Nudge letter · private practice income
Medical consultants' private practice income letter
For HMRC's letter to medical consultants about private practice or consultancy income and their Self Assessment returns. This page sets out why HMRC sends it, what the letter says about replying and the routes GOV.UK describes, with each source and the date it was checked.
Last reviewed 8 October 2026 · How Tax Letters checks its facts
The short answer
- What this letter is
- One of HMRC's nudge letters. HMRC's Compliance Handbook says a One to Many approach is where HMRC sends one standard message to many customers, to influence their behaviour so they are more likely to comply with their tax obligations. [1]
- Is it a compliance check?
- HMRC's manual says: “A One to Many approach is not a compliance check.” If your letter says a check has already been opened, it is a different kind of letter, with its own page. [1]
- Why it is sent
- ICAEW reports that HMRC is writing to people it believes may have left consultancy income off their Self Assessment returns, based on information from healthcare providers, and that agents will not receive copies of the letters. [2]
- Your routes at a glance
Every fact on this page comes from a source listed at the foot of the page, with the date it was last checked. All sources and dates
Why you got this letter
ICAEW reports that HMRC is writing to people it believes may have left consultancy income off their Self Assessment returns, based on information from healthcare providers, and that agents will not receive copies of the letters. [2]
HMRC's manual says a One to Many approach sets out what HMRC wants customers to do and why, what happens if they do or do not respond, and what follow up HMRC will undertake. So the letter's own words are the best record of what HMRC is asking about, and why. [3]
HMRC's manual tells its staff that if a One to Many letter asks people for more information or records to show their tax affairs are correct, HMRC must either open a compliance check or make clear that, where information is asked for voluntarily, there is no obligation to provide it. [3]
The reply date, and what follows
The copy of HMRC's letter that ICAEW published asks for a reply within 30 days of the date of the letter. It says that if you do not respond, HMRC will make a decision based on the information it has, which may lead to a compliance check, and that if there are errors in your return, any disclosure about consultancy fees made from now on will be treated as prompted. The date printed on your letter is the one that counts. [4]
What HMRC's own guidance says about disclosure and penalties: HMRC's factsheet CC/FS7a calls it an unprompted disclosure when you tell HMRC about an inaccuracy before you have any reason to believe it has discovered it, or is about to. Telling HMRC at any other time is a prompted disclosure. The same factsheet says the minimum penalty for an unprompted disclosure is lower than the minimum penalty for a prompted one. HMRC's guide to voluntary disclosure says any penalties it charges on outstanding tax will usually be lower if you tell HMRC about it yourself. [5] [6]
For an inaccuracy in a return you sent, HMRC's factsheet CC/FS7a gives the ranges: CC/FS7a gives the penalty range for a careless inaccuracy as 0% to 30% where the disclosure was unprompted, which means you told HMRC before you had any reason to believe it had found the inaccuracy or was about to. Where the disclosure was prompted, which means at any other time, CC/FS7a gives the range for a careless inaccuracy as 15% to 30%. The penalty is a percentage of what HMRC calls the potential lost revenue, the amount that arises from correcting the inaccuracy. GOV.UK: penalties for inaccuracies, CC/FS7a [5]
Your routes
Nothing to declare
If your tax is already right, your letter's own words say whether and how to tell HMRC so.
Amend a recent return
A Self Assessment return can be amended within 12 months of the statutory filing deadline. [7]
A voluntary disclosure
HMRC's guide sets out the ways to make a voluntary disclosure, including the digital disclosure service for Income Tax, Capital Gains Tax and other taxes, and says that people who qualify for a current HMRC campaign should follow its guidance. HMRC's guide says that once it acknowledges your notification, your disclosure must reach it within 90 days of that acknowledgement, and so must your payment unless you have made payment arrangements with HMRC by that date. GOV.UK: make a voluntary disclosure [6]
These are the routes GOV.UK describes. Which one fits depends on your own affairs, and this page does not say which.
If one of these is you
You think you took reasonable care
HMRC says it will not charge a penalty for an inaccuracy if you took reasonable care to get things right but your return or document was still wrong; keeping accurate records is one way it gives of showing reasonable care. [5]
Your health or circumstances make the date hard
GOV.UK says that in certain circumstances HMRC can give you an extension to a deadline, for example if you have a mental health condition, are receiving treatment in hospital or are experiencing financial difficulties. You may need to prove why you need more time. GOV.UK: get help from HMRC if you need extra support [8] [9]
Someone else helps with your tax
You can authorise a friend, relative or voluntary organisation to talk to HMRC for you and help you fill in forms. You can also authorise an agent, such as an accountant or tax adviser, to deal with HMRC for you. [10]
Questions to take to an adviser
If you talk to an adviser, these questions keep the conversation on your letter:
- Which years and which income or gains is the letter asking about, and are they on my returns?
- If something is missing, which route fits my affairs, and why?
- What would my reply say, and which records would go with it?
- Is there anything else in those years that a reply or disclosure would need to cover?
Need help with this?
Vision Consulting Chartered Accountants and Registered Auditors, Tax Letters' founding partner, is regulated by ICAEW. Talk to them in confidence, with no obligation. [11] [12] [13]
Call 020 8554 2135How Vision handles HMRC nudge letters
You can also deal with HMRC directly, free, without any adviser. Free help: TaxAid, which says it helps “people who can’t afford to pay for help”, and Citizens Advice.
The two are connected. Tax Letters takes no referral fees.How Tax Letters is funded.
Sources
Each source is linked, with the date Tax Letters last checked it.
- HMRC Compliance Handbook CH600110: The One to Many approach, overview (checked 7 Oct 2026)
- ICAEW: Tax news in brief, 30 September 2026 (checked 8 Oct 2026)
- HMRC Compliance Handbook CH600120: What is One to Many? (checked 7 Oct 2026)
- ICAEW: copy of HMRC's one-to-many letter to the medical sector, September 2026 (checked 8 Oct 2026)
- GOV.UK: Penalties for inaccuracies in returns or documents, CC/FS7a (checked 7 Oct 2026)
- GOV.UK: Make a voluntary disclosure to HMRC (checked 7 Oct 2026)
- Taxes Management Act 1970, section 9ZA (checked 7 Oct 2026)
- GOV.UK: Get help from HMRC if you need extra support, if you need more time (checked 7 Oct 2026)
- GOV.UK: Get help from HMRC if you need extra support (checked 7 Oct 2026)
- GOV.UK: Appoint someone to deal with HMRC on your behalf (checked 7 Oct 2026)
- Vision Consulting: Contact us (checked 7 Oct 2026)
- TaxAid: About us (checked 8 Oct 2026)
- Citizens Advice: About us (checked 7 Oct 2026)