Legalities and Pensions for Clients

Supplies of self-employed locum GPs and nurses

When self-employed locum GPs supply their services to an employment business which makes an onward supply to a third party who is legally responsible for providing health care to the final patient, both the supplies to and from the employment business are taxable. The fact that the locum GPs may be supplied to a prison or other institution where they may not be supervised by any medical staff does not mean that the employment business supplying the locum doctor to the third party is legally responsible for providing healthcare to the final patient.

Failure to comply with this will result in a retrospective payment demand by HMRC together with a retrospective fine for both the agency and client.

However, this ruling does not apply to supplying Nurse medical services that is VAT exempt, but is applicable on the agency fee.

Identity and registered to work as a GP or nurse

We need to ensure that suitable and approved identity checks are in place in order to be able to offer work. We require sight of work permits for foreign doctors or nurses who must have an address in the UK to obtain a National Insurance number in order to work. All GP’s must have a GMC number and be in the process of getting onto an English Performers list. We do have Welsh clients/surgeries and so it is an advantage to be on the Welsh Performers list as well. Nurses must be registered with the NMC.  We require dates of your appraisal and revalidation. A full list of the requirements both professionally considered as mandatory and those which the clients are required ( these will include ID) to have as a result of CQC inspection are available by contacting the office.


For negotiated short term contracts with individual GP’s and clients the GP may wish to claim their NHS superannuation employers  contribution. Should this contractual position apply the surgery will have a reduction in other fees and the financial costs will be less than arranging ad hoc locums. However it is always advisable that you enquire with us to learn more about what is available to you given your individual needs.

Payment of VAT for medical services

We refer you to the following guidance from HMRC:

HMRC Reference:Notice 701/57 (November 2012)