In England, a clinic in a single property with a rateable value of £12,000 or less pays no business rates in 2026/27, because Small Business Rate Relief takes the bill to zero. Between £12,001 and £15,000 the relief tapers away. Most one- or two-room practices sit under the threshold, and practitioners who hire a room by the session in someone else's clinic are usually not the ratepayer at all.
The catch is the word "single". Take on a second site and the relief on your first one can disappear, and the rules on how far the second site can go before that happens are tighter than most guides say.
This covers England in detail, then Scotland, Wales and Northern Ireland, which all run different schemes.
How are business rates worked out?
Your bill is your property's rateable value multiplied by a multiplier, minus any relief. Rateable value is the Valuation Office Agency's (VOA) estimate of the annual rent the property could have been let for on a set date. For the revaluation that took effect on 1 April 2026, that date is 1 April 2024.
So rateable value is roughly a rent figure, not a turnover figure and not a property price. A room that would let for £600 a month on the open market has a rateable value somewhere near £7,200, before any adjustments the VOA makes.
From 1 April 2026, England has five multipliers instead of two. The two that matter to a clinic:
| Multiplier, England 2026/27 | Rate | Applies to |
|---|---|---|
| Small business multiplier | 43.2p | Rateable value under £51,000 |
| Standard multiplier | 48.0p | Rateable value £51,000 to £499,999 |
Both fell this year, from 49.9p and 55.5p in 2025/26. You can look up any property's rateable value, and see how it was calculated, with GOV.UK's find a rateable value service.
What changed at the 2026 revaluation?
New rateable values took effect on 1 April 2026, and they are the first since 2023. If you last looked at your rates bill in 2025, the figure on it is out of date.
The headline movement was large. On the compiled 2026 local list, the Valuation Office Agency reports total rateable value in England up 19.6%, and 19.4% across England and Wales together, from £70.9 billion to £84.6 billion across 2.14 million properties. The increases were not evenly spread. London rose most of any English region at 22.5%, the East Midlands least at 16.4%, and by sector the "other" category, which is where health premises sit, rose 28.1% across England and Wales while retail rose 9.8%.
A higher rateable value does not automatically mean a higher bill. Both multipliers that matter to a clinic fell in the same year, from 49.9p to 43.2p and from 55.5p to 48.0p. The two movements partly cancel each other out, and which way your bill went depends on how your own property moved relative to the average.
That is the practical point, and it is the reason not to read a national average as news about your clinic. A room whose rateable value rose by less than the multiplier fell is cheaper this year. A room that rose by more is dearer. Look up your own property on GOV.UK's find a rateable value service, which shows the new value and how it was arrived at, rather than inferring anything from the 19.6%.
One more detail that is easy to miss on a bill. The published multipliers above exclude a 1p transitional supplement, charged on properties that are not receiving transitional relief or Supporting Small Business Relief. If your bill is already nil under Small Business Rate Relief it changes nothing. If you are paying something, check which figure your council has actually used.
What the October 2026 Budget changed
The Budget of 28 October 2026 was widely reported as taking 70,000 small businesses out of business rates. A clinic is not one of them.
The headline relief does not reach clinics. The Small Business Rate Relief threshold rises from £12,000 to £18,000 for full relief, and the taper from £15,000 to £21,000, on 1 April 2027. Both changes apply only to qualifying retail, hospitality and leisure property in England. The regulations that define that category list the uses falling outside it, and physiotherapy, osteopathy and chiropractic are named there, alongside dentistry and acupuncture. This is a definitional exclusion rather than something a council assesses, so there is nothing to apply for and nothing to appeal. A clinic stays on £12,000 and £15,000.
Counselling is not named in that list, which is introduced as examples rather than as a closed set. A counselling practice should ask its council rather than assume it falls either way.
Both multipliers a clinic pays rise on 1 April 2027:
| Multiplier, England | 2026/27 | 2027/28 |
|---|---|---|
| Small business multiplier | 43.2p | 44.7p |
| Standard multiplier | 48.0p | 49.7p |
That is about 3.5%, and it is uncapped. The two-year real-terms freeze announced in the same Budget covers retail, hospitality and leisure property only.
