Recent NHS guidance states that if you have a long-term, fee-based GP locum, the practice should be treating them as a salaried practitioner for NHS superannuation purposes.
This means that the practice must deduct employee’s superannuation from the locum’s earnings and pay over both the employee’s and employer’s superannuation for the locum.
A long-term, fee-based locum is classified as someone drawing a regular fee from the practice for a period of over six months. This will directly affect any practice using a locum to cover a maternity vacancy or long-term sickness, as the cover will definitely be considered to be a ‘regular’ position.
What is deemed regular, could be as little as doing a Monday morning session every week. However, the ultimate interpretation of ‘regular’ rests with the primary care organisation (PCO).
A GP locum can continue to work for a practice for longer than six months on a self-employed basis, with the PCO paying their employer’s superannuation, so long as the position is not regular.
Allow locums autonomy
If the position is regular, it may also trigger HM Revenue and Customs (HMRC) to argue that the locum is now an employee of the practice and that the locum has received employment benefits from the practice - one of the key tests HMRC uses to establish employment status.
The major problem with this is that HMRC will deem all payments made to the locum to have been made net of tax and national insurance (NI) and demand that the practice pays the tax and NI. The locum will receive a refund of the tax paid.
To preserve your locum’s self-employed status, you must allow them as much autonomy as possible. For example, if the usual locum cannot attend, ask them to provide a replacement from a list of approved locums. The practice should take on locums on a sessional basis rather than by the hour and let them use their own equipment.
Check your locum's status
The more integrated into the practice a locum is, the greater the risk of them being classed as an employee. Using a locum for a regular clinic could well be considered too integrated to maintain self-employed status.
Also practices should avoid offering to pay standard employment benefits, such as sick leave or holiday pay. Again this crosses the line from self-employed locum GP to salaried GP.
If you want to check to see if your locums are self-employed, speak to your accountant first. Alternatively HMRC has an online employment status indicator tool, which can help to decide on employment status.
- Russell Finn is client principal at specialist medical accountants Ramsay Brown & Partners.
HMRC employment status indicator