IR35 and locum status

For the purposes of the off-payroll working rules in Chapter 10, yes — where it holds a registered patient list. That is the finding that changes everything else on this page, because the small-client exemption which releases most small private businesses from Chapter 10 does not apply to a public authority at all. Practice size is irrelevant. A two-partner practice is in exactly the same position as a large one. That is genuinely counter-intuitive — every other tax regime scales with size — and it is why so many practices have never looked at it.

6 April 2017, not April 2021. April 2021 is when the rules were extended to medium and large private-sector clients, which is the change most people remember. Public authorities were brought in four years earlier. That difference matters because it lengthens the period over which a practice that has never issued Status Determination Statements may have exposure. If your practice has engaged locums through personal service companies at any point since then and has no determinations on file, that is the first thing to look at.

Determine the status of any worker supplying services through an intermediary such as a personal service company, issue a Status Determination Statement with reasons, and have a process for the worker to disagree with it. Where the determination is that the engagement is inside the rules, deductions follow. HMRC's CEST tool was updated on 30 April 2025 and HMRC states it will stand by results given by the tool, provided the information given remains accurate and accords with its guidance.

No, and assuming so is its own mistake. There is no special status rule for locum GPs; the ordinary tests apply, and HMRC's ESM4062 warns specifically that where a locum stands in for another doctor it must not be assumed they share that doctor's status — some so-called locums are in fact assistants, with employment income and Class 1 National Insurance. The contractual terms have to be established and status reviewed in the normal way. Getting this right in both directions matters: treating a genuinely self-employed locum as inside costs the practice money it did not need to spend.

From 6 April 2026 umbrella companies are no longer legally responsible for operating PAYE on payments to workers they employ. Responsibility moves to the recruitment agency supplying the worker, or where there is no agency, to the end client — with joint and several liability. This is a separate regime from off-payroll working and it does not change Chapter 10. If your practice engages workers through an umbrella rather than an agency, that liability may now sit with you. It is worth establishing who is in your supply chain before an assessment arrives, because joint and several liability means HMRC can choose whom to pursue.