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Financial FAQs

If you can't find an answer to your question, please get in touch and we'll try and answer it for you.

NHS pension superannuation scheme

We have a whole page dedicated to that.

NHS pension scheme

Rates and pay

If you're a Freelance GP, you are self-employed and therefore are responsible for covering your own holiday and sickness pay. And maternity/paternity pay, redundancy (there will be times when you're unemployed), tax, national insurance, travel - pretty much everything.

But that's the choice you make when you're Freelance. That's why you have to make sure that the rates you charge - and the insurance policies you purchase - cover these circumstances. There is a common misunderstanding that GP Principals get holiday pay - they don't. They instead pay a practice manager to spread their 'drawings' over the year.

Of course, as a Freelance GP, you could get holiday/sickness pay if you negotiated it into your terms and conditions. For that matter, you could even demand a case of wine for every week you work, but no practice in their right mind would want to take you on!

But if you're doing a long-term locum e.g. for maternity leave, then it would be entirely reasonable for you to try and negotiate paid leave into your Terms and Conditions (though beware that the 'counter-bid' from the practice would probably be a reduced daily/weekly rate - as the other party, it's entirely up to you what you agree to).

It's all down to what you can negotiate. No harm in trying!

Am I entitled to sick pay?

If you are employed, you really ought to have a contract that somewhere will tell you your sick-pay entitlements. If you are employed and don't have a contract, you must insist on one.

If you are self-employed, you are responsible for ensuring that your own needs will be met if you fall sick.

Take out one or more Insurance Policies

  • Income Protection Plan
    • This is an insurance plan that, after a specified time (often between 3 to 6 months), will start paying you a salary until you're better again. Speak to an Independent Financial Advisor about the policy that would best suit your needs.
  • Critical Illness Cover
    • This type of plan will usually pay out a one-off lump sum on confirmation that you are suffering from a specified critical illness
  • Life Insurance
    • Your relatives will receive a one-off lump sum from your insurer on receipt of your death certificate.
  • Keep enough money in an account to take care of your needs until one or more of your insurance policies takes effect.

This information is a guide only. We recommend that you contact an Independent Financial Advisor for advice regarding your specific needs.

Maternity pay or maternity allowanceIf you are a self employed locum you can not claim Statutory Maternity pay but, if you're eligibleyou can claim standard-rate Maternity Allowance; you can claim as soon as you’ve been pregnant for 26 weeks, and payments can start 11 weeks before your baby is due.

Fill out the simple application form on the gov.uk website.

More on paternity and maternity
  • Write to them explaining what they owe you - give dates and times and a further copy of your Terms & Conditions
    • Keep a copy of all such correspondence
    • Send such correspondence as Recorded Delivery
    • Try to avoid emails when pursuing unpaid bills - too easy to ignore.
  • Speak to the practice manager and keep a record of your conversation.
    • If you want to make an audio recording of the conversation, many mobile phones offer this facility - you must explain to the person that you are recording the conversation
  • Speak to your LMC, who will be able to talk to the practice on your behalf.
  • If you have no joy with the practice manager, talk to one of the partners.
    • Speak to someone likely to see your side of the argument
  • If you're still not getting anywhere, start thinking about making a small claim through a County Court.

NASGP AppraisalAidEngland

In 2004, the NHS England allocated £30 million to support GP appraisal, but in May 2013 announced that it would no longer fund the locum appraisal payment for the time during which a locum undertakes their appraisal.

So what should you do?

You must still send an invoice! Just because NHS England has taken this unilateral decision not to fund, this doesn't stop you having an equal right to funding.

How will this help? Clinical Commissioning Groups are run by GPs, and by sessional GPs continually alerting the CCG board to this discriminatory practice will be a good reminder as to your importance as a clinician caring for patients in their CCG. And of course, more and more sessional GPs are getting involved with running CCGs and will be able to make ongoing decisions about supporting locum GPs.

On your invoice, we suggest you charge a figure similar to all the other GPs – it’ll be a figure that includes travel etc i.e. an all-encompassing sum. It varies across England, and from year to year – anywhere from £200 to £500.

