Specialist advice for Locum Doctors

Working as a Locum can give you flexibility and a varied work experience, but making sure you are being paid correctly and not storing up trouble with HMRC can be more difficult, which is where we can help.

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PAYE Salary for Locums

Simple, but not necessarily best

This is the simplest way to get paid but often less tax efficient.

You can be paid in this way if you provide your services directly to an employer (sometimes through an employee bank) or if you work for an agency.

The hourly or sessional rates offered may be less if you are paid by PAYE salary. This is because your employer has to bear the costs of employers’ national insurance contributions at nearly 14%. If you are working directly for an NHS provider rather than through an agency, your employer may also have to pay NHS employers’ superannuation contributions, again at 14%.

There are some important benefits though

There can be additional benefits associated with being paid in this way. If you are an employee you will enjoy the usual employment rights, sickness benefits and holidays. Casual workers paid under a PAYE salary will not enjoy the same rights as a full time employee.

If you are paid by salary, the tax and national insurance will be deducted from the amount you are paid. If you are working for an NHS provider, superannuation may also be deducted. The benefit of this is that you may not need to prepare an annual income tax return or make separate provisions for additional tax payments.

One of the reasons this structure can be less tax efficient is that there are only very limited types of expenses that can be claimed against a PAYE salaried income.

‘Off Payroll’ Working Rules (IR35)

Since 2017 the ‘off payroll’ working rules, (IR35) has forced many NHS authorities to pay locums under PAYE


Agencies are usually happy to pay locums by PAYE salary.

How can we help

Once we know your work patterns and potential sources of income we can advise you when a PAYE salary is your best option. Simple may be best sometimes, but it is worth checking just in case you are missing out.


Contact us for specialist medical accountancy services for Locums

If you’re looking to plan your finances for the future or trying to find an answer to a problem then get in touch today.



Are you in danger of being hit with a huge tax bill on your pension growth? Our NHS Pension Review Service can provide an advance warning of impending pension issues.

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HMRC have increasingly got GPs in their sights and many Practices have been subject to lengthy tax investigations. Make sure you’re covered with our annual insurance scheme.

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Talk to one of our Medical Accounting Team for free. We can discuss your circumstances and how we can help you achieve better financial management, reduce your tax bills or plan for the future with a tailored fixed price plan.

Meet our team

We have a panel of subject experts and a team of professional accountancy support staff to make sure your specific needs are met reliably and cost effectively.


A specialist healthcare team to advise you
Call free for support at any time
Keep you up to date with the latest changes
No fuss, smooth process to change to us
Members of AISMA - Association of Independent Specialist Medical Accountants

What our clients say…

Dr Ravi Bansal, Locum GP

I’ve been with Nichols and Co for nearly 10 years with Debra being my accountant. I first contacted them when I received letters for tax arrears due to the wrong tax codes being applied during my hospital jobs.

Debra sorted this matter out and has always provided helpful and honest advice regarding tax matters. She has also helped my wife with her tax returns. I would definitely recommend their services for accounting matters with a special interest in helping doctors with their tax affairs. They are approachable, helpful and efficient.

Dr Jayran Mistry, Locum

Thank you for everything you at Nichols & Co have done for me with regard to my tax returns to date. I have always felt I am able to approach you with any question and that the answer is always helpful and thorough.

I am very grateful for how detailed, clear and efficient you are with tax returns and letters and for expediting things when needed. Every time I make contact with you I am met with polite staff and helpful advice and I have spoken with many of my friends about the service you provide and how good I think it is. I always recommend you. Thanks very much again, I really appreciate your hard work and help.