Specialist Accountants for Locum GPs, Locum Consultants & Agency Doctors
Locum work buys you freedom, not simplicity. One tax year can involve six trusts, three agencies, a chambers, a handful of private clinics and a pile of unpaid invoices. Somebody still has to decide whether you belong inside IR35, whether a limited company beats sole trader, what you can legitimately claim for travel and accommodation, and how your locum sessions affect your NHS pension. That is what our accountants for locum doctors do, for one fixed monthly fee.
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We act for locums at every grade and in every setting across the UK. Your engagement route, your IR35 position and your pension options change with each one, so the advice should too.
Sessional rates, GP Locum A and B forms for NHS pension purposes, mileage between surgeries, and a tax return that pulls every practice and agency together accurately.
IR35 and off-payroll status reviews for trust and agency engagements, umbrella versus limited company comparisons, and reconciliation of deductions already taken at source.
Higher rate planning, private and medico-legal income alongside locum sessions, Annual Allowance and tapering checks, and profit extraction from a personal company.
Multiple trusts and tax codes in one year, extra shift income, relocation and exam costs, and a simple system for keeping records without spending your rest days on admin.
Every service below is built around the way locums actually get paid — invoices, agency remittances, chambers statements and trust payslips — not around a generic small business template.
One return that brings together every trust, agency, practice and private engagement, with allowable expenses claimed in full and payments on account explained before they land.
Contract and working practice reviews for each engagement, a written status conclusion, and practical steps to strengthen your position where the contract allows.
Company set-up, PAYE and VAT registration where needed, statutory accounts, corporation tax returns and a salary and dividend plan that keeps your effective tax rate down.
Xero or QuickBooks set up for locum work, invoice templates, automatic chasing of late payers and receipts captured from your phone between shifts.
Guidance on GP Locum A and B forms, which locum work is pensionable, Type 2 declarations, and Annual Allowance checks when locum income pushes you into tapering.
Locums carry tax problems most professionals never meet: income from several payers at once, deductions taken before the money reaches you, and rules that change depending on who booked the shift. These are the issues we fix:
Several trusts, agencies and practices in one tax year
IR35 and off-payroll uncertainty on every new engagement
Umbrella company deductions that nobody can explain
Travel, accommodation and subsistence claims done wrongly
Cash flow when invoices are paid 60 or 90 days late
Locum sessions not being pensioned in the NHS scheme
Payments on account and a first-year double tax bill
Locum finances take specialist knowledge. Our team already knows how agency remittances work, what a GP Locum B form does and where HMRC draws the line on travel between temporary workplaces. Here is what you get:
Status reviews on your engagements and a clear, written answer on limited company versus sole trader versus umbrella for your circumstances.
GMC and indemnity fees, royal college subscriptions, exams, courses, equipment, mileage and qualifying accommodation — nothing left on the table.
Automated invoicing and chasing, so late-paying agencies and trusts stop being your problem and your tax reserve is always funded.
Advice on pensioning locum work, Locum A and B forms, Type 2 declarations and Annual Allowance checks when your income spikes.
Returns, accounts, VAT and payroll filed on time with reminders well in advance, so penalties never happen.
One agreed monthly fee, quoted up front, with no hourly billing and no surprise invoice after a five-minute phone call.
Chasing paperwork between shifts is nobody’s idea of a career. Our three-step process gets you set up quickly and keeps you informed all year:
We begin by getting to know your practice and understanding your unique needs. This step ensures we have a clear picture of your operations and your goals.
Based on our initial discussion, we create a personalised plan designed specifically for you. The aim is to keep everything organised and easy to follow. You can rest assured that your numbers are being handled with expert precision.
From there, we take care of the ongoing work and keep you updated with reports. You’ll always know what’s happening, and we’re always here to answer your questions, ensuring you have a clear picture of your financial health at all times.
Chartered, experienced and genuinely specialised in healthcare. Here is what working with us looks like in practice:
We use Xero, Quickbooks, Sage & many other online software.
