IR35 for Health Sector

Health Sector

Care Worker, Doctor, Laboratory Technician, Occupational Therapist, Pharmacist, Pharmacy Technician, Physiotherapist, Psychotherapist, Social Worker.

Due to changes in IR35 which were introduced in April 2017, Public Sector clients have the responsibility to determine whether IR35 applies to an engagement. This decision is often based on guidance from NHS Improvement and you should therefore seek confirmation of the IR35 status of your engagement at the outset of your contract.

In the October 2018 budget, the Government confirmed that they will roll out changes to IR35 in the private sector in April 2020, which was updated later to April 2021. This is only for contractors engaged by large or medium sized businesses. It is therefore worth bearing this in mind for any lengthy or long-term contracts (9-12 months or more) taken that overlap with the IR35 changes that were implemented in April 2021. 

Care Worker

• Ensure that you are engaged to work on a specific body of work, which is separate to the work undertaken by employees of the client.
• Ensure that there are no employees doing the same work as you. Otherwise you will need to distinguish between your work and that undertaken by the employee(s).
• Agree the cases that you are expected to work on at the outset of the project. This will ensure that you are not allocated further cases as they come in which employees of the client will work on.
• Keep your engagements with each client short. Long-term assignments with a client could suggest you are filling a gap in the client’s employed workforce
• Ensure that you undertake and pay for all of your CPD training.
•  Try to secure as many assignments as possible with different clients to demonstrate that you are building your client base.
• Ensure that your contract specifies an end date at which time your involvement with the client will come to an end.
• Ensure that you are not responsible for managing the client’s employees.

Doctor

If you are engaged to work in an NHS Hospital the IR35 status will be determined by the NHS Trust/Health Board.

If you are engaged to work as a General Practitioner in a GP Surgery, the IR35 status will be determined by the surgery engaging your services.

It is important to note that NHS Improvement consider that all medical/clinical roles are likely to be captured by IR35.

Laboratory Technician

• Ensure that you are engaged at a level of band 6 or above.
• Ensure that you are engaged to work on a specific project or body of work.
• Ensure that you are not undertaking the same role as an employee of the client; otherwise you will need to distinguish between your role and that undertaken by the employee(s).
• Keep your engagements with each client short. Long-term assignments with a client could suggest you are filling a gap in the client’s employed workforce.
• Try to secure as many assignments as possible with different clients to demonstrate that you are building your client base.
• Ensure that your contract specifies an end date at which time your involvement with the client will come to an end.

Occupational Therapist

• Ensure that you are engaged at a level of band 6 or above.
• Ensure that you are engaged to work on a specific number of patients or for a specific period of time that is defined at the outset in your contract.
• Try to charge a fixed fee per patient as opposed to an hourly rate.
• Undertake and pay for your own CPD training.
• Ensure that you are not undertaking the same role as an employee of the client; otherwise you will need to distinguish between your role and that undertaken by the employee(s).
• Keep your engagements with each client short. Long-term assignments with a client could suggest you are filling a gap in the client’s employed workforce.
• Try to secure as many assignments as possible with different clients to demonstrate that you are building your client base.
• Ensure that your contract specifies an end date at which time your involvement with the client will come to an end. 

Pharmacist

• Ensure that you are engaged at a level of band 6 or above.
• Ensure that you are engaged for a specific period and that your contract reflects this by stating the end date of your engagement.
• Ensure that you can distinguish your work from that undertaken by employees of the client.
• Undertake and pay for your own CPD training.
• Ensure that you are not undertaking the same role as an employee of the client; otherwise you will need to distinguish between your role and that undertaken by the employee(s).
• Keep your engagements with each client short. Long-term assignments with a client could suggest you are filling a gap in the client’s employed workforce.
• Try to secure as many assignments as possible with different clients to demonstrate that you are building your client base.
• Ensure that your contract specifies an end date at which time your involvement with the client will come to an end.
• Ensure that you are fully qualified and that the assignment does not form part of your professional qualification.
• Ensure that you are only responsible for managing a project.

Pharmacy Technician

• Ensure that you are engaged at a level of band 6 or above.
• Ensure that you are engaged for a specific period and that your contract reflects this by stating the end date of your engagement.
• Ensure that you can distinguish your work from that undertaken by employees of the client.
• Undertake and pay for your own CPD training.
• Ensure that you are not undertaking the same role as an employee of the client; otherwise you will need to distinguish between your role and that undertaken by the employee(s).
• Keep your engagements with each client short. Long-term assignments with a client could suggest you are filling a gap in the client’s employed workforce.
• Try to secure as many assignments as possible with different clients to demonstrate that you are building your client base.
• Ensure that your contract specifies an end date at which time your involvement with the client will come to an end.
• Ensure that you are not subject to any supervision or control from a qualified pharmacist, as this will suggest your client controls your work.
• Ensure that you are fully qualified and that the assignment does not form part of your professional qualification. 

Physiotherapist

• Ensure that you are engaged at a level of band 6 or above.
• Ensure that you are engaged to work on a specific number of patients or for a specific period of time that is defined at the outset in your contract.
• Try to charge a fixed fee per patient as opposed to an hourly rate.
• Undertake and pay for your own CPD training.
• Ensure that you are not undertaking the same role as an employee of the client; otherwise you will need to distinguish between your role and that undertaken by the employee(s).
• Keep your engagements with each client short. Long-term assignments with a client could suggest you are filling a gap in the client’s employed workforce.
• Try to secure as many assignments as possible with different clients to demonstrate that you are building your client base.
• Ensure that your contract specifies an end date at which time your involvement with the client will come to an end. 

Psychotherapist

• Ensure that you are engaged at a level of band 6 or above.
• Ensure that you are engaged to work on a specific number of patients or for a specific period of time that is defined at the outset in your contract.
• Try to charge a fixed fee per patient as opposed to an hourly rate.
• Undertake and pay for your own CPD training.
• Ensure that you are not undertaking the same role as an employee of the client; otherwise you will need to distinguish between your role and that undertaken by the employee(s).
• Keep your engagements with each client short. Long-term assignments with a client could suggest you are filling a gap in the client’s employed workforce.
• Try to secure as many assignments as possible with different clients to demonstrate that you are building your client base.
• Ensure that your contract specifies an end date at which time your involvement with the client will come to an end.

Social Worker

• Ensure that you are engaged to work on a specific body of work that is separate to the work undertaken by employees of the client.
• Ensure that there are no employees doing the same work as you. Otherwise you will need to distinguish between your work and that undertaken by the employee(s).
• Agree the cases that you are expected to work on at the outset of the project. This will ensure that you are not allocated further cases as they come in which employees of the client will work on.
• Keep your engagements with each client short. Long-term assignments with a client could suggest you are filling a gap in the client’s employed workforce.
• Ensure that you undertake and pay for all of your CPD training.
• Try to charge a fixed fee per case as opposed to an hourly rate.
• Try to secure as many assignments as possible with different clients to demonstrate that you are building your client base.
• Ensure that your contract specifies an end date at which time your involvement with the client will come to an end.
• Ensure that you are not responsible for managing the client’s employees.