to sign you up. From September 2026, HMRC began signing up people who should already be using MTD but have not done so.
- Choose HMRC-recognised software such as Xero, QuickBooks, FreeAgent or Sage, or bridging software if you prefer spreadsheets.
- Keep digital records of every item of income and expense, including NHS and private fees, lab bills and practice deductions.
- Send quarterly updates and the final return on time.
Keeping Records as a Locum or Associate Dentist
Your software should record each source of income separately so it can be matched to practice statements and NHS schedules. Typical items to record include:
- Gross fees from each practice, both NHS and private.
- Lab fees and materials you pay for, and any share of costs deducted by the practice.
- Indemnity insurance, GDC annual retention fee and professional subscriptions.
- Continuing professional development and training courses.
- Travel between practices (not home to a regular workplace), claimed at HMRC’s approved mileage rates or actual costs.
- Equipment such as loupes and instruments, and a proportion of phone and home office costs.
NHS Pension and MTD
MTD does not change how NHS Pension Scheme contributions work, but accurate quarterly records make it easier to complete your annual certificate of pensionable profits for the practices you work at, and to check for annual allowance charges.
Penalties Under MTD
For 2026/27, HMRC will not give penalty points for late quarterly updates, but you still have to send them before you can file your tax return. From 6 April 2027, each missed quarterly deadline earns one penalty point and a £200 penalty is charged once you reach four points. A new points-based system already applies to late returns, and new late payment penalties apply if tax is paid late.
VAT and Dentists
Most dental treatment is exempt from VAT, so few dentists need to register. If you do make taxable supplies above the £90,000 registration threshold (for example cosmetic work that is not treatment), your VAT returns must already be filed through MTD software.
Exemptions
You may be exempt if you are digitally excluded, for example because of age, disability or location. Income you earn as a partner in a partnership does not count towards qualifying income yet, because partnerships will join MTD at a later date. Some exemptions are automatic and others must be applied for, so check GOV.UK or ask us.
Frequently Asked Questions
I am an associate dentist paid a share of fees. Is my income “self-employed”?
Most associates are self-employed, so their gross fees count as qualifying income for MTD. If you are employed by the practice and paid through PAYE, MTD does not apply to that income.
Is it too late to sign up if my income was over £50,000 in 2024/25?
No. You can still sign up now. Send any missed quarterly updates through your software as soon as possible; there are no penalty points for late quarterly updates in 2026/27.
Do I still need to file a Self Assessment tax return?
Yes. You file your 2025/26 return as normal by 31 January 2027, and your first MTD final return for 2026/27 by 31 January 2028.
Can my accountant send the quarterly updates for me?
Yes. An agent can sign you up, keep or review your digital records and submit the updates and final return on your behalf.
Specialist Accountants for Dentists
Accotax works with locum and associate dentists, practice owners and other healthcare professionals. Our accountants for dentists and accountants for locums can sign you up for MTD, set up your software and handle every submission. Contact us to get started.
