For self-employed carers & private nurses

MTD for Income Tax for carers & private nurses.

Agency-introduced and direct-hire clients, live-in and hourly work, mileage between visits and DBS and training costs. Here's how Making Tax Digital for Income Tax affects self-employed carers and private nurses, and when it starts.

When does it start for me?

For many, April 2027 is the date to watch.

MTD for Income Tax phases in by gross income before expenses. Many self-employed carers sit between £30,000 and £50,000, so it's worth knowing your wave.

£50,000
Already live, from April 2026
Your likely date
£30,000
In scope from April 2027
£20,000
In scope from April 2028
Agency or direct?

If you're self-employed, it's your tax to report.

Working through an introductory agency usually still makes you self-employed, unlike an employed care worker on PAYE. That means your own records and, once you're over the threshold, MTD for Income Tax.

What records you need →
What's changing

Digital records, four quarterly updates, one final declaration.

When you're in scope, your annual Self Assessment return is replaced by four short quarterly updates and a year-end final declaration, all through recognised software.

What to keep digital

  • Income from every client
  • Live-in and hourly pay
  • Mileage between clients
  • DBS checks and training
  • Professional registration and insurance
  • Uniform and PPE

Log each shift or visit as you're paid so your quarterly total matches the work you actually did.

  • Several clients Reconciled into one update
  • Live-in and hourly Both recorded as you're paid
  • Mileage and DBS Deductible business costs
The care detail

The bits specific to self-employed care.

Agency and direct clients

Whether introduced by an agency or hired directly, it's your self-employed income in one set of records.

Live-in and hourly

A daily live-in rate or an hourly visit, both are income recorded as you're paid and totalled for the quarter.

Mileage between clients

Travel between visits is deductible. Log it as you go, by flat rate or actual costs, and nothing is missed.

DBS and training

DBS checks, training and professional registration are deductible. Keep them recorded so your expenses stay complete.

Why Clear Books

Every client and shift in one place.

Between clients and on the road, records need to be quick. Clear Books works from your phone and gives HMRC exactly what MTD needs, whenever you're in scope.

  • Record income from every client
  • Keep live-in and hourly pay together
  • Log mileage between visits
  • Track DBS, training and insurance
  • Send HMRC-compliant quarterly updates in minutes
  • Free plan available, no timer
The Clear Books MTD for Income Tax submissions screen showing four quarterly updates submitted to HMRC
Q1 update submitted
HMRC recognised
Common questions

Carer & private nurse MTD FAQ.

When does MTD for Income Tax start for self-employed carers?
The key date for many is April 2027, at £30,000 of gross income. Over £50,000 it applies now, and from April 2028 it drops to £20,000.
Am I self-employed if I work through an introductory agency?
Often, yes. Introductory agencies find you clients but you're self-employed and responsible for your own tax, unlike an employed care worker on PAYE. Check with the agency or your accountant if unsure.
How do live-in and hourly work differ for records?
Both are income you record as you're paid, whether hourly or a daily live-in rate. Clear Books totals them into a single quarterly update.
Can I claim mileage and DBS costs?
Yes. Mileage between clients, DBS checks, training and professional registration relevant to your work are generally deductible.
I work for several clients, is that harder?
No. Whether you have one client or several, it's all one set of self-employed records that totals into a single quarterly update.
Free for self-employed carers

Know where you stand before the deadline.

Record shifts, visits and mileage as you go, watch your gross against the thresholds, and be ready to submit when your wave lands.