Meet, call or email the same qualified accountant who knows your practice and your pension position.
Free telephone & email support
throughout the year.
Our team have over 100 years of combined experienced.
Never Miss any deadline with our automated email reminders.
We’re an ICAEW, ACCA & AAT accredited Firm.
Take a back seat and let our specialist healthcare accountants handle everything. Switching part way through the year is straightforward and you never need to speak to your old accountant:
Reach out to us, and we’ll discuss your needs and how we can help your healthcare practice thrive.
We’ll send over a simple letter to formalise our partnership and get everything in motion.
If you're switching, we’ll take care of contacting your previous accountants to make the transition smooth.
From there, sit back and relax. We’ll manage your accounts, taxes, and everything in between, keeping your practice running smoothly.
It depends on your income level, how much you need to draw and whether your engagements fall inside IR35. A company can be more tax efficient once profits are retained, but it brings filing obligations and locum work through a company is not pensionable in the NHS scheme. We model both routes on your actual figures before you decide.
GMC registration, medical indemnity, royal college and BMA subscriptions, exams and courses, clinical equipment, professional journals, mobile and home office costs where used for work, mileage to temporary workplaces, and accommodation and subsistence on qualifying trips. The rules on travel depend on whether the site is a temporary workplace, which is where most locums get caught out.
If you work through your own company, IR35 asks whether the engagement looks like employment. For public sector bodies and medium or large agencies, the client decides your status and issues a determination. Where a determination is inside IR35, tax and National Insurance are deducted at source. We review determinations and challenge them where the working practices do not support the conclusion.
Freelance GP locum work in a GMS or PMS practice can be pensioned using GP Locum A and B forms, submitted within strict time limits. Locum work performed through your own limited company generally cannot be pensioned. Agency and bank work through a trust payroll usually can be. We tell you exactly where you stand.
Most medical services provided by a registered practitioner for the protection of health are VAT exempt, so many locums never need to register. Medico-legal reports, some cosmetic work, expert witness fees and certain training or consultancy income are standard rated and count towards the threshold. We monitor your taxable turnover for you.
Because of payments on account. In your first year of self employment you pay the tax for that year plus 50 per cent on account for the next, all on 31 January. We forecast this from the start so the money is already set aside.
Yes. We check that the deductions on your payslip are correct, identify unlawful skimming, reconcile the figures to your P60 and advise whether moving to your own company or a different engagement route would leave you better off.
We set up automated invoicing and reminders and give you a live view of who owes what. Many locums recover several thousand pounds of forgotten invoices in their first year with us simply because the system finally tracks them.
Not for us. Multiple employments almost always produce incorrect tax codes and either an overpayment or an unexpected bill. We reconcile every P45, P60 and remittance so the final position is right and ask HMRC to correct your coding going forward.
We quote one fixed monthly fee based on whether you operate as a sole trader or through a company, and whether payroll, VAT and bookkeeping are included. The quote comes before any work starts and covers unlimited telephone and email support.
Yes. We request professional clearance and the handover information from your existing accountant directly, and pick up from wherever they stopped. You never need to make the awkward call.
Yes. We are based in Morden, South London but act for locum doctors throughout the UK using secure cloud accounting, video meetings and electronic signatures.
Please double-check the figures before you act. The tax, NHS pension and accounting information on this page is general guidance for UK doctors and healthcare professionals, not personal advice. Tax rates, allowances, thresholds and NHS pension rules change regularly, including at each Budget and at the start of every tax year on 6 April. Locum rates, Class 2 and Class 4 National Insurance, IR35 status rules and payment-on-account amounts all move over time. Always cross-check any rates or figures against HMRC, the NHS Business Services Authority and the latest Budget announcements, or speak to one of our qualified accountants before acting. CruseBurke cannot accept liability for decisions made solely on the basis of this page. Last reviewed: August 2026.
