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IR35 FAQs for Doctors

What is IR35?

IR35 legislation which is also known as the ‘intermediaries legislation’ is a set of rules that aid in the determination of the tax and National Insurance a locum doctor working through an intermediary should pay, based on the substance of that working arrangement. These rules were originally introduced in April 2000.

What is a personal service company?

A personal service company (PSC) is a term first used by HMRC following the introduction of IR35 in April 2000. Although there is no clear legal definition of what exactly constitutes a PSC, in most freelancing circles it is widely regarded as the following:

  • A UK registered limited company.
  • The contractor acts as director of the company.
  • The contractor is the sole shareholder (sometimes split 50/50 with their spouse).
  • The contractor manages and controls the company's bank account.
  • The contractor supplies professional services to agencies/clients via the PSC.

What is an umbrella company?

An umbrella company is a company that acts as an employer to agency contractors who work under a fixed term contract assignment. Using an umbrella is the main alternative to setting up your own limited company. They serve as an intermediary between the contractor and their client (either an employer or an agency), with their principal responsibility of arranging payment for your work.

Exactly which roles are affected?

The determination of which roles are affected is up to the NHS Trust or Health Board where the worker is ultimately engaged. This determination is made under the rules set out by HMRC and guidance by the relative frameworks under which they work. These changes impact any NHS locum doctors whether paid by an agency or through any NHS direct engagement arrangement who are not currently being paid via PAYE.

Can I still work for the NHS?

The simple answer to this question is YES! These are changes to tax legislation and do not place any restriction on your ability to work for any employer.

Do I need to start working for an umbrella company?

There is no obligation on you to move to an umbrella company as a result of IR35. You need to seek advice on which payment model works best for you and provides you with the optimal outcome.

What if I don’t follow the IR35 rules?

It is simply not a case of you having a choice of complying with the IR35 rules. If your falls within IR35 by the ultimate public body (NHS Trust or Health Board), then the relevant taxes and National Insurance contributions are deducted.

Who can I contact if I have any questions?

If you are a Global Medics candidate, you can get in touch with your consultant.

Is this being promoted by agencies so that locum doctors can work for umbrella companies?

No, these rules are forced on the public sector by HMRC. The determination for whether IR35 applies rests with the NHS, and all NHS Trusts and Health Boards apply these rules as set out by HMRC.

Am I affected if I work through an agency?

These changes impact any worker that ultimately engages into the NHS that is not currently paid via PAYE. This is the case regardless of whether you work through an agency or through an NHS direct engagement model.

I was considering starting up my own limited company, what does this mean for me now?

You need to consult with your accountant on what this means for you as they are best placed to explain how this tax legislation impacts on your position and which method of working provides you with the optimal outcome.

I have spoken to several accountants and got different answers. Why is this?

This might be due to the fact that there was uncertainty about how these rules were going to be applied prior to all the guidance notes being released. What is clear is that application of these rules is something which is subject to the determination of the public body (NHS Trust or Health Board) and is enforced as such, which ensures consistency.

Most locum doctors I have spoken to are looking at working as a limited company, so I assume that this route is acceptable?

Working as a limited company is a route that a large group of doctors currently choose to work through. It does need to be noted that this specific route is the one that is the most impacted by the changes in legislation.

Do I have to sign a new contract with my locum agency if I want to continue working for them?

Depending on whether you contract with your agency through an intermediary, you might need to sign a new contract. It is the responsibility of your agency to provide you with a new contract where necessary to do so.

Do I need to go back to working permanently with the NHS?

There is no onus on you to going permanent with the NHS and you are still able to work in the locum market. There is still a demand for locum doctors in the NHS.

Will my pay decrease from April?

If you are deemed to be working through an intermediary and ‘inside of IR35’ you might find that your rate will be reduced by the National Insurance contributions that the party paying your fees will have to pay over to HMRC. To understand any impact on your tax position you may wish to speak to your accountant.

I’ve seen a reduction in my pay, what is the benefit of staying with an agency?

It is highly likely that working through an agency will still secure you a better rate, preferable working arrangements and the flexibility you might desire.

How does working for multiple agencies affect IR35?

You can still work for multiple agencies as this has no impact on IR35. The question of whether IR35 applies to a working arrangement is viewed on a contract by contract basis. Each engagement is viewed independently so IR35 only applies to any specific contract it is deemed to apply. Taxes and National Insurance contributions are also only deducted for the specific contract they are deemed to apply to. Also remember that at year end, HMRC will take a holistic view at the time of submission of your tax return, so if there are any under- or overpaid taxes they will be settled at that time.

What if I am ‘outside IR35’ but get taxed as though I am ‘inside IR35’ regulations? What should I do?

If you are not deemed to work ‘within IR35’, no taxes should be deducted and if any taxes are deducted you should take it up with the party paying your fee. However, the determination of whether IR35 applies is solely up to the public body (NHS Trust or Health Board) into which you contract. If you disagree with the decision they have arrived at, you can appeal the outcome with the Trust.

How do I access the HMRC assessment tool?

The HMRC assessment tool can be accessed here -

How can I make sure I am IR35 compliant?

It is not up to you to make any representations about whether your intermediary is IR35 compliant. This decision rests with the public body (NHS Trust or Health Board) which needs to determine whether your engagement falls within or outside of the rules relating to IR35.

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