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HMRC internal manual

Employment Status Manual

From
HM Revenue & Customs
Updated
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Particular occupations: nursing staff - advice to nursing agencies

Where a nursing agency is newly identified, you should advise the agency about the agency legislation in the following terms

‘Treatment of home nursing remuneration and agency nurse’s travelling and subsistence expenses

A qualified nurse who works in the home of a client is not normally regarded as being subject to, or to the right of, supervision, direction or control, so her earnings from such work are not within the scope of the agency legislation. PAYE deductions should not therefore be made from the remuneration paid to qualified nurses in respect of home nursing. You should, however, keep a record of all remuneration paid and be prepared to make a yearly return of payments in respect of home nursing under Section 16 TMA 1970, if required to do so.

All other remuneration paid to qualified nurses should be subject to PAYE and Class 1 NICs.

All remuneration paid to unqualified nurses, including that for home nursing, should be subject to PAYE and Class 1 NICs.

For engagements within the scope of the agency legislation, the client’s premises are regarded as the place at which the services are performed by the nurse. The expense of travelling to that place is the cost of an ordinary commuting journey and if it is met by the agency it will be regarded as additional earnings. Thus, payments which are designed to reimburse the nurse for the cost of travelling to the client’s premises should be treated as pay for the purposes of PAYE and Class 1 NICs. Subsistence payments towards the cost of meals, accommodation etc at the place at which the services are performed should be similarly treated.

For your information you may wish to note that where the nurse bears his or her own travelling expenses, no relief will be allowed to the nurse for the cost of travelling from home to the client’s premises. However, relief will be allowed for the cost of travelling from one client to another in the course of a day provided that the nurse begins and ends the day at his or her own home.

For the purposes of the treatment outlined above, a qualified nurse should be regarded as any one falling within the scope of Regulation 3 of the Nurses’ Agencies Regulations 1961, or anyone who has a nursing qualification which is recognised by the UK Central Council for Nursing, Midwifery and Health Visiting (UKCC).