The 1p supplement runs two years longer. It was due to end, and has been extended from 1 April 2027 to help fund that retail freeze. Because it falls on ratepayers whose bills did not rise sharply at the revaluation, a clinic sits on the paying side of a relief it is defined out of. Quoted at 44.7p, a liable clinic is charged on 45.7p before reliefs. If your bill is nil under Small Business Rate Relief, none of this costs you anything, which is the position most single-room practices are in.
One genuine win: appeal fees go. The Budget abolishes the £150 and £300 fees charged for business rates appeals in England, covering the 2026 rating list and later lists, and says it "will enable fees already paid for appeals on the 2026 list to be refunded". There is no commencement date and no refund process yet, so if you have already paid one, keep the receipt and watch for the fee regulations rather than chasing it now.
One thing to watch rather than plan around. The government has said it intends to replace the second-property thresholds described below with a single England-wide figure of not more than £29,999 from 1 April 2027. The regulations have not been laid, the Budget document does not mention it, and the published wording does not say whether it is restricted by sector. The rules in the next section are the ones in force until 31 March 2027, and they are what to work from today.
For how the rest of the Budget reaches a clinic, including the wage rise and the measures affecting room rent and mileage, see what the Autumn Budget 2026 changed for a private clinic.
How much can your bill rise in one year?
Less than the revaluation on its own would suggest, because England is running a three-year transitional relief scheme alongside the new list. It caps the year-on-year increase rather than the value.
| Rateable value | Cap on the increase, 2026/27 | 2027/28 | 2028/29 |
|---|---|---|---|
| Up to £20,000, or £28,000 in London | 5% | 10% plus CPI | 25% plus CPI |
| £20,001 to £100,000 | 15% | 25% plus CPI | 40% plus CPI |
| £100,001 and above | 30% | 25% plus CPI | 25% plus CPI |
Almost every clinic sits in the first row. A practice whose bill would otherwise have jumped by a third sees a 5% rise in 2026/27 instead, with the rest arriving over the following two years. The caps are upward only; a bill that should fall is not held up.
The scheme that matters more to a small clinic is the other one. Transitional relief caps an increase on a bill you were already paying. The clinic that was paying nothing has no bill to cap, so a revaluation that pushes a rateable value from £11,500 to £13,200 takes it out of full Small Business Rate Relief and into the taper, and the increase from zero is not a percentage of anything.
That is what the 2026 Supporting Small Business Relief scheme exists for. GOV.UK's guidance to councils describes it as capping bill increases at £800 a year, or the relevant caps within transitional relief, whichever is the greatest, for businesses that lost eligibility for Small Business Rate Relief, Rural Rate Relief or the 40% retail, hospitality and leisure relief at the 2026 revaluation. Councils run it for up to three years, with higher cash caps in the later years, and most apply it automatically rather than asking you to claim.
Three things to do with that.
- Check your 2026/27 bill against your 2025/26 one, not against the gross figure. The number to look for is what changed, and whether a relief line appears.
- If you lost Small Business Rate Relief this year and no relief line appears on the bill, ring the council's business rates team and ask specifically about Supporting Small Business Relief. Automatic is not the same as guaranteed.
- Do not assume the help continues. Transitional caps loosen each year and the Supporting Small Business scheme runs for a limited period. Budget for the bill you will have in 2028/29, not the one you are paying now.
Can a physio clinic use the new retail, hospitality and leisure multiplier?
No. From April 2026 the old 40% retail, hospitality and leisure (RHL) relief was replaced by two permanently lower RHL multipliers, 38.2p below £51,000 and 43.0p above it. The eligibility rules are set in law by SI 2025/1093, and Schedule 1 excludes premises used for "medical or health services", naming physiotherapy explicitly. Council guidance lists osteopathy, chiropractic and acupuncture in the same excluded group.
The same regulations put "health spas and massage parlours" inside the scheme. A massage-only business may therefore qualify for the lower multiplier where a physiotherapy clinic down the road does not. If your premises are mainly used for massage or wellness treatments rather than clinical care, ask your council which side of the line you fall on. Most clinics will not need to, because Small Business Rate Relief already takes them to zero.
How does Small Business Rate Relief work in England?
GOV.UK sets two conditions: your rateable value is under £15,000, and your business uses only one property.
| Rateable value | Relief in 2026/27 |
|---|---|
| £12,000 or less | 100%, nothing to pay |
| £12,001 to £14,999 | Tapers from 100% down towards 0% |
| £15,000 or more | None |
The taper is linear across the £3,000 band. The formula is:
Relief % = (1 − ((rateable value − £12,000) ÷ £3,000)) × 100
GOV.UK's own example: a rateable value of £13,500 gets 50% off.
