What you keep from a locum shift, on top of your NHS job.
Locum pay is taxed at your top rate, because your main job has already used your tax-free allowance. Enter your job and the shifts, choose how you’re paid, and see what reaches your bank after income tax, National Insurance, pension and student loan.
Locum shifts cost you too. Claim them back.
Travel to other trusts, indemnity, the GMC fee. Reimbsr does the admin to get it back.
- Snap the receiptOr forward the email. Reimbsr works out who pays it back.
- Send each claimOne for each trust, ready for you to check.
- Download your tax formYour P87, HMRC’s form for tax back on work costs.
Nothing is sent until you’ve checked it.
How each route is taxed.
The same shift can leave you a different amount depending on who pays you and how.
| Route | Income tax | National Insurance | Pension | Student loan |
|---|---|---|---|---|
| Your own trust’s bank | Through payroll, with your salary | 8% or 2%, on your salary and bank pay together | The NHS Pension, if your bank pay is pensionable | Through payroll, on your salary and bank pay together |
| Another trust’s bank | Through its payroll, often on a BR code (20% on every pound) | Its own thresholds, then HMRC refunds anything over the yearly cap | The NHS Pension, if your bank pay is pensionable | Its own threshold each month |
| Agency, through an umbrella | Through the umbrella’s payroll | The umbrella pays 15% employer’s NI out of your rate, and you pay employee NI | A workplace pension, not the NHS Pension | Its own threshold each pay period |
| Self-employed | Self Assessment | Class 4: 6% then 2%, or 2% on all of it if your job already pays 8% | The NHS Pension for GP locum work, through Forms A and B | Self Assessment, on all your income |
| Your limited company | Corporation tax, then dividend tax through Self Assessment | None on dividends | Not the NHS Pension | Self Assessment, with dividends over £2,000 |
Most NHS agency work counts as employment for tax (IR35): the agency then deducts tax and NI before paying your company, so the limited company route above is for work that is genuinely outside IR35.
The 2026/27 rates this uses.
Employed: bank and umbrella
| Employee NI | 8% on £1,048 to £4,189 a month, 2% above |
|---|---|
| Employer’s NI | 15% above £417 a month (£96 a week) |
| Apprenticeship levy | 0.5% of pay |
| Holiday pay, rolled up | 12.07% of pay for hours worked |
GOV.UK rates and thresholds for employers, 2026 to 2027.
Self-employed and companies
| Class 4 NI | 6% on profits of £12,570 to £50,270, 2% above |
|---|---|
| Corporation tax | 19% up to £50,000 of profit, 25% from £250,000 |
| Dividend tax | 10.75%, 35.75% or 39.35%, after a £500 allowance |
| GP locum pension | Your tier on 90% of the fee; the practice adds 14.38% |
GOV.UK, and NHS Pensions’ GP locum Form A for 1 April 2026 to 31 March 2027.
Questions doctors ask about locum pay.
How much tax do I pay on locum shifts?
Your main job uses your tax-free allowance, so locum pay is taxed at your top rate: 40% if your pay after pension is over £50,270, as it is for most doctors from ST3, and 20% below that. An ST3 on £67,325 with a Plan 2 loan, doing £18,000 of bank shifts at their own trust, keeps £8,820 of it: 40% income tax, 2% NI and 9% student loan.
Why was so little tax taken from my bank shift, then I owed more?
Another employer’s payroll usually taxes your bank pay on a BR code: 20% on every pound. If your main job makes you a higher-rate taxpayer, you really owe 40%, and HMRC collects the rest after the year through your tax code or a bill. Your own trust’s bank is added to your salary, so its payroll takes the right amount as you go.
Do I pay National Insurance twice with two jobs?
Each employer’s payroll charges NI on its own, with its own thresholds. With two jobs, HMRC caps your NI for the year: if the payrolls took more, you can ask for the difference back after the tax year ends.
Is my bank work pensionable?
It can be: NHS bank staff can be members of the NHS Pension Scheme, and your bank payslip shows whether a contribution was taken and at what rate. Agency work through an umbrella isn’t NHS pensionable. GP locums can pension self-employed sessions using NHS Pensions’ Forms A and B.
How does the umbrella company take its share?
The agency pays the umbrella a rate for your hours. The umbrella takes its fee, then pays employer’s NI at 15% and the 0.5% apprenticeship levy on your pay out of what’s left, and pays you the rest through PAYE, holiday pay included. That’s why an umbrella rate needs to be higher than a bank rate to leave you the same.
Should I locum through a limited company?
Only for work that is genuinely outside IR35, and most NHS agency work isn’t: the hiring trust decides, and if it’s inside IR35 the agency deducts tax and NI first. Outside IR35, the company pays 19% corporation tax on profits up to £50,000, then you pay dividend tax on what it pays out. Accountancy costs come out of it too.
Do I need to do a tax return?
For self-employed work or dividends from your company, yes: you report them in Self Assessment, and pay by 31 January after the tax year ends, sometimes with payments in advance for the next year. Bank and umbrella pay is taxed through payroll.