HMRC is changing how you report income.
Not once a year. Every quarter. And your current setup probably isn't ready for it.
What actually changes
From April 2026, if you earn over £50,000 from locum or private work, you won't just file one tax return per year.
You'll send HMRC a summary of your income and expenses every 3 months.
Not full accounts — just a snapshot:
- Income from shifts and private work
- Expenses like indemnity, travel, training
- Basic totals, submitted digitally
At the end of the year, you confirm everything once. That part doesn't change.
Simple in theory. Messier in practice.
Why this is harder for clinicians
A typical sole trader has one income stream. You probably don't.
Different practices. Different session rates. NHS work on one side, private work on the other. Reimbursements that don't fit neatly anywhere.
Expenses that change month to month.
MTD doesn't simplify any of this. It just expects the numbers, every quarter, in the right format.
MTD Thresholds for Clinicians
MTD applies based on your total self-employed income:
From 6 April 2026
Over £50,000 in total income
From 6 April 2027
Over £30,000 in total income
This includes all income combined — locum, private, and any other self-employed work.
You don't need new software. You need a bridge.
Most locums already track income in a spreadsheet. That's not the problem.
The problem is submitting that data to HMRC in the format it expects — without rebuilding your entire workflow.
That's what bridging software does. And it's exactly what Otis is built for.
How Otis works
1. Drop in your spreadsheet. Excel, Google Sheets export — whatever you already use.
2. It organises your data. Income and expenses mapped into HMRC-ready categories.
3. You check everything. Nothing gets submitted without your review.
4. Submit in a few clicks. No copying. No re-entering. No manual totals.
The one thing most tools get wrong
Most accounting software assumes you run a business.
You don't — not in the traditional sense.
You run a clinical career with multiple income sources and a schedule that changes week to week.
Otis doesn't try to turn you into an accountant. It just handles the compliance part so you can ignore it the rest of the time.
Handle MTD in minutes, not hours
MTD doesn't change how much tax you pay. It just increases how often you report.
The goal is to handle it in the least amount of time, with as little disruption as possible.