Accountants for salaried GPs taking locum and out-of-hours work
You are employed by the practice, taxed under PAYE with Class 1 National Insurance at source, and an active member of the NHS Pension Scheme. Then the extra sessions start: a locum day at a neighbouring surgery, an out-of-hours shift, an occasional private clinic. That second income is self-employed, and nothing about it is handled for you. Four things decide what this costs you: whether you registered for self assessment in time, whether those sessions were pensioned inside the 10-week window, whether your Type 2 form reached PCSE, and whether pension growth across both roles is heading towards the £60,000 annual allowance. The deadlines below arrive in a fixed order, and missing the pension ones costs accrual that cannot be bought back.
Note: Statutory figures for the tax year shown. Your own position is what decides the answer.
What we hear
What we hear from salaried GPs
The questions and concerns that come up most in the first conversation.
When does locum work mean registering for self assessment?
The first paid session outside your contract makes you a sole trader alongside your employment, and HMRC has to be told by 5 October following the end of the tax year the work started in. The bill surprises people: where the prior bill exceeds £1,000 and less than 80% of your tax was collected at source, payments on account begin at half the prior year's liability each. The locum filing guide covers the return.
Pension growth is measured across both roles, not one
For 2026/27 the allowance stands at £60,000, and in a defined benefit scheme the measure is the pension input amount: the capitalised rise in the value of your benefits, not the contributions leaving your payslip. Salaried service and pensioned sessions feed one figure. Tapering starts once adjusted income passes £260,000 while threshold income also passes £200,000, and runs down to a £10,000 floor. Unused allowance from the previous three tax years carries forward, which usually absorbs a one-off spike.
Expenses split in two, and the employment side is tighter
Costs met against your salaried post face the strict employment test, while costs of the locum work come off that profit on the wholly and exclusively rule. Indemnity, the GMC retention fee and subscriptions on HMRC's approved List 3 are deductible. Travel between separate engagements in a day runs at 55p a mile up to 10,000 business miles in 2026/27 and 25p after that, but home to your first site is commuting and never qualifies.
Superannuating the sessions: Form A, Form B and a hard 10-week limit
In England, freelance GP locum sessions are pensioned through the locum forms: Form A is approved by the practice, Form B then goes to PCSE, and contributions are paid over no later than the seventh of the following month. Any period that finished over 10 weeks earlier cannot be pensioned, and PCSE rejects the late form. That is accrual lost for good rather than a penalty. The Form A and B walkthrough has the sequence.
The Type 2 form a salaried GP owes, and the tier it sets
As a salaried GP you are a Type 2 medical practitioner, and the Type 2 self-assessment form records your total GP pay so the right tiered contribution is charged. The deadline is 28 February a year in arrears, so 2025/26 is due by 28 February 2027. Tiers sit on pensionable pay, not total taxable income, from 5.2% up to 12.5% on pay of £67,669 and above for 2026/27.
Would a company actually help with the side income?
Rarely, and the pension answer arrives before the tax one. Income drawn from a company as dividends is not NHS-pensionable, so accrual on that work stops. Against that sits corporation tax of 19% on profits to £50,000 rising to 25% above £250,000, dividends taxed at 10.75%, 35.75% and 39.35% in 2026/27, and a second set of filings. The company comparison sets out the trade-offs.
How it works
How we work with salaried GPs
- 01
Getting the second income on HMRC's record
One of our specialists confirms when the sessions began, checks whether the 5 October point has passed, registers the self-employment and sets up the records. Where a year has been missed, the position is quantified and the disclosure route chosen first.
- 02
One return covering the salary and the sessions
Both sides go on one return: employment income with tax already deducted, and locum profit carrying Class 4 National Insurance at 6% between £12,570 and £50,270 and 2% above. There is no Class 2, which stopped being a required payment on 6 April 2024. Each expense is tested against the rule for its own source.
- 03
The pension paperwork checked end to end
Form A and Form B submissions are traced against the sessions worked, the 10-week clock checked on each, and the Type 2 self-assessment reconciled so the tier charged matches the pay recorded. Where a session has fallen outside the window you are told plainly.
- 04
The annual allowance position, and Scheme Pays if it bites
Pension input across both roles is calculated, carry forward from the previous three years applied, and any charge quantified. Mandatory Scheme Pays runs where the charge exceeds £2,000 and NHS input alone exceeds £60,000, elected by 31 July in the following year, so 2026/27 runs to 31 July 2028.
Free first call, then a fixed fee in writing
Talk to an accountant who works with salaried GPs
Put your self assessment registration, whether your locum sessions are inside the 10-week pension window, and your Type 2 form and annual allowance position to one of our medical accountants. Fees and scope are settled with you first, and asking commits you to nothing.
- Medical work onlyNHS pension, practice accounts and private practice
- Read by a medical accountantYour enquiry goes to our accountants who work with doctors
- One position, not threePractice, pension and personal return read together
No obligation. If our specialists think your position is already right, they will tell you so.
Book your free first call
FAQ