Information about 2C Practices

Locum General Practitioners – Salaried Practices

Guidance on the New Payment Arrangements

As a result of past changes in HMRC regulations in relation to “Off Payroll Workers” and also the more recent changes around IR35, it is necessary for NHS Lothian to review the way Locum General Practitioners who opt to work in one of the Salaried Practices are paid.

This will require a move away from payment by invoice to payment through the payroll via a Provisions of Service Agreement with PAYE and National Insurance deducted at source.

This guidance document has been prepared to address a number of questions that have been raised in relation to this change and also to explain how the new arrangements will work in practice.

A: In 2015, HMRC reviewed NHS Scotland’s payment mechanism for individuals who are considered to be doing a similar job in a similar manner to an employee. The outcome of this review was that individuals within this category should be paid via the payroll system with the appropriate PAYE and National Insurance contributions deducted at source by the Health Board.

At that time we applied this legislation to the LUCS Out Of Hours Sessional Doctors as this was where the main focus of attention by HMRC was at that time.  Over recent months, we have been addressing the same issue with other groups of staff who previously had been paid by invoice but who now are  covered by the change in the legislation in relation to Off Payroll Workers.

With the changes in HMRC IR35 legislation it is the Board’s responsibility to ensure that we are fully compliant with all Off Payroll Working agreements both within the IR35 rules and the employment/self employment rules.

A: Off Payroll Workers include the following:

• Individuals;
• Limited companies;
• Personal Service Company;
• Sole Traders;
• Umbrella companies.

A: This legislation applies to all Off Payroll Workers. Although the IR35 legislation changed from 6 April 2017 the Board should have been applying the employment/self employment rules to all Off Payroll Workers already.  Pre 6 April 2017, the obligation to account for PAYE and National Insurance rested with the Company/Personal Service Company (PSC)/partnership/individual (Self employed)/sole trader.

However, from 6 April 2017 the obligation to account for PAYE and National Insurance rests with the Board or Agency and the Board is responsible for any underpaid PAYE and National Insurance together with interest and penalties.

A: The new tax rules (IR35) applies to all Public Authorities as defined for the purpose of the Freedom of Information Act 2000 and the Freedom of Information (Scotland) Act 2002. Part 4 of this act relates to the National Health Service, and as well as the 22 health boards there are other bodies covered by the Act. One of these other bodies is “a person providing primary medical services under a general medical services contract, general dental services, general ophthalmic services or pharmaceutical services.”

A: The new legislation around IR35 came into force from 6 April 2017. Even if the work was performed before 6 April 2017, if the payment date is on or after 6 April then the payment should be made via the payroll and the appropriate tax and national insurance should be deducted.

However, the Board should already have been applying the employment/self employment rules following the HMRC 2015 inspection.

A: The Board is responsible for making the decision on this issue. The Board have reviewed the service that is provided by a Locum GP and considers our interpretation is correct that such a role should be classed as an Off Payroll Worker.

A: The HMRC Employment Status for Tax Purposes Toolkit has been provided to assist employers with the decision as to whether an individual should be classed as a worker or self employed. One of the main areas that it questions is over the right of control – what, when, where and how the work is carried out.

A: No, HMRC have confirmed that engaging an individual as a worker under these arrangements does not make you an employee under employment law and you will not receive the rights and benefits that go with employment including any additional entitlements such as annual leave, sick leave etc. You will receive a Provisions of Service Agreement outlining the service to be provided.

A: The Board will advise HMRC that you are now a worker and being paid through the payroll and HMRC will then confirm your tax code. At the start, you will be on basic rate tax, until we are advised of your tax code, but this will also depend on your level of earnings.

A: This will be the current employee rate which is set by HMRC.

A: Yes, you will be automatically enrolled into the SPPA scheme, as a practitioner for any locum work done. Normally, the employee superannuation contribution rate for a Practitioner is based on total pensionable earnings from all jobs and operates a year in arrears.

However, as we will not have the information on total earnings, the advice from SPPA is that we should use an employee contribution rate of 9.5% and an employer’s rate of 14.9% for any locum work undertaken. At the end of the year, the Practitioner Services Division will make any necessary adjustments based on your total earnings.

There would also be the option that if you consider that the 9.5% contribution is not appropriate due to your overall earnings, the percentage contribution can be amended to a percentage that you think is correct to avoid any issues of underpayment of superannuation contributions at the year end. If you wish to opt out of the scheme you should complete the opt out form which is available from the SPPA website but you would require to opt out of all of your service and not just for the locum work.

