Leaving PAYE and becoming a self-employed GP locum

27th June 2012 by Liz Densley

Summer is the time of the year when a lot of new NASGP members will be moving on from being an employed GP registrar and branching out on their own as locums – or as a mixture of locum/salaried work.  This entails a whole new way of thinking about work and you need to make the mental change from employee status to running your own small business.

Here’s a brief summary of important first things to consider.  It is not an exhaustive list.  Start off as you mean to go on – there are onerous penalties for getting things wrong or leaving them too late.

  • Make sure you get your P45 from your employer.  You do not need to send it anywhere unless you obtain another employment – but you will need it for your tax return,so keep it safely.
  • Register with HMRC for self-employment and Class 2 National Insurance. See Revenue website or consult a professional adviser.
  • Record keeping:
    • Retain receipts for all business expenses, for example:
      • Motor expenses
      • Telephones/internet access
      • Professional subscriptions
      • Training courses/technical books, etc
  • Keep a mileage log – you are running your business from home, so record miles from your home to each individual place of work.  It is not quite the same if you are doing a long-term locum, that might make it harder to argue that the surgery is not your place of business
  • Keep copies of invoices issued.
  • NHS pension scheme
    • Locums may pension their income through the NHS scheme and the PCT will pay the 14% employer contribution
    • You should get a ‘pack’ when you register with your PCT (or equivalent) and they will advise on your initial tier level
    • You must complete forms Locum A & B on a regular basis and send them to the primary care support team promptly – late applications are not permitted.
    • Consider business entity:
      • If you wish to be a member of the NHS pension scheme, then simple self- employment is most beneficial.
      • If you do not wish to be a member of the NHS scheme and are prepared to forego the 14% that the PCT will contribute, then it may be possible to save money by using a limited company.  You should not opt out of the NHS scheme without proper advice.  It is rarely beneficial.

Save for your tax, national insurance and student loan repayments as you go. Your professional adviser can estimate your tax liability for you. If ‘going it alone’, you will find some assistance on the HMRC website.


Join to view the rest of this content, as well as access all the benefits of joining NASGP.



Already a member? Login to view this content.


"I am so glad and grateful for being a member of NASGP's BOB locum chambers. I started with them in a critical period of my career as I was a newly-qualified GP, looking for work in a new area with a new virus hardly hitting the world and the jobs market.

Richard and Ali's help was a godsend. They introduced me to locum work in a friendly and kind manner, provided valuable support and excellent service through the ever-improving LocumDeck and NASGP website. With the help of the chambers, I received a face to face tutorial on Emis (I trained on SystmOne) and my online profile was promoted on a growing network of GP practices throughout Buckinghamshire, Oxford and Berkshire.

I was able to work in different GP practices with different staff and patient demographics, massively increasing my clinical experience, resilience and communication skills.

It also helped me funnelling down all the job offers I received through my locum work until I recently agreed for a salaried position in a GP practice that I love working at. "

Dr Nazar Ahmed

See the full list of features within our NASGP membership plans