Locum Doctors accounting, handled.

Only NHS-pensionable work counts toward the NHS pension — and that has to be paid through the trust's payroll, not your PSC. So locum sessions invoiced through a Ltd are outside the scheme. We model the trade-off: the company structure usually nets you more in cash, but it costs you the employer NHS contribution. Many doctors split — pensionable bank shifts plus PSC-invoiced agency work.

Not automatically, but in practice many NHS trust engagements have been status-determined as inside IR35 since April 2021. The agency is required to provide you the Status Determination Statement. For private clinic work and direct trust engagements with small employers, the determination still rests with you. We review each contract and keep written evidence of your status.

GMC registration, BMA membership, medical defence union/MDDUS/MPS indemnity, royal college fees, mandatory CPD, journal subscriptions, and travel between different workplaces are all allowable. Examinations and courses that lead to a new qualification (e.g. CCT) are generally not deductible — only those maintaining existing skills are. We keep a doctor-specific expense checklist so nothing routine gets missed.

Once your threshold income exceeds £200,000 and adjusted income exceeds £260,000, your £60,000 annual allowance starts tapering down to a floor of £10,000. Locum income piled on top of consultant or partnership earnings is the classic trigger. We forecast your adjusted income before tax year-end so you don't accidentally trigger an annual allowance charge on NHS pension growth.

Yes — this is the most common pattern we see. We reconcile each income stream separately so it's clear what came from where, handle CIS-style deductions if any agencies are taking tax at source, and produce one combined Self-Assessment plus PSC accounts. Fixed monthly fee covers it all, no per-source surcharges.