IR35 advice for locum doctors
We help locum doctors, consultants and medical professionals review IR35 and off-payroll working risks where income is earned through a limited company, agency arrangement, NHS body, private hospital or healthcare provider.
Locum income is not automatically outside IR35 just because it is paid to a company.
The IR35 position depends on the real working relationship. The contract matters, but HMRC will also look at what happens in practice: who controls the work, whether substitution is genuine, whether there is ongoing obligation, and whether the doctor is operating like an independent business.
NHS and public sector engagements often put status decisions on the engager.
Where the off-payroll rules apply, the client or fee-payer may decide whether the contract is inside or outside IR35 and whether PAYE/NIC should be deducted before payment.
Private hospitals and clinics can create different responsibility chains.
The position may depend on the size of the client, agency chain, status determination process and whether the locum doctor works through a personal service company.
Inside IR35 income paid to a company needs careful accounting treatment.
Where PAYE has already been deducted from deemed employment income, the company and personal tax return position should be reconciled to avoid double counting or incorrect dividends.
We check the contract, the working practices and the tax treatment together.
A proper IR35 review should not rely on one clause or one CEST answer. The contract, day-to-day working arrangements, payment chain and tax treatment all need to align.
Client and chain
NHS body, agency, private hospital, clinic, end client and fee-payer position.
Contract review
Substitution, control, mutuality, payment terms, termination and financial risk clauses.
Working practice
Rota control, clinical supervision, equipment, integration, autonomy and business-on-own-account factors.
Status outcome
Inside IR35, outside IR35, direct PAYE, umbrella, agency payroll or PSC treatment.
Tax reporting
Company accounts, Corporation Tax, PAYE deductions, dividends, Self Assessment and HMRC evidence.
IR35 and off-payroll working support for locum doctors.
We can review a single contract, advise on a status determination, help where income has been treated inside IR35, or support a company where HMRC has raised questions.
IR35 contract review
Review of locum doctor contracts, agency terms, substitution clauses, control provisions and working practice evidence.
Start enquiry →Locum doctor PSC advice
Advice for doctors working through a personal service company, including accounts, payroll, dividends and deemed employment income issues.
Company accounts →Inside IR35 income received by a company
Review of how inside IR35 income should be treated in the company accounts, tax return and director’s personal tax position.
Start enquiry →CEST and status determination review
Review of CEST answers, status determination statements, client reasoning and whether the facts have been entered correctly.
Start enquiry →Agency, umbrella and direct engagement advice
Comparison of payment routes, tax deductions, payroll treatment, company impact and practical reporting issues.
Start enquiry →HMRC IR35 compliance checks
Support where HMRC asks about employment status, company income, working practices, historic contracts or contractor arrangements.
HMRC support →When inside IR35 income reaches your company, the accounts need careful treatment.
A common issue for locum doctors is that income may be paid to the company after PAYE and NIC deductions have already been applied by the fee-payer. That does not mean the company can treat the same funds in the same way as ordinary trading income without reviewing the tax treatment.
We check whether the income has already been taxed as deemed employment income, how it should appear in the company records, whether expenses or salary entries need adjustment, and how the director’s Self Assessment return should reflect the position.
What we usually need for an IR35 review.
The exact records depend on whether you are reviewing a future contract, an active engagement, company income already received or an HMRC enquiry.
Agency contract, client contract, assignment schedule and any status determination statement issued by the engager or agency.
Rota arrangements, supervision, substitution position, location, equipment, cancellation terms and practical control during the engagement.
Invoices, remittance statements, PAYE deductions, agency statements and company bank entries showing how income was paid.
Company accounts, payroll, dividends, Corporation Tax returns and director loan account records where income was paid to a PSC.
CEST output, HMRC letters, client reasoning and correspondence where a status decision or compliance check is involved.
A clear process for reviewing IR35 risk and tax treatment.
We start with the contract and working facts, then review the payment chain and tax reporting position before advising on next steps.
Scope the engagement
We identify the client, agency chain, contract period, payment route and whether a status determination exists.
Review contract and practice
We compare written terms with the actual working arrangements, including control, substitution and mutuality.
Assess tax treatment
We review whether the income is inside or outside IR35, and how the company and personal tax position should be handled.
Advise or respond
We prepare written advice, tax return treatment, company accounts adjustments or HMRC response as agreed.
Common IR35 questions from locum doctors.
These answers are general guidance only. The correct position depends on the contract, working practices, client, payment chain and tax year.
Does IR35 apply to locum doctors?
It can. IR35 may be relevant where a locum doctor provides services through a limited company or other intermediary and the direct relationship would look like employment.
Who decides if a contract is inside IR35?
For public sector and medium or large private sector clients, the engager will usually have responsibility for assessing the status. For small private sector clients, the contractor’s company may still need to assess the position.
What happens if income is inside IR35?
The fee-payer may deduct PAYE and employee NIC before paying the company. The company accounts and personal tax return then need to reflect the taxed income correctly.
Is a CEST result enough?
CEST can be useful, but the result depends on the facts entered. We review whether the answers match the contract and actual working practices.
Need IR35 advice for a locum doctor contract or company income?
Send a short summary of how you are paid, whether you use a company, who the client is and whether a status determination has been issued.