Every question we get asked by locum doctors — answered clearly, with links to detailed guides. Covers Self Assessment, NHS pension, annual allowance, IR35, expenses, limited companies, and working with AccTek.
Yes. If you earn any income outside PAYE — including locum shifts paid gross, private practice income, or rental income — you must register for Self Assessment with HMRC and file a tax return by 31 January following the end of the tax year. Even if tax is deducted at source via an agency, you may still need to file if your total income exceeds £100,000 or you have multiple income streams.
The Self Assessment deadline is 31 January for online returns and 31 October for paper returns. For the 2025/26 tax year, the online deadline is 31 January 2027. Late filing triggers an automatic £100 penalty, with further penalties accruing after 3, 6, and 12 months.
It depends on your total taxable income from all sources. For 2026/27, the personal allowance is £12,570, the basic rate (20%) applies up to £50,270, the higher rate (40%) applies from £50,271 to £125,140, and the additional rate (45%) applies above £125,140. If you earn between £100,000 and £125,140, your personal allowance tapers away at £1 for every £2, creating an effective 60% marginal tax rate.
When your adjusted net income exceeds £100,000, your £12,570 personal allowance reduces by £1 for every £2 above £100,000. This means income between £100,000 and £125,140 is effectively taxed at 60%. Pension contributions and allowable expenses can reduce your adjusted net income below £100,000 and restore your personal allowance. Read our full guide on tax planning for doctors earning over £100k.
If you work through PAYE (e.g. via an agency inside IR35), Class 1 NICs are deducted at source. If you are self-employed or work through a limited company, you pay Class 2 NICs (£3.45/week if profits exceed £12,570) and Class 4 NICs (6% on profits between £12,570 and £50,270, plus 2% above £50,270). Directors of limited companies pay Class 1 NICs on salary drawn from the company.
You must keep records of all income (payslips, invoices, remittance advices), allowable expenses (receipts, mileage logs, subscription confirmations), bank statements, and pension contribution statements. HMRC requires you to retain records for at least 5 years after the 31 January filing deadline. Cloud accounting software like Xero makes this significantly easier.
Locum doctors can claim expenses that are incurred wholly and exclusively for the purpose of their work. Common allowable expenses include: travel between temporary workplaces (mileage at 45p per mile for the first 10,000 miles), professional indemnity insurance (MDU, MPS, MDDUS), GMC registration fees, Royal College subscriptions, BMA membership, professional courses and CPD, medical equipment (stethoscopes, clinical tools), uniforms and laundry, and accommodation when working away from home. Read our full locum doctor expenses guide.
Yes — but only for travel to temporary workplaces. If a locum placement lasts less than 24 months and you do not expect it to exceed 24 months, the trust is a temporary workplace and travel is allowable. You can claim HMRC's approved mileage rate of 45p per mile for the first 10,000 miles and 25p per mile thereafter, or actual vehicle costs apportioned by business mileage percentage.
Yes. Professional indemnity insurance (MDU, MPS, or MDDUS) is an allowable expense for locum doctors. The full annual premium can be claimed on your Self Assessment tax return. If you pay via monthly direct debit, claim the total paid during the tax year.
Yes. Your annual GMC registration fee is an allowable expense. For 2026/27, the GMC registration fee for doctors with a licence to practise is £456. HMRC specifically lists the GMC under approved professional bodies whose fees qualify for tax relief.
Generally no. HMRC does not allow meal expenses for travel within your normal pattern of work. However, if you are working away from home overnight on a locum placement, you can claim the cost of evening meals and breakfast as part of a subsistence claim, provided the expense is reasonable and you retain receipts.
Yes — if you work directly for an NHS trust or through an agency with an NHS pension framework agreement. You must actively opt in by submitting a Type 2 pension joiner form (SD502A) to each trust you work at. Shifts paid through a personal limited company outside an NHS contract are generally not pensionable. Read our comprehensive NHS pension guide.
A Type 1 form (SD502) is used by salaried doctors with pension deducted automatically via payroll. A Type 2 form (SD502A) is used by locum doctors who must manually opt in for each trust engagement. Locum doctors almost always need a Type 2 form. See our full guide on Type 1 and Type 2 pension forms.
The standard annual allowance is £60,000. This is the maximum pension growth allowed in a single tax year before an annual allowance tax charge applies. Higher earners may face a tapered allowance — if your threshold income exceeds £200,000 and adjusted income exceeds £260,000, the allowance reduces to a minimum of £10,000. Use our NHS pension calculator to check your position.
Scheme Pays allows NHS Pensions to pay your annual allowance tax charge from your pension benefits, reducing your eventual pension. Mandatory Scheme Pays is available if the charge exceeds £2,000 and your pension input exceeds the standard £60,000 allowance. Voluntary Scheme Pays may be available in other circumstances. The election deadline for 2025/26 is 31 July 2027.
