Answers · UK 2025/26
Are locum doctors employed or self-employed for tax in the UK?
GP locums working in primary care are typically self-employed and pay tax via Self Assessment. Hospital locums can be either employed (PAYE through the trust or agency) or self-employed, but NHS trusts increasingly treat locum doctors as employees for IR35 purposes. The correct status depends on actual working arrangements, not personal preference.
Full answer
The employment status of locum doctors is a nuanced area and getting it wrong can lead to significant tax bills or penalties. **GP locums (primary care)** GP locums working in surgeries or primary care networks are almost always treated as **self-employed** for tax purposes. They: - Work for multiple practices with no single dominant client - Control their own hours and availability - Invoice practices for sessions completed - Pay income tax and Class 4 NI through Self Assessment - Must register for a UTR (Unique Taxpayer Reference) with HMRC - May be eligible to join the NHS Pension Scheme as a locum (subject to rules) Self-employed GP locums pay: - Class 4 NI: **6%** on profits between £12,570 and £50,270; **2%** above - Income tax at marginal rates above the £12,570 Personal Allowance **Hospital locums and bank workers** Hospital locums present a more complex picture: - Those working through NHS staffing banks are typically **employed** and taxed through PAYE - Locums working through personal service companies (limited companies) are subject to **IR35** rules since April 2017 for the public sector -- the trust determines employment status and deducts PAYE if inside IR35 - Locums placed by agencies may be PAYE through the agency **IR35 risk for hospital locums** Since the 2017 public sector IR35 reform, NHS trusts determine whether an engagement is inside or outside IR35. If inside: - The trust or agency deducts income tax and NI through PAYE - The locum loses the tax efficiency of a limited company - HMRC's Check Employment Status for Tax (CEST) tool can indicate likely status **Practical steps** 1. Register for Self Assessment if self-employed 2. Keep records of all sessions worked, invoices, and expenses 3. Deduct allowable expenses: medical indemnity, GMC registration, CPD costs, professional memberships 4. Consider IR35 carefully before operating through a limited company for NHS work
Try the calculator
More answers
This answer is informational only and does not constitute financial, tax or legal advice. Figures are for the 2025/26 UK tax year. See our methodology and sources.