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HMRC internal manual

Business Income Manual

Particular trades: nurses

S44-S47 Income Tax (Earnings and Pensions) Act 2003

In many cases trained nurses, who undertake private nursing, obtain their successive engagements through a particular nursing co-operative, bureau, agency or other institute. Each engagement is normally for a relatively short period. The fees earned by the nurse are usually paid to the nurse by the agency. A nurse may, in addition, receive other monetary payments which are unknown to the agency.

Although the relationship between agency and nurse is not normally that of employer to employee, tax law imposes this relationship in the majority of cases. Where, however, a qualified nurse is working at the patient’s home without direct supervision or control, the nurse will probably not come within the agency legislation and the fee will form part of the individual’s trade receipts (see ESM4251).