Wales and Northern Ireland

The allocated sum is £300.

Scotland

NHS Scotland has never organised centralised appraisal funding for GP locums, so we advise to use the same invoice for England as above.

Salaried GP

  • This will be stated in the written contract. The private fee can either be entirely subsumed within the normal, regular work of the salaried GP, or there could be a provision for private work to be undertaken over and above the their usual work, stating how much of the fee they receive (bearing in mind the practice's overheads.

Locum GPs

For locum GPs, there is no issue as to whether or not a freelance GP can perform private work in a GP practice.

The practice and locum will need to agree beforehand whether their normal clinical caseload will contain private as well as NHS patients, with adequate time given for the private work in line with what other GPs in the practice would expect.

The practice and locum will also need to agree between them whether private work is charged at the same rate as NHS work.

NB you can now set your T&Cs online in NASGP's LocumDeck.

If you're doing any sort of locum work as part of your portfolio career, you'll definitely need your own personalised Terms and Conditions to help protect both you and the practice you're working for. NASGP's model T&Cs has been specifically developed for us by a specialist employment law firm, and allows you to not only fully adopt all its recommendations, but also to add any necessary clauses, and tailor it to suit your personal needs.

LocumDeck's T&Cs generator allows you to

  • Set your own cancellation sliding scale from 0 to 100% of your booked fee for 0 to 28 days in advance.
  • Include your 14.38% employer's pension contributions
  • Legal employment status
  • Tax status, IR35 etc
  • Duties (on-call, triage etc)
  • Private fees (HGV medical etc)
  • Cremation fees
  • Payment terms (14 days? 28 days?)
  • Plus much more.

As an NASGP member, go to your T&Cs generator, choose your settings and then save. You'll then be given a unique link "View my TCs" which will automatically be added to your automated invoices and session request emails, or you can paste the link into your own website.

As an added bonus, you can update your T&Cs as often as you like, with each change being saved in an archive accessible by your practices for extra confidence.

In our experience, if private patients are seen within the usual agreed hours then the locum would not expect to be paid any extra. But if seen outside the usual agreed hours, the locum would expect to be paid the full private fee, with any practice overheads being offset by the additional service being offered by the locum. It makes the paperwork easier too.

 

 

We've created a calculator to help you arrive at a ballpark figure taking into account covering your professional and personal running costs.

But in addition to your circumstances, there may be local factors at play which could influence your locum pay environment. If you’re new to an area or new to locuming, how do you work out what rates to charge?

Simply asking around is not option, with anti-competition laws being quite clear about the illegality of discussing rates with fellow GP locums.

Local factors that may affect locum pay

  • Supply of locums - the more locums, the more potential for downward pressure on rates. We hear this from members in the more vibrant towns and cities, perhaps with a local GP training scheme that then attracts and retains lots of GPs to start out as locums.
  • Presence of a dominant practice-facing online platform or agency. We hear from members that having one of these in your area can sometimes skew the pay and conditions of local independent locums in a downwards direction.

So how can LocumDeck’s Instant Book help?

With Instant Book, the whole point is that you carefully pre-define your booking parameters for each practice, including the pay rate, in advance, and then publish your terms and availability and wait for bookings. So you can make calculated judgements about the pay you would like to receive and use Instant Book to do the talking for you. Bear in mind too that the Instant Book process itself will add to your ‘value’, as practices are being offered a speedy, transparent way of booking a GP - a task that might otherwise cost them significant workload and resources.

Here’s how you can use Instant Book to experiment with your rates

  • Add a local practice to your LocumDeck address book where you haven't recently worked.
  • Set a sessional/hourly rate for that practice at the level that you'd like to be booked at.
  • Activate that practice for Instant Book.
  • Add 'Committed Availability' to your LocumDeck calendar as far in advance as possible.
  • As and when practices Instant Book you, you’ll soon be able to use your judgement if your rates are too high or two low, and you’ll be able to adjust your rates accordingly.

If you run this experiment for a range of practices and add availability over a range of periods in advance, you’ll soon start to build a picture of the local factors that may affect your rate decisions.

