Locum Dentist Tax UK 2026/27: NHS vs Private Mix and a £65,000 Example
Locum dentists often mix NHS and private income, with different VAT treatment for each. Full worked example on £65,000 income and how the NHS/private split affects tax.
Self-employed across NHS and private work
Locum dentists commonly cover sessions across several practices, often mixing NHS contract work and private patient treatment within the same week. For income tax purposes, this is straightforward — both NHS and private fees are simply combined as trading income — but the VAT picture needs a bit more care, since clinical dental treatment is generally exempt while some purely cosmetic services can fall outside that exemption.
Self-Employed Tax Calculator
Calculate income tax, Class 2 and Class 4 National Insurance for self-employed and sole traders for 2025/26.
Open Self-Employed Tax calculatorWorked example: £65,000 locum income
Gross locum income (NHS + private sessions across the year): £65,000
Deductible expenses:
- GDC annual retention fee: £750
- Professional indemnity cover: £2,200
- CPD courses and conferences: £900
- Travel between practices (mileage): £900
- Accountancy fees: £500
- Total expenses: £5,250
Taxable profit: £65,000 − £5,250 = £59,750
Income tax: (£37,700 × 20%) + ((£59,750 − £12,570 − £37,700) × 40%) = £7,540 + (£9,480 × 40%) = £7,540 + £3,792 = £11,332
Class 4 NI: (£50,270 − £12,570) × 6% + (£59,750 − £50,270) × 2% = £37,700 × 6% + £9,480 × 2% = £2,262 + £190 = £2,452
Total tax and NI: £13,784
Take-home: £65,000 − £5,250 − £13,784 = £45,966
Take-Home Pay Calculator
Calculate your net salary after income tax, National Insurance and student loan deductions.
Open Take-Home Pay calculatorThe VAT wrinkle: clinical vs cosmetic
Direct clinical dental treatment — fillings, extractions, hygiene work, both NHS and private — is generally VAT-exempt, meaning it doesn't count toward the £90,000 VAT registration threshold. But some services with a purely cosmetic element (certain whitening services outside a course of clinical treatment, for example) can be treated differently, so a locum doing a meaningful volume of cosmetic work should check which specific income counts toward the threshold rather than assuming all dental income is automatically exempt.
VAT Calculator
Add or remove VAT from any amount. Supports 20%, 5% and 0% UK VAT rates.
Open VAT calculatorDeductible expenses checklist
- GDC annual retention fee
- Professional indemnity cover
- CPD, conferences, courses
- Travel between practices
- Accountancy and bookkeeping fees
- Locum agency fees, where separately charged
Filing and paying
Register for Self Assessment once self-employed income exceeds £1,000, keep session invoices from each practice, and file online by 31 January following the tax year end.
self-employed-tax-ukFrequently asked questions
Are locum dentists self-employed?
Most locum dentists work as self-employed sole traders, covering sessions at multiple practices under locum agreements, invoicing practices directly or through a locum agency, reflecting the genuinely varied nature of the work across different sites and terms.
Is dental treatment income VAT-exempt?
Direct dental care that is the treatment of patients (both NHS and private clinical treatment) is generally VAT-exempt, similar to medical care more broadly. However, some cosmetic or non-clinical dental services can fall outside the exemption depending on their specific nature, so a locum doing a mix of clinical and purely cosmetic work should check which income counts toward VAT registration turnover.
Can locum dentists claim GDC registration and indemnity as expenses?
Yes. The annual General Dental Council retention fee and professional indemnity cover are core deductible business expenses for a practising dentist, self-employed or otherwise.
How much tax does a locum dentist pay on £65,000 income?
After typical expenses of around £5,000-£6,000 (indemnity, GDC fees, CPD, travel, accountancy), taxable profit lands around £59,500-£60,000, giving combined income tax and Class 4 NI of roughly £14,600-£14,800.
Does mixing NHS and private dental work complicate a locum's tax return?
Not really for income tax purposes — NHS and private fees are simply combined as total trading income. The main practical difference is around VAT (clinical treatment is exempt regardless of NHS/private source) and record-keeping, since NHS payments often come through a central pipeline while private fees are paid directly by patients or the practice.
Try the calculators
Self-Employed Tax Calculator
Calculate income tax, Class 2 and Class 4 National Insurance for self-employed and sole traders for 2025/26.
Take-Home Pay Calculator
Calculate your net salary after income tax, National Insurance and student loan deductions.
VAT Calculator
Add or remove VAT from any amount. Supports 20%, 5% and 0% UK VAT rates.
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