Medical income, with theNHS pension done properly.
Locum sessions, private practice, salaried posts and on-call all land on one tax return. We prepare it, deal with the pension forms and advise on whether a locum company still makes sense.
What makes your finances different.
Several income streams
A salaried NHS post taxed under PAYE, locum work paid gross, private practice through a company and the odd medico-legal report each have their own treatment.
The annual allowance trap
NHS pension growth in a good year can exceed the annual allowance, triggering a tax charge that arrives as a surprise. The taper for higher earners makes it worse.
Locum companies and IR35
Many NHS trusts treat locum engagements as inside IR35, which removes most of the benefit of a company. Private hospitals and GP practices can differ.
Locum pension forms
GP locums must complete Forms A and B to pension their income, with 10-week deadlines. Missing them means lost pension.
What we do for you.
- Prepare Self Assessment returns covering salaried, locum, private and other income
- Calculate NHS pension annual allowance charges and advise on scheme pays elections
- Complete locum pension Forms A and B and Type 2 certificates
- Run locum or private practice companies: accounts, Corporation Tax and dividend planning
- Review engagements for IR35 and explain each trust's or practice's determination
- Identify allowable expenses: GMC, indemnity, exams, courses, equipment and travel between sites
- Advise on incorporating private practice income
- Plan around the 60% effective rate between £100,000 and £125,140
The tax rules that matter here.
- Annual allowance and taper
- Pension growth is tested against £60,000 a year. For adjusted income over £260,000 the allowance tapers by £1 for every £2, down to £10,000. Unused allowance from the previous three years can be carried forward.
- Personal allowance taper
- Between £100,000 and £125,140 of income the personal allowance is withdrawn at £1 for every £2, giving an effective rate of 60%. Pension contributions and Gift Aid can bring income back below the threshold.
- GP locum pensions
- Locum GPs pension their NHS income through Forms A and B, submitted within 10 weeks of the work. Employee contributions are tiered by pensionable pay, and employer contributions are paid by the engaging practice or ICB.
- IR35 for locums
- NHS trusts are public authorities and must determine status for every engagement. Many treat ad hoc locum shifts as inside IR35, so PAYE is deducted. Private practice contracts are assessed separately.
- Professional expenses
- GMC and royal college fees, medical indemnity, examination fees for required qualifications and professional journals are deductible, including against employment income on a Self Assessment return.
Rules and rates are those in force for 2026/27 at the time of writing. Check your own position before acting.
Run your own numbers first.
- Salary vs dividend calculator
Find the most tax-efficient mix of salary and dividends from your company's profit.
- Self-employed tax calculator
Income tax and National Insurance on sole trader profits.
- Take-home pay calculator
Salary after tax, National Insurance, student loan and pension.
Worth asking.
Doctors with only PAYE income rarely do. Once you have locum work, private practice, a company or an NHS pension annual allowance issue, an accountant typically saves more than the fee through correct expense claims, pension planning and avoiding penalties on the 60-day and 31 January deadlines.
It depends on who you work for. Most NHS trusts treat locum shifts as inside IR35, which means tax is deducted at source and a company adds cost without benefit. For private hospitals, GP practices and medico-legal work that is outside IR35, a company can still be worthwhile. We check your actual engagements.
NHS Business Services Authority sends a pension savings statement if your growth exceeds the allowance, but often late. We calculate the growth from your pension records, apply carry-forward and the taper, and advise whether to pay the charge personally or through scheme pays.
GMC registration, royal college membership, medical indemnity, mandatory exam fees, professional journals and equipment used for work. Travel between sites counts, but travel from home to a regular place of work does not. Employees claim these through a Self Assessment return or form P87.
As self-employment if you work as an individual, taxed at your marginal rate with Class 4 National Insurance, or through a company at Corporation Tax rates with salary and dividends drawn. Above about £100,000 of total income, the choice interacts with the personal allowance taper and pension planning.
Yes. We complete and submit them each month from your session records so your NHS pension contributions are correct and nothing is lost to the 10-week deadline.
The services involved
- Self AssessmentPersonal tax return support for individuals, directors and sole traders.
- Annual Accounts & Corporation TaxYear-end accounts and company tax work within the agreed engagement.
- Payroll & PensionsPayroll processing and related workplace pension administration.
- Tax Advice & PlanningPractical tax planning for directors, sole traders and landlords, and an HMRC agent on your side all year.
Guides for doctors & locums
All articles
Tax
Mastering Self Assessment 2026: A Comprehensive Guide for UK Business Owners
Master the intricacies of Self Assessment 2026 with our comprehensive guide designed for UK business owners to navigate tax laws confidently.
Running a limited company
Leveraging Director Pensions for a Tax-Efficient Strategy in 2026/27: A Guide for UK Business Owners
Director Pensions Tax Efficiency is a critical consideration for UK business owners in 2026/27, offering powerful financial planning tools for entrepreneurs.
Running a limited company
Most Tax-Efficient Way to Pay Yourself as a Director in 2026/27 (UK Guide)
Structuring your income in the most tax-efficient way can help reduce your tax liability and maximise take-home pay.