Our experience of using Instant Book is that once practices have used it, they return to it as their favoured booking method, further cementing its value to them. It is a win-win tool - locums have more control over their work and pay, whilst the practice saves significant resources in finding and directly booking locums.

Optimise your settings to maximise your bookings

Cancellations

Cancelling sessions through unforeseen circumstances such as illness is just one of those things. Obviously, it shouldn't be undertaken lightly as it can create an inordinate amount of inconvenience for the practice and patients. Wherever possible, if you can help ease the inconvenience by suggesting an alternative, then so much the better - but not always possible considering the precipitating circumstances.

If you make a habit of cancelling in this way, the sad reality is that the practice will think very hard about booking you again.

But cancelling work because of a change in mind, a better offer or to take a holiday is invariably professional suicide. For starters, the GMC's Good Medical Practice has something to say about this, and bad news about a locum cancelling at such short notice would (and does!) spread like wildfire to other practices. Unforeseen circumstances aside, only ever book work that you know you will not have to cancel.

A cancellation can be devastating for a locum GP, particularly if it's last-minute. You may have put off other work in order to undertake the planned work, and of course may have dependents, a mortgage, loans. Same applies to anyone, which is why you have legal rights in this situation.

Firstly, refer to the terms and conditions that you agreed to - if you used the NASGP's model T&Cs, you will have a cancellation clause that means the practice must pay you a certain figure if cancelled within the agreed time limit.

If there is no agreement in place and the practice does not pay appropriate compensation the locum may be able to pursue a claim for breach of contract in a small claims court - have a word with your BMA or MPU Industrial Relations Officer or, if you get no joy, your local Citizens Advice Bureau should help you out.

See more in the NASGP Locum Toolkit

  • Click on the session in your calendar.
  • Then click ‘Edit or cancel booking’
  • You will be taken to LocumDeck >> Bookings >> Edit or cancel with the relevant session already selected on the right hand side in Session list
  • Click the red dustbin icon next to the session details. ‘Awaiting cancellation’ will appear in red text.
  • Now you have a choice of two ways of informing the practice, depending on the circumstances of the cancellation.
    • Ask practice to confirm
      • Rewinds the confirmed booking to a booking “Awaiting cancellation” in your calendar and the practice’s calendar and sends you both an email of the proposed cancellation. The practice can click a special link within the email to cancel the booking. Or they can confirm the cancellation within LocumDeck.
    • Manually confirm
      • Immediately removes the booking from your calendar, the practice’s calendar and sends you both a confirmation email of the cancellation.

More LocumDeck FAQs

In LocumDeck >> Settings >> T&Cs, you can generate your own personalised T&Cs using NASGP's T&Cs picker. This includes a cancellation policy section.

Your T&Cs are linked to every email that is sent to the practice. What's more, if you are linked with a practice, they can easily access your up-to-date T&Cs via your profile.

More LocumDeck FAQs

Travel and mileage

Recently we have seen examples of HMRC asking to see locum mileage logs and refusing claims without them. So please try to keep a mileage log of all practice related journeys. It is much easier to take out what turns out not to be deductible, than to try to recreate information that wasn’t retained in the first place.

A mileage log can be a notebook kept in the car; a spreadsheet or a phone app that calculates journeys that you can annotate.

What if you have not kept a log?

For home to GP surgeries, it is easy enough to ‘google’ journeys to find the mileage. Visits are much harder if you haven’t retained records. Some surgeries’ computer systems can produce a printout of visits by doctor, from which you can then work out the mileage. This might work for salaried doctors, but the practices are likely to be less enthusiastic hunting out the information for irregular locums.

Don’t forget to include other travel in the course of work – such as for training courses. If they are not local, that can be a noticeable amount. Salaried doctors will not be able to claim it themselves; they will need to try to get reimbursement from the practice.

If the pattern of work has not changed then a sample period might be sufficient but this is only likely to work for salaried doctors’ visits – and if HMRC want to do it by the book, it still may not be enough. Locum work is unlikely to ever be settled enough for a sample period of mileage log to be representative – so doctors in that position need to get into the habit of keeping a regular log.

