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HMRC internal manual

Employment Status Manual

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 ESM2029 and interim guidance. For periods before April 2014 see ESM2000 onwards.

Where an agency supplies a doctor to personally work in a hospital, nursing home or general practice HMRC would normally expect that doctor to be subject to supervision, direction or control by a consultant or a nominated person responsible for clinical governance, see interim guidance ESM2055a and Bhadra v Ellam (H M Inspector of Taxes) 60 TC466. Agencies are therefore required to operate PAYE and deduct Class 1 NICs on the earnings of such doctors.

Where an agency supplies a consultant to a hospital HMRC would normally expect that doctor to be an officer of the hospital. (For general information concerning officers see ESM2500)