How US centric is the software? I've found that a lot of these accounting/finance type programs have very prescriptive ideas and expected usage of it that doesn't really seem to even remotely match the type of exported data I get from my UK bank account.

The core software itself is completely agnostic to currency or country. Otoh the importer ecosystem is somewhat US focused but a) you can easily write importers yourself b) I just published importers for a bunch of UK institutions (e.g. HSBC, Barclays, AJ Bell) - see the other post hanging around the HN frontpage :)