Self-employed doctors may usually claim a mileage rate similar to salaried GPs, but if their turnover exceeds £81k (for 2014-15) they should claim a proportion of total car running costs.

Salaried GPs

As an employee, probably not; it's not usual practise in any employment to charge for mileage to and from work. However, there may be an allowance in your contract for use of your car for visits, or if your practice requires you to travel to certain meetings to represent the practice.

Locum GPs

If you're a locum GP then you can charge for mileage to and from your place of work and for visits too if you want to - some locums do, some don't. When you charge for mileage, it's not just the fuel you're charging for - think of the tax, insurance, oil, servicing bills, wear-and-tear, tyres and the time taken to physically get there etc. What you [successfully] charge is entirely up to your negotiations with your employing practice.

A decision on whether or not to charge depends on how much it's actually costing you vs both the hassle of working it all out plus the 'perceived pettiness' by the practices that may ultimately lead them to booking someone else.

See also

Locum GP claims will depend on the pattern of their work. If they are ‘itinerant workers’ – so that they work at different places from day-to-day with no discernible pattern, then it should be possible to argue that the main place of work is home – the base from which the business is run. This should make all journeys to surgeries allowable.

If however there is a pattern claims will be restricted. For example:

  • Dr L is a freelance locum. He has a number of regular jobs. He covers at surgery A on Mondays, does 2 days a week at surgery B and the 4th and 5th days are totally variable. It is likely that surgery A and surgery B become ‘workplaces’ so that home to each of those premises will be a personal journey. The 4th and 5th days should fall within the itinerant rules so that home to surgery will be deductible.

Sometimes the pattern will not be obvious in advance. A short spell of locum work may develop into something more regular (at this stage there is a risk that the locum is no longer freelance in respect of that placement and may need to become salaried, but that is beyond the scope of this article).

Recently we have seen examples of HMRC asking to see locum mileage logs and refusing claims without them. So please try to keep a mileage log of all practice related journeys. It is much easier to take out what turns out not to be deductible, than to try to recreate information that wasn’t retained in the first place.

A mileage log can be a notebook kept in the car; a spreadsheet or a phone app that calculates journeys that you can annotate.

What if you have not kept a log?

For home to GP surgeries, it is easy enough to ‘google’ journeys to find the mileage. Visits are much harder if you haven’t retained records. Some surgeries’ computer systems can produce a printout of visits by doctor, from which you can then work out the mileage. This might work for salaried doctors, but the practices are likely to be less enthusiastic hunting out the information for irregular locums.

Don’t forget to include other travel in the course of work – such as for training courses. If they are not local, that can be a noticeable amount. Salaried doctors will not be able to claim it themselves; they will need to try to get reimbursement from the practice.

If the pattern of work has not changed then a sample period might be sufficient but this is only likely to work for salaried doctors’ visits – and if HMRC want to do it by the book, it still may not be enough. Locum work is unlikely to ever be settled enough for a sample period of mileage log to be representative – so doctors in that position need to get into the habit of keeping a regular log.

Self-employed doctors may usually claim a mileage rate similar to salaried GPs, but if their turnover exceeds £81k (for 2014-15) they should claim a proportion of total car running costs.

Salaried GPs may claim for journeys undertaken wholly in the performance of their duties. Where the practice reimburses a doctor for visits (pretty rare!), then salaried GP mileage reimbursements up to 45p per mile (assuming less than 10k miles pa) are tax free. Payments in excess of that (sometimes seen in payments by hospital trusts) will be treated as taxable benefits and should be shown on form P11d at the end of the year, and must be recorded on the employment pages of the tax return.

If the practice reimburses less than 45p per mile, the difference can be claimed as an expense of employment. If there is no reimbursement at all, the then full 45p per mile can be claimed as an expense of employment. Where miles exceed 10k p.a. then the reimbursement rate drops to 25p.

The above rates relate to car travel; motorcycles can be reimbursed/claimed at 24p; cycles at 20p.

