Medical.Accountants
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IR35 Reviews for Agency Nurses

IR35 Reviews for agency nurses. Inside-IR35 determinations? We fix it: fixed fees, ICAEW-regulated specialists. Free quote.

What does ir35 reviews for agency nurses involve?

Our ir35 reviews service for agency nurses covers contract and working-practice review, status assessment, challenge support. It solves the problems we see most often — agency nurses: Inside-IR35 determinations, disputed status, losing take-home pay — on a fixed monthly fee agreed in writing before any work starts.

Fixed fees, specialist healthcare accountants, and every HMRC and NHS Pensions deadline handled.

  • Fixed monthly fee — no surprises
  • Specialist in NHS pension and healthcare tax
  • Onboarding within 48 hours
  • ICAEW & ACCA regulated
  • 5,000+ clients served by ACCOTAX
  • Specialist healthcare accountants

Reviewed by Waqas Sagar ACA FCCA FMAAT, Founder of ACCOTAX, 18+ years' experience · Last reviewed: 8 October 2026 · Updated for the 2026/27 tax year

Medical.Accountants by ACCOTAX, ICAEW/ACCA-regulated chartered accountants, London, serving clients across the UK. Over 5,000 clients served.

Key takeaways

  • Problems solved: Agency nurses: Inside-IR35 determinations, disputed status, losing take-home pay.
  • Included: Contract and working-practice review.
  • Included: status assessment.
  • Included: challenge support.

Which accountancy support fits your income?

Start with how you are paid. Different income sources can need different accounts, returns and expense checks.

How you workWhat we checkSupport to explore
Employed or umbrella (PAYE)Tax codes, eligible employment expenses and whether a tax return is needed.Healthcare tax refund support
Genuinely self-employedBusiness income and expenses, Self Assessment and MTD eligibility.Healthcare Self Assessment service
Your own limited companyCompany accounts, Corporation Tax, director income and off-payroll status where relevant.Healthcare limited company accounts
PartnershipPractice accounts, allocated profit and each partner’s personal tax position.Healthcare partnership accounts

Sound familiar?

Problems we fix for nurses, midwives and healthcare assistants

  • "I can't decide between umbrella, limited company or self-employed agency work."
  • "My bank shifts are on emergency tax."
  • "I've never claimed my NMC fees, uniform or mileage."
  • "I work for several employers and my tax codes are a mess."
  • "I do aesthetic work and don't know about VAT."

What it's costing you

Leaving it unfixed is rarely free

Overpaid tax
Unclaimed expenses and wrong tax codes mean paying more than you owe, year after year.
HMRC penalties and interest
Late returns attract automatic penalties, plus interest on tax paid late.
Lost evenings
Hours spent on forms, invoices and spreadsheets after a long shift.

General examples — your position depends on your own figures.

How we solve it

What we actually do for you

Refund claims

We check what you've overpaid and claim it back from HMRC.

Agency structure advice

A clear comparison of the ways you can