Your earnings from that trust engagement will not be pensionable. The lost pension accrual is permanent — there is no mechanism to backdate Type 2 forms. Given the employer contribution of 23.7%, a missed form on £50,000 of earnings means losing £11,850 in employer contributions alone.
Yes. You can carry forward unused annual allowance from the three previous tax years (2023/24, 2024/25, and 2025/26) and add it to your 2026/27 allowance. You must have been a member of a registered pension scheme in each year. This can significantly reduce or eliminate an annual allowance charge.
IR35 is HMRC's off-payroll working legislation designed to identify contractors who would be employees if engaged directly. For locum doctors, the NHS trust (or agency acting as the fee-payer) determines your IR35 status. If you are deemed inside IR35, tax and National Insurance are deducted at source before you are paid, similar to employment. If outside IR35, you receive gross payment and handle your own tax. Read our full guide on IR35 for locum doctors.
Most locum doctors working through agencies for NHS trusts are determined to be inside IR35. The key factors are control (the trust directs your clinical work), substitution (you personally must attend), and mutuality of obligation (the trust offers shifts and you accept them). However, each engagement must be assessed individually. Blanket determinations are not compliant with the legislation.
Yes, but the tax advantages are significantly reduced. When inside IR35, the agency or trust deducts tax and NICs from your fee before paying your limited company. You can still claim limited company expenses, but the deemed employment payment rules mean most of the income is taxed as employment income. Many locum doctors inside IR35 choose direct engagement or umbrella companies instead.
You have the right to challenge the determination through the client's status disagreement process. The trust must respond within 45 days. If the determination is incorrect, the trust (not you) bears the tax liability. Keep a copy of every Status Determination Statement (SDS) you receive and seek specialist advice before accepting or challenging.
It depends on your income level, IR35 status, and pension position. A limited company can offer tax savings through a salary-and-dividends extraction strategy, access to the £1,000 dividend allowance, and Corporation Tax at 25% (or 19% for small profits). However, if most of your locum work is inside IR35, the tax benefits are minimal. You also need to consider the impact on NHS pension eligibility. Read our detailed guide on whether locum doctors should use a limited company.
For 2026/27, the most tax-efficient director's salary is typically £12,570 (the personal allowance threshold). This avoids income tax while maintaining National Insurance credits for State Pension eligibility. Above this, you extract profits as dividends, which are taxed at 8.75% (basic rate), 33.75% (higher rate), or 39.35% (additional rate) — all lower than the equivalent employment tax rates.
While not legally required, it is strongly recommended. A limited company has statutory obligations including annual accounts filed with Companies House, a Corporation Tax return filed with HMRC, confirmation statements, VAT returns (if registered), payroll (RTI submissions), and your personal Self Assessment. A specialist locum doctor accountant ensures compliance and optimises your tax position.
An umbrella company employs you and handles all payroll, tax, and administration. You receive a net salary after deductions. A limited company is your own business — you are a director and shareholder, responsible for all compliance but with greater control over how you extract profits. Umbrella companies are simpler but offer fewer tax planning opportunities. Limited companies are more complex but potentially more tax-efficient, especially for doctors outside IR35.
AccTek's locum doctor accounting service starts from £19.99 per month for sole traders and basic limited company packages. Pricing depends on your turnover, number of transactions, and whether you need payroll or VAT returns. Get an instant quote on our pricing page — all fees are fixed monthly with no hidden charges.
The service includes Self Assessment tax returns, bookkeeping, Xero cloud accounting setup and support, expense tracking and optimisation, NHS pension annual allowance reviews, IR35 status guidance, Companies House filings (for limited companies), Corporation Tax returns, payroll (if needed), and year-round tax planning advice. Every client has a dedicated accountant and access to our AI-enhanced client portal.
Yes. We handle the entire transition including contacting your previous accountant for handover, collecting outstanding records, reviewing your current position for missed opportunities, and ensuring a seamless switch with no gaps in compliance. The process typically takes 2-4 weeks.
Yes. Every prospective client gets a free, no-obligation consultation with our locum doctor specialist, Kishan Kedia. You can book a free consultation online at a time that suits you. We will review your current setup, identify any immediate issues, and explain exactly how we can help.
Book a free consultation with Kishan Kedia — no obligation, no jargon.
This FAQ page is for general information only and does not constitute tax, pension, or financial advice. Tax rules and thresholds are for the 2026/27 tax year unless stated otherwise. Always consult a qualified Chartered Accountant before making financial decisions based on the information provided here.
Kishan Kedia ICAI, CAMS is a specialist accountant at AccTek with 20+ years of experience in locum doctor tax, NHS pension annual allowance, landlord tax, Section 24 planning and Making Tax Digital for Income Tax. He holds the ICAI qualification and is a Certified Anti-Money Laundering Specialist (CAMS).