Allowable journeys for salaried doctors would include patient visits, meetings (necessary ones as part of the employment), and travel between different sites, but see the caveat below.

Home to work journeys are not allowable.

Additional mileage may be claimed in restricted circumstances such as:

  • Dr D is employed by multi-site practice A to work at surgery X. If Dr D is asked to work at surgery Y for a limited time (perhaps to cover a maternity leave), then temporary travel from home to another place of work for an intended period of less than 2 years will be treated as allowable.

Note on the other hand that if Dr E was employed on a temporary basis for the maternity leave mentioned above, home to work mileage would not be allowed because surgery Y would be his main (and indeed only) workplace.

Travel between sites cannot be claimed in the following circumstance:

  • Dr D is still employed by practice A at surgery X. He lives close to surgery Y and pops in each day on his way to work to pick up post. This does not make the journey between the two surgeries a business journey.
  • Dr D is still employed by practice A. He works Mondays and Tuesday at surgery X and Wednesday and Thursday at surgery Y. These are two separate places of employment and travel between them or from home to work for either of them is not deductible.

Claiming for GP travel expenses

Locum GP claims will depend on the pattern of their work. If they are ‘itinerant workers’ – so that they work at different places from day-to-day with no discernible pattern, then it should be possible to argue that the main place of work is home – the base from which the business is run. This should make all journeys to surgeries allowable.

If however there is a pattern claims will be restricted. For example:

  • Dr L is a freelance locum. He has a number of regular jobs. He covers at surgery A on Mondays, does 2 days a week at surgery B and the 4th and 5th days are totally variable. It is likely that surgery A and surgery B become ‘workplaces’ so that home to each of those premises will be a personal journey. The 4th and 5th days should fall within the itinerant rules so that home to surgery will be deductible.

Sometimes the pattern will not be obvious in advance. A short spell of locum work may develop into something more regular (at this stage there is a risk that the locum is no longer freelance in respect of that placement and may need to become salaried, but that is beyond the scope of this article).

Salaried GPs may claim for journeys undertaken wholly in the performance of their duties. Where the practice reimburses a doctor for visits (pretty rare!), then salaried GP mileage reimbursements up to 45p per mile (assuming less than 10k miles pa) are tax free. Payments in excess of that (sometimes seen in payments by hospital trusts) will be treated as taxable benefits and should be shown on form P11d at the end of the year, and must be recorded on the employment pages of the tax return.

If the practice reimburses less than 45p per mile, the difference can be claimed as an expense of employment. If there is no reimbursement at all, the then full 45p per mile can be claimed as an expense of employment. Where miles exceed 10k p.a. then the reimbursement rate drops to 25p.

The above rates relate to car travel; motorcycles can be reimbursed/claimed at 24p; cycles at 20p.

Allowable journeys for salaried doctors would include patient visits, meetings (necessary ones as part of the employment), and travel between different sites, but see the caveat below.

Home to work journeys are not allowable.

Additional mileage may be claimed in restricted circumstances such as:

  • Dr D is employed by multi-site practice A to work at surgery X. If Dr D is asked to work at surgery Y for a limited time (perhaps to cover a maternity leave), then temporary travel from home to another place of work for an intended period of less than 2 years will be treated as allowable.

Note on the other hand that if Dr E was employed on a temporary basis for the maternity leave mentioned above, home to work mileage would not be allowed because surgery Y would be his main (and indeed only) workplace.

Travel between sites cannot be claimed in the following circumstance:

  • Dr D is still employed by practice A at surgery X. He lives close to surgery Y and pops in each day on his way to work to pick up post. This does not make the journey between the two surgeries a business journey.
  • Dr D is still employed by practice A. He works Mondays and Tuesday at surgery X and Wednesday and Thursday at surgery Y. These are two separate places of employment and travel between them or from home to work for either of them is not deductible.

NASGP member BD has raised this very important question, since NASGP's LocumDeck excludes travel costs from the Locum A pension calculation.

