Thinking of Becoming Self Employed in the NHS?

Anyone who has chosen a career in the healthcare sector will know how much of a demanding but rewarding job it can be. However, it is often a difficult work-life balance.

There has been a recent change for people in the NHS to leave the direct employment of the health service and set up as self employed, or set up your own company, and return to the NHS under contract either directly or via an agency. It’s the same as councils and the out sourcing of social care workers. Working as a locum or agency/bank staff can restore the work-life balance.

However, going it alone as a self employed worker in the healthcare sector can be a scary thing. Agencies are asking more and more for “staff” to become a limited company when working through them.

It is not for everybody. There is very little training time available for people coming in on odd days/weeks work, so you need to be highly trained & experienced or have a specialism. There are many benefits for going as a self-employed / company owned healthcare worker.:Technology in medicine

  • Ability to advance your skills as locum/agency staff get thrown into a wide range of departments in a short space of time;
  • You don’t tend to get involved in office/department politics – although that does depend on how long you are in the department on contract;
  • Potential to pick your own hours;
  • Freedom of where you work. You don’t have to accept a contract or days work if you don’t want to;
  • Higher rates of pay.

Just looking at the rates of pay published by Ambition24 for the South of England (outside London) as at 10th November 2014, they are higher than working directly with the NHS. A general hospital nurse rates as self-employed/company work can receive:

Grade Day Night Saturday Sunday Public Holiday
5 – General £30.95 £32.76 £35.07 £40.95 £43.25
6 – General £31.61 £33.47 £36.55 £41.30 £44.64
7 – General £32.77 £34.89 £37.96 £42.42 £45.95

Critical care, specialty care and midwifery can earn up to £10 per hour more than the general grades

BUT – what does it all involve? You never wanted to be an Accountant!!

Performance Accountancy can help you not only with the transition from employed to self-employed/one-person company, but also help you run yourself as a business with all the bookkeeping, accounting and tax work taken care of.

Here are a few of the things you would need to do, whereas we can do for you in the launch of your venture outside the NHS employment on ongoing:

  • Formation of the company and registering at Companies House
  • Advice on the legal obligations placed on the company director(s)
  • Registering the company with HMRC setting up a company payroll scheme
  • Company record keeping advice and setting up accounting record keeping systems.
  • Monthly or quarterly company bookkeeping
  • Advice on the most tax efficient remuneration structure e.g. salary and dividends and the important changes from 6th April 2016
  • Advice on employment related benefits in kind
  • Advice on tax-allowable expenditure for the business
  • Preparation of the statutory company accounts and submission of these to the Companies House
  • Preparation of the annual return and company secretarial duties as needed
  • Preparation of the company tax return form CT600 together with corporation tax and capital allowances computations and submission of these to HMRC
  • Advising on the company corporation tax payment required and the due date for payment
  • Preparation of company dividend vouchers
  • Dealing with company payroll including preparation of payslips, forms P60, P45 and company PAYE dispensation
  • Dealing with HMRC and Companies House on all issues


So – Don’t panic, give us a call on 01344 834257 and we can have a chat about how to get set up and running in a few days.

We will be launching a guide to expenses you can claim as a self employed person working in the NHS. If you would like a copy of this, please leave your contact details below and we’ll ensure that you are one of the first people to get this document.



Performance Accountancy – Your local Accounting service making sure you don’t get sick & tired of tax.

E: [email protected]
T: 01344 834257*





*Please note that calls to this number may be recorded for use in training purposes and as memory joggers.