A: No, the Board is part of the Clinical Negligence and other Risks Indemnity Scheme (CNORIS) and as such will be vicariously liable for healthcare professionals working under their direction and control and performing services as part of delivery of NHS patient care. This will apply to you as a GP Locum working under a Provisions of Service Agreement within a Board Salaried Practice.

However, it is recommended that you may also want to have your own indemnity cover in addition.

A: We will add the details you provide to us onto our payroll system. Once you are set up on the payroll system you will be paid weekly, in arrears, on a Thursday based on the sessions/hours worked. The appropriate PAYE and National Insurance will be deducted.

A: Yes, a payslip will be provided for each week you have worked and this will be posted to you. You will also receive a P60 at the end of the financial tax year.

A: Yes, a payroll number will be allocated to you for payment of all Locum GP hours worked.

A: No, as the rates of pay for any Locum GP work will be different from rates that you are currently paid, it will require to be paid through a separate payroll number although tax and national insurance contributions will be aggregated across your different roles.

A: You should go onto the Locum Scotland’s website, https://locum-scotland.co.uk/ and any sessions that are available will be advertised on the site in the normal way as at present.

A: No, the arrangements for booking a session have now changed. All sessions will be booked through the NHS Lothian Staff Bank. The Locum Scotland Website will advise you to contact the Staff Bank to book the relevant session. This can either be done directly online with your own log in or by telephoning the Staff Bank on 0131 536 2020 option 2. The telephone hours for the Staff Bank are Monday to Sunday 8am to 6pm.

The Staff Bank will confirm that you are undertaking the session in the particular Practice and the Practice Manager will then be able to view the system to see who is covering the session. Although the session is booked through the Staff Bank you should also contact the Practice directly prior to the session to confirm working times, log on details for computer systems etc.

A: When you confirm you agree to work under the new payment arrangements you will be registered on the Staff Bank. You will be issued with log in details and a password for the Staff Bank System which means that you will be able to access the online system to book a session directly or by phoning as above.

A: No, as all GP’s undertaking Locum shifts are on the Performers List in Lothian, the Primary Care Division have already undertaken all of the necessary checks, so no further checks will be required as a result of you joining the Staff Bank.

A: No, the Practice Manager will confirm on the Staff Bank System that you have worked the session. The Staff Bank will then arrange for the hours worked to be submitted to Payroll and you will receive payment for the session directly into your bank account, one week in arrears.

A: No, invoices/timesheets will no longer be required. After you have worked a session there is no further action you require to take and payment will be generated through the Staff Bank System direct to Payroll.

A: There will be four separate rates of pay depending on what is required in the Practice. The rate to be paid for any particular session will be made clear to you when you are booking in for a session. Although you may be booked for a 4 hour session, the Staff Bank database records and pays by the hour. The rates are as follows:

Level 1 – This is where the Locum is engaged to undertake a clinical session only seeing an average of 12 – 16 patients within that session with no other commitments except for the clinical administration generated by the patient contacts. The rate for this is £50 an hour or £200 per 4 hour session.

Level 2 – This is where the Locum is engaged to undertake a clinical session as above but in addition is required to deal with the workflow within the practice and undertake routine house calls. The rate for this is £57.50 per hour or £230 per 4 hour session.

Level 3 – This is where the Locum is engaged to undertake a clinical session as above but in addition is required to act as the Duty Doctor, deal with the workflow within the Practice and also undertake emergency house calls. The rate for this is £61.25 per hour or £245 per 4 hour session.

Level 4 – This is where the Locum is working within a Practice as a Single Handed GP and is required to provide advice and guidance on all clinical issues and deal with any emergencies that may arise during the session as they are the only GP in the Practice. The rate for this is £65 per hour or £260 per 4 hour session.

Where house calls are required as part of the work that you undertake, travel expenses will be reimbursed.

A: You should contact the Staff Bank as soon as possible to notify them of any changes.

A: It is your responsibility to ensure that you are available to work any session that you book. If the event that you are unwell or have to cancel a session for any other reason, you should contact the Staff Bank and they will contact the Practice to advise. If however, this is a short notice call off you should also contact the Practice directly to advise of your non attendance so that alternative arrangements can be put in place as soon as possible to cover clinics.

A: You should contact the Staff Bank on 0131 536 2020 option 2 or at staffbank.medical@nhslothian.scot.nhs.uk who will make enquiries on your behalf with the payroll team.