The NHSBSA, in its 2017 factsheet for GP locums, states:

Q. Are travel expenses, i.e. motor mileage allowance pensionable?

A. No. Deduct 10% of your gross pay first which accounts for expenses.

So is it just a plain fat 'no'? Does one include one's charges for travel as 'gross pay', or include it? And is NASGP correct in not including expenses i.e. travel costs/mileage in our automated Locum A forms within LocumDeck?

Our advice from Honey Barrett accountants (4th May 2017), and confirmed by their pension experts from the Association of Independent Specialist Medical Accountants, has confirmed NASGP's position by pinning down the actual legislation:

1995 regulations, schedule 2, regulation R1, paragraph 6(3):

"In the case of a locum practitioner, "pensionable earnings" means all fees and other payments made to the locum practitioner in respect of the provision of locum services (but excluding payments made to cover expenses or for overtime), less such expenses as are deductible in accordance with guidance laid down by the Secretary of State."

Honey Barrett conclude "...[pensionable earnings] excludes expenses, so just the locum fee x 90% (which is the allowance for expenses as stipulated by the Secretary of State)."

Indemnity payments

Depending on how much you charge and how expensive your indemnity fees are, we're hearing reports of suggestions from 0.7% to 2%.

Purely for illustration purposes, let's say you're a locum earning £100k, and your annual indemnity fee is £10k. So if indemnity goes up by 10%, it's now £11k i.e. it's gone up by £1k.

£1k is 1% of your £100k income, so if you raise your income by 1%, it'll back-cover the 10% indemnity rise.

This rise is to reimburse you for the backdated indemnity fee inflation. If indemnity goes up next year, the plan is that you'll claim at the end of next year, spread over the forthcoming year, for that indemnity inflation rise.

Please follow the instructions below. For full background on how and why locum GPs can claim payment for indemnity inflation, see our news article here.

Depending on how much you charge and how expensive your indemnity fees are, we're hearing reports of suggestions from 0.7% to 2%.

Purely for illustration purposes, let's say you're a locum earning £100k, and your annual indemnity fee is £10k. So if indemnity goes up by 10%, it's now £11k i.e. it's gone up by £1k.

£1k is 1% of your £100k income, so if you raise your income by 1%, it'll back-cover the 10% indemnity rise.

This rise is to reimburse you for the backdated indemnity fee inflation. If indemnity goes up next year, the plan is that you'll claim at the end of next year, spread over the forthcoming year, for that indemnity inflation rise.

Financial advice

clinical commissioning groupAs a freelance locum GP, the only way that you can pension CCG work under the NHS superannuation scheme is if you bite the bullet and become a salaried CCG employee. At retirement, you may get a separate Officer pension, or the CCG post may convert to Practitioner under what is known as the 'flexibilities'.

So why can't I pension my CCG work without becoming a CCG employee?

A GP (Dr X) who is solely a freelance GP locum cannot superannuate CCG work on locum forms A and B. This is because a freelance GP locum is defined under the NHSPS regs as follows....

"Locum practitioner" means a registered medical practitioner (other than a specialist trainee in general practice) whose name is included in a medical performers list and who is engaged, otherwise than in pursuance of a commercial arrangement with an agent, under a contract for services by:

  1. a GMS practice; 
  2. a PMS practice; 
  3. an APMS contractor; 
  4. an OOH provider; 
  5. or Local Health Board,

to deputise or assist temporarily in the provision of essential services, additional services, enhanced services, dispensing services, OOH services, commissioned services, certification services, Board and advisory work, health related functions exercised under section 75 of the 2006 Act, NHS 111 services or collaborative services (or any combination thereof)"

In particular, note that there is no scope for Dr X to superannuate CCG work if working directly for a CCG. Nor can Dr X superannuate their CCG work in any other way; i.e. as a type 2 (assistant) Practitioner.

A type 2 medical Practitioner is defined in the NHSPS regs as follows....

