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HMRC internal manual

Employment Status Manual

HM Revenue & Customs
, see all updates

Particular occupations: doctors - agency doctors

Doctors are often supplied by medical agencies or deputising services for work in the NHS or elsewhere. For general information concerning agency workers see ESM2000onwards.

The agency legislation applies only where workers are subject to, or to the right of, supervision, direction or control as to the manner in which they render their services. A doctor supplied by an agency to work in a hospital or nursing home is regarded as subject to such supervision, direction or control unless the post filled is that of a hospital consultant (see Bhadra v Ellam 60TC466). Agencies are therefore required to operate PAYE and deduct Class 1 NICs on the earnings of such doctors.

A doctor supplied by an agency to stand in for a doctor in general practice, for example, to cover for periods of illness or holidays, or to deal with calls outside surgery hours, is not regarded as subject to such supervision. In these circumstances the doctor is not within the scope of the legislation and agencies may make payments to such doctors without deduction of tax. The fees will be assessable as trading income and liable to Class 2/4 NICs.