Locum GP Tax UK 2026/27: Superannuation, Indemnity and a £75,000 Example
Locum GPs face a distinctive mix of NHS pension superannuation, medical indemnity and practice-by-practice self-employment. Full worked example on £75,000 income and what's deductible.
The structure: self-employed across multiple practices
Locum GPs typically work session by session across several practices, invoicing each one (often through an agency) rather than being employed by any single surgery. This genuinely varied pattern — different practices, different terms per session, real freedom to accept or decline bookings — is what supports self-employed status for most locum GPs, distinct from a salaried GP employed by one practice under a contract of employment.
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: £75,000 locum income
Gross locum income (session fees across the year): £75,000
Deductible expenses:
- Medical indemnity cover: £2,800
- GMC annual retention fee: £450
- CPD, appraisal-related costs, courses: £900
- Travel between practices (mileage): £900
- Accountancy fees: £450
- Total expenses: £5,500
Taxable profit: £75,000 − £5,500 = £69,500
Income tax: (£37,700 × 20%) + ((£69,500 − £12,570 − £37,700) × 40%) = £7,540 + (£19,230 × 40%) = £7,540 + £7,692 = £15,232
Class 4 NI: (£50,270 − £12,570) × 6% + (£69,500 − £50,270) × 2% = £37,700 × 6% + £19,230 × 2% = £2,262 + £385 = £2,647
Total tax and NI: £17,879
Take-home: £75,000 − £5,500 − £17,879 = £51,621
Take-Home Pay Calculator
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Open Take-Home Pay calculatorThe NHS Pension Scheme angle
Unlike most self-employed traders, locum GPs have the option to keep building an NHS Pension Scheme record on their locum earnings, via the Type 2 self-employed GP pension certificate. This requires declaring pensionable locum income and paying both the "employee" and "employer" contribution tiers yourself (since there's no practice payroll to split the cost), which is a meaningful extra admin step but can be valuable given the strength of the NHS Pension Scheme's defined-benefit terms relative to a typical private pension. Pension contributions also reduce adjusted net income, which matters for anyone whose locum earnings push them toward higher tax bands or the £100,000 personal allowance taper.
Pension Calculator
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Open Pension calculatorDeductible expenses checklist
- Medical indemnity/defence organisation subscription
- GMC annual retention fee
- CPD, appraisal preparation, revalidation costs
- Travel between different practice sites (mileage)
- 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, indemnity and CPD receipts, and file online by 31 January following the tax year end, paying any income tax and Class 4 NI owed, plus payments on account where applicable.
self-employed-tax-ukFrequently asked questions
Are locum GPs self-employed for tax purposes?
Most locum GPs work as self-employed sole traders, invoicing individual practices or NHS bodies for sessions worked, and file via Self Assessment. This reflects the genuinely varied, multi-practice nature of most locum work, though the specific facts of each engagement (degree of control, mutuality of obligation) still matter for employment status.
Can locum GPs stay in the NHS Pension Scheme?
Yes — locum GPs can generally continue contributing to the NHS Pension Scheme on their locum sessions, using the Type 2 self-employed GP pension certificate process to declare pensionable income and pay both the employee and 'employer' contribution elements, though this involves separate administration compared with salaried GP pension contributions handled automatically through a practice payroll.
Is medical indemnity insurance tax deductible for a locum GP?
Yes, medical indemnity/defence cover (whether through a traditional medical defence organisation or state-backed indemnity arrangements plus top-up cover) is a core deductible business expense for any GP seeing patients, employed or self-employed.
How much tax does a locum GP pay on £75,000 income?
After typical expenses of around £4,500-£5,500 (indemnity, GMC/CQC-related fees, CPD, travel, accountancy), taxable profit lands around £70,000, giving combined income tax and Class 4 NI of roughly £19,700-£19,900 before any pension contributions, which would reduce the taxable figure further.
Do locum GPs need to register for VAT?
Medical services that are the direct care of patients are generally VAT-exempt, so most locum GP income doesn't count towards the £90,000 VAT registration threshold in the first place — though other services (medico-legal reports, certain occupational health work) can be treated differently, so it's worth checking the specific nature of the work.
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.
Pension Calculator
Estimate your pension pot at retirement and projected annual income.
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