"type 2 medical practitioner" means a GP performer who

  1. is not a GP provider, and
    1. is employed (whether under a contract of service or for services) by a GMS practice, a PMS practice, an APMS contractor, an OOH provider, or a Local Health Board, and 
    2. in that employment is engaged wholly or mainly in assisting his employer in the discharge of the employer's duties as a GMS practice, a PMS practice, an APMS contractor, an OOH provider, or a Local Health Board; or 
  2. is participating in a Doctors' Retainer Scheme"

In summary, a type 2 is a salaried GP or long term fee based GP working for a GP Practice, an APMS contractor, an OOH provider, or a Local Health Board. By virtue that there is no reference to a CCG means that Dr X cannot superannuate their CCG income.

If Dr X has been an existing type 1 (GP Partners, single-handed GPs, and GP shareholders in GMS, PMS, sPMS, and APMS are regarded as type 1 medical Practitioners) or 2 (in addition to working as a GP locum) there would be no problem.

We find that Locums don’t seem to struggle to get a mortgage, unless they have only just commenced as self-employed and don’t have any accounts yet. We don’t find that lenders classify you as high risk, probably the opposite, and we don’t see a pattern of locums using a particular lender, so we would suggest that you discuss your options with an independent mortgage broker.

As with any one who is self-employed, when you apply, the lender normally sends us an accountants certificate for completion by your accountant. We basically confirm your last three years profits, your NI number and how long we have been acting for you. The lender also normally asks us to obtain Revenue forms SA302’s. These are Revenue tax calculations which are normally only issued when someone files a paper Tax Return. However, on request, the Revenue will issue these forms even when Tax Returns have been filed electronically.

See also

Computer says no – getting a mortgage as a GP locum

If you are a locum GP in the NHS scheme the practice must pay a 14.3% contribution to the locum, and you then pay that to NHS pensions along with your personal contribution.

If you are not in the NHS scheme, you can still negotiate an employer's contribution with the practice if that is your wish, although there is nothing contractual in place for non-NHS schemes.

This is one of the questions we get asked most at NASGP, since there's been a lot of conflicting advice over the years, not helped by some very strong opinions on social media. We've received exclusive clarification from the Technical Consultancy Team, NHS Business Services Authority (NHS Pensions).

View FAQ

If you are in receipt of a pension the rules are the same whether or not you had been a locum GP, salaried GP or partner. There is a 50% spouse's pension, and if you have a dependent child under 23 then they get 25% and if you have a child who has special needs and not capable of independent living then 23 does not apply.

And if you are not married you need to fill in form PN1 to nominate you partner to receive you pension benefits.

There's been a lot of conflicting talk recently about locums not being entitled to 'death in service' benefits, so we've been working closely with the NHS Superannuation people and Paul Gordon from MacArthur Gordon Ltd to come up with some pragmatic advice and steps that GP locums can take to fully compensate for this discrepancy. We hope that by looking at the following example, GP locums can then get advice as to how large their shortfall could be if the death in service benefit didn't apply to them so that they could then purchase the appropriate life insurance policy should they so wish.

As a locum GP, as long as you are, or have been a member of the NHS Pension Scheme, the NHS will provide some sort of protection in the event of death and ill health, but the amount will vary significantly depending upon your length of service, pensionable income and whether at the time of death you are considered an active member of the Scheme.

As such, reviewing your individual position is important but also difficult unless you know exactly when you plan to die.

Alternatives to the NHS pension's death-in-service benefit

If you'd rather not leave it to chance, you could always cover yourself with a life assurance policy. Either speak to your usual financial advisor, or get in touch with Claire Wilson claire.wilson@blackett-walker.co.uk from the Blackett Walker team.

The following are examples of likely benefits payable from the NHS in the event of death. In order to put figures to each of the examples we need to make the following assumptions. Dr is 33 and has been working in the NHS for 9 years, has Pensionable Pay of £70,000, is a member of the Old (or 1995) NHS Pension Scheme and currently has a Normal Retirement Age of 60. Rather than cover the complexities of dynamisation, we will assume that the average annual pensionable pay is £60,000.

Dr A is a GP Locum (or 'Locum Practitioner' in NHS pension terms) and is contracted to work Monday to Friday at the High St Practice. Unfortunately he dies midweek (i.e. death in service) on the Wednesday.