Councils administer the relief. Many apply it automatically when you become liable, but not all do, so check your first bill and ask if it is missing.
A worked example
Four clinics, all in England, all on the 43.2p small business multiplier.
| Clinic | Rateable value | Gross bill (RV × 43.2p) | Relief | Payable 2026/27 |
|---|---|---|---|---|
| One treatment room in a shared building | £7,500 | £3,240 | 100% | £0 |
| Two-room unit | £13,500 | £5,832 | 50% | £2,916 |
| Small clinic with waiting area | £14,250 | £6,156 | 25% | £4,617 |
| Three-room high street unit | £18,000 | £7,776 | 0% | £7,776 |
The £14,250 row: (14,250 − 12,000) ÷ 3,000 = 0.75, so relief is 25% and you pay 75% of £6,156.
Read the gap between the first and last rows before you sign anything. The jump from a £12,000 property to an £18,000 one is not £6,000 of extra rent a year. It is the extra rent plus £7,776 of rates that were previously zero.
What happens if you open a second site?
This is the trap. Relief is meant for businesses using one property, and a second one changes the picture.
GOV.UK says you can keep relief on your main property after taking on another only if both of these are true:
- none of your other properties has a rateable value above £2,899
- the total rateable value of all your properties is under £20,000, or £28,000 in London
Many guides quote £28,000 as the national figure. Outside London it is £20,000.
There is a grace period. If you took on the second property on or after 27 November 2025, you keep relief on the first for 36 months. Before that date the grace period was 12 months.
Worked through: you have a room with a rateable value of £9,000, fully relieved. You rent a second room across town with a rateable value of £4,000. That is above £2,899, so once the 36 months run out:
| During grace period | After grace period | |
|---|---|---|
| Main room (RV £9,000) | £0 | £3,888 |
| Second room (RV £4,000) | £1,728 | £1,728 |
| Total rates a year | £1,728 | £5,616 |
If the second room had a rateable value of £2,500 instead, you would keep full relief on the main room indefinitely, because both conditions are met (£2,500 is under £2,899, and £11,500 combined is under £20,000). You would pay rates only on the second room: £2,500 × 43.2p = £1,080.
The difference between those two outcomes is £4,536 a year, decided by a valuation you probably never looked at. Check the second property's rateable value on the VOA service before you commit.
How is a clinic actually valued?
Two different ways, and it is worth knowing which applies to you before you argue with a number.
Most clinics are valued on rental evidence. A high-street unit, a room in an office building, a suite above a shop: the Valuation Office Agency has rents for comparable space in the area and works from them. That is why a rateable value reads like an annual rent, and why the comparison to check is what similar premises nearby are assessed at. The find a rateable value service shows the floor areas and rates per square metre used, which is the only sensible starting point for a challenge.
Purpose-built health premises can be valued on the contractor's basis instead. Where there is no usable rental evidence, because nothing comparable is ever let, the VOA values the property from what it would cost to build and then converts that capital figure into an annual rent using a decapitalisation rate set by Ministers rather than by the VOA.
| Property type, England | Decapitalisation rate |
|---|---|
| Educational, healthcare and defence | 2.6% |
| All other property valued on the contractor's basis | 4.4% |
Those rates were set in 2016 and the government confirmed they remain unchanged for the 2026 to 2029 lists. Healthcare sits in the lower band, which means a purpose-built health property converts its build cost into rateable value at a materially lower rate than a warehouse would.
For most readers this is background rather than a lever. A practitioner renting a treatment room is on rental evidence and the decapitalisation rate never enters the calculation. It starts to matter if you build, convert or buy a purpose-built clinic, because then the basis of valuation itself is in play, and a specialist rating surveyor is the person to ask rather than a general accountant. Ask which basis has been used before you ask whether the number is right.
Do you pay rates if you rent a room in someone else's clinic?
Usually not. Rates are paid by whoever is in rateable occupation, which courts have long defined through four tests: actual occupation, exclusive occupation, occupation of some value to the occupier, and occupation that is not too transient. All four must be met.
A practitioner who hires a room by the hour or the session, sharing it with other clinicians on other days, normally fails the exclusivity test. The clinic owner is the ratepayer for the building and recovers the cost through what you pay to use the room.
It changes when you have exclusive use: your own lockable room, let to you alone on a lease, with no one else using it. The VOA can then assess that room as a separate property with its own rateable value, and you become the ratepayer. Even then, a single room is very likely under £12,000, so you would pay nothing, but only once you have claimed the relief. Being liable at zero is not the same as not being liable.
Leases and licences are a subject of their own. For rates, the practical test is simple: if no one else can use the room when you are not there, assume you may be assessed.
What about Scotland, Wales and Northern Ireland?
Each nation runs its own system and the numbers differ more than you would expect.
| Nation | Small business scheme 2026/27 | Full relief up to | Notes |
|---|---|---|---|
| England | Small Business Rate Relief | £12,000 RV | Tapers to £15,000; one-property rule as above |
| Scotland | Small Business Bonus Scheme | £12,000 RV | Tapers to 25% at £15,000, then to 0% at £20,000; combined RV across Scotland must be £35,000 or less |
| Wales | Small Business Rates Relief | £6,000 RV | Tapers to zero at £12,000; maximum two properties per business in each local authority |
| Northern Ireland | Small Business Rate Relief | None at 100% | Based on Net Annual Value: 50% off up to £2,000, 25% up to £5,000, 20% up to £15,000; scheme extended to 31 March 2027 |
Two things stand out. Wales gives full relief at half the English threshold, so a two-room clinic in Cardiff can pay where the same clinic in Bristol would not. Northern Ireland never removes the bill entirely, so every clinic there pays something. Scottish valuations are set by local assessors rather than the VOA, and Northern Ireland's by Land & Property Services.
How Atlacare fits
Business rates sit outside practice software. Where it does help is the decision that triggers the second-site rule: diary utilisation is one of the six dimensions in Atlacare's Clinic Health score, so you can see whether your first room is genuinely full before you take on a second one and its rates bill.
The short version
In England, a single-property clinic with a rateable value of £12,000 or less pays nothing in 2026/27. The relief tapers to zero at £15,000. Physiotherapy, osteopathy and chiropractic premises do not get the new lower retail, hospitality and leisure multiplier.
A second property costs you the relief on the first unless it is valued under £2,899 and your combined total stays under £20,000 (£28,000 in London). You get 36 months' grace if you took it on from 27 November 2025. Hiring a room by the session usually makes the clinic owner the ratepayer, not you. Wales and Northern Ireland are less generous.
Frequently asked questions
Do I have to apply for Small Business Rate Relief?
Sometimes. Councils in England administer it, and many apply it automatically, but some require an application. If your first bill shows a charge on a property under £12,000, contact the council's business rates team.
My rates went up in April 2026. Is there any help?
Possibly. Businesses that lost some or all of their Small Business Rate Relief because of the 2026 revaluation may get Supporting Small Business Relief, which caps the yearly increase at £800 or the transitional relief cap, whichever is greater. Ask your council.
Can I challenge my rateable value?
Yes, through your business rates valuation account with the VOA in England and Wales. Look up comparable properties on the find a rateable value service first, because a challenge needs evidence that the valuation is wrong rather than that the bill is high.
I work from home. Do I pay business rates?
It depends on how much of the property is used for the business and whether it has been adapted. That question needs its own guide and is not covered here.
General information, not legal or tax advice. Figures are for the 2026/27 rating year and are as published at 2 October 2026. Worked examples use illustrative rateable values; check your property's actual valuation and your council's policy.
Sources: GOV.UK, Small Business Rate Relief · GOV.UK, find a rateable value · SI 2025/1093, qualifying retail, hospitality or leisure hereditament · Cheshire East Council, RHL multiplier 2026-27 · Scottish Government, Small Business Bonus Scheme worked examples · Business Wales, business rates · nibusinessinfo, rate support schemes 2026-27 · VOA, change in rateable value, 2026 revaluation compiled list: statistical commentary · House of Commons Library, Business rates (CBP-10438) · GOV.UK, 2026 Supporting Small Business Relief local authority guidance · Business Rates Information Letter 3/2025, confirmation of decapitalisation rates · VOA Rating Manual, the contractor's basis: prescribed decapitalisation rate
Related: What does it actually cost to set up a private practice in year one? · What is a good diary utilisation rate? · Do I need a local authority special treatment licence? · Sole trader or limited company?
