If you are thinking about becoming a locum GP, there are a number of areas to consider:
Registration
You will need to ensure you are included on the GMC’s GP Register as well as the National Performer’s List. If you live near a border, you may need to be included on the Performer’s List for both countries if conducting work in both.
You will need to consider which geographical areas to work in, and it may be easier to begin in an area you know and are known, as you will need to make contacts and build relationships with providers to find work. Joining your local Sessional GP Group can also help in finding work.
You will need to register with HMRC as a self-employed individual, which can be done online here. You must ensure you are registered by 5 October in your second tax year of business. Once you are registered with HMRC, you will receive a unique taxpayer reference number (UTR). You will need your UTR number to file your tax return.
Recording keeping
You will need to decide on your preferred method of recording details of your income and expenses for the tax year. This may be done via specially designed online software such as MyLocumManager.
Income
It is taxed in the tax year it is earned and not in the year it is received. For example, a locum shift worked on 31 March 2022 with monies received on 15 April 2022, should be taxed in the tax year to 5 April 2022. Therefore, it is important to keep details of when your shifts are worked.
NHS Pension
If you decide to contribute to the NHS Pension as a freelance GP, there are two forms to be submitted – Locum Form A and Form B. Form A is sent to the GP practice, together with your invoice for each engagement, and details both your fee and the employer’s pension contribution to be paid by the practice.
At the end of each month, you will also need to complete Form B, which summarises the income for the month along with the required employee contributions (which are tiered depending on your level of income). Both forms should be submitted to PCSE/your local area team, together with payment of both the employee’s and the employer’s contributions, within 10 weeks of conducting the work. If you do not submit your forms within the 10-week window, you will lose your right to pension the income.
Forms A and B are available on the NHSBSA website along with detailed guidance notes:
If you are working for an NHS organisation that provides Out of Hours care, a GP solo form will need to be completed instead of Locum Forms A and B. This is usually completed by the organisation and given to the GP. It is important to confirm that the organisation you have worked for is an ‘NHS approved employing authority’, so you can check that you are able to pension your income. The list of employing authorities can be found here.
Your pension contribution is based on your anticipated annual GP earnings (inclusive of other pensioned NHS work, such as salaried/partnership work) and has a tiered contribution structure.
It may be difficult to accurately assess the level of your earnings at the start of the year, and at the end of the year, you may find you have incorrectly assessed your tiered contribution level. You will either need to pay the arrears to your Primary Care Organisation (PCO) (Out of Hours organisation, integrated Care Board or directly to PCSE) or arrange for any overpayment to be refunded to you.
If you have also received income in a salaried GP role during the year, this is done via a Type 2 Pension Certificate. This is submitted to PCSE via their online enquiry system or by inputting the information directly into the online form by logging into your individual PCSE account. The deadline for submission is 28 February after the end of the tax year.
If you only have income as a freelance locum, once you know your annual pensionable income and the relevant tier rate, if you have paid at the incorrect rate, you will need to make the adjustment for the arrears/refund on your locum form. This is done by adding a separate adjustment line onto one of the monthly forms.
The total rewards statement shows an estimate of your pension benefits on retirement and shows pensionable income per year. This will only be up to date if PCSE passes over information to NHS pensions. It is important to keep a record of forms submitted to PCSE as they do not always process the information on a timely basis.
Expenses
Can be claimed if they are deemed wholly and necessary for the purpose of your business. Expenses may include professional subscriptions, business use of mobile phone and internet, medical equipment, business mileage (this does not include travel to a regular place of work), course fees and accountancy fees. Other expenses may also be allowable and should be discussed with your accountant or tax adviser.
Your tax return may be completed as soon as the 5 April tax year end has passed and your records are available.
Early completion of your tax return will result in advance notice of your tax liabilities. Your first tax payment will be due in January following the end of the tax year, with the possibility of a further 50% payment on the account being due the following July, depending on your level of income.
It is important to start saving towards your tax bill as soon as you start to receive income, setting aside a monthly sum to make sure you have enough money to pay the tax when it falls due.
Depending on the level of your income and start date, your first tax return may result in a large tax bill.
Avoid nasty surprises by having early discussions with your accountant, who can guide you on how much to save towards your tax bill. One size does not fit all, and how much you should save depends on your circumstances.
If you have any questions on the content in this article, please contact your usual BHP Healthcare contact.