  • Death Gratuity: this would be equal to twice Dr A's uprated (dynamised) average annual pensionable pay.
  • Dependants Benefits: any (normal) widow's pension would be based on Dr A's hypothetical tier 2 (enhanced) ill health pension at date of death. (However for the first 6 months Mrs A would receive the initial widows pension based on Dr A's pensionable pay before the normal widow's pension took over).
  • In this case:
    • Dr A’s estate would receive £120,000 as a Death in Service Lump Sum.
    • The widow would also receive 6 months income of the pre death pensionable amount.
    • The Dependants Benefits would be calculated as follows:
    • 9 years service accrued.
    • Age 33 at death, leaving 27 years remaining to age 60 of which, the enhancement would be 2/3rds.
    • 9 + 18 = 27 years service.
    • His spouse would be entitled to 50% of the Enhanced Income for life, in this case the Enhanced Income would be calculated as follows:
      • 27 x £60,000 = £1,620,000 x 1.4% / 2 = £11,340 per annum.
    • Any child would receive a quarter each of the Enhanced Income until the age of 23 if in full time education, although this is capped at a maximum of 2 children at any one time.

Dr B is a GP Locum and is contracted to work Monday to Friday at the High St Practice. Unfortunately he dies on a Saturday; he does not work at weekends. In this instance the death within 12 months rules apply.

  • Death Gratuity: this would be equal to three times the value of Dr B's annual pension at date of death.
  • Dependants Benefits: any (normal) widow's pension would be paid on the first day after date of death and be based on Dr B's hypothetical tier 2 (enhanced) ill health pension at date of death.
  • In order to gauge likely Death Benefits we need to assume the likely accrued pension benefits.
    • As such, 9 years service within the Scheme in a sessional position post training will see accrued benefits of approximately £6,000 per annum (from 60).
    • The Lump sum payable would therefore be 3 x £6,000 = £18,000.
    • The dependants benefits would again be enhanced, so assuming death aged 33, with 27 years potential service remaining, an additional 18 years would be added to the accrued service, giving a total of 27 years as previously mentioned for Dr A.

Dr C is a GP Locum. Unfortunately he dies more than 12 months after his last pensionable post ceased. In this instance the death on preservation rules apply.

  • Death Gratuity; this would be equal to three times the value of Dr C's annual preserved pension.
  • Dependants Benefits; any (normal) widow's pension would be paid on the first day after date of death and be based on Dr C's accrued pension; i.e. no enhancement.
  • As with the previous example, the lump sum would be £18,000. The dependants benefits would be significantly less and based purely on the 9 years service.

As you can see, the above examples highlight the issues that could arise depending upon literally the date of death. It is therefore important that your individual situation is reviewed to ensure debts and liabilities are covered, your spouse can maintain their standard of living and your children can continue with their education or childcare.

Even as a GP locum there are some simple and affordable steps you can take to reduce the risk of losing out financially if you can't work through illness.

Your ability to receive income whilst off work through ill health whilst working as a GP locum very much depends on your employment status i.e. whether you're an employee, self-employed or 'worker'.

Remember that your legal employment status is something that is not necessarily determined by you, and is different to your tax employment status and your NHS pension employment status.

This FAQ is from the perspective of being a GP locum in the same practice for a 'long time', rather than about choosing working as a GP locum as part of your career portfolio.

It explains it from four different perspectives - NHS pension scheme, HMRC tax perspective, employment law and 'mission creep', and there's even an audio podcast too.

View FAQ

I work for a locum agency

I'm self-employed

  • If you're locuming in different practices using your own Terms and Conditions, managing your own bookings and determining the way within which you work, either manually or through platforms like LocumDeck, then your employment status is likely to fall within the self-employed status.
  • In which case, you don't qualify for SSP in that role.
  • But if you already have a Locum Insurance Policy, then this could cover you for up to £3,000 a week or 75% of your earnings for a year if you’re ill or injured and can’t work.

I work for an online locum platform

What about Permanent Health Insurance and Critical Illness Cover?

These are policies for much longer long-term benefits. Read this for more information:

Should locum and salaried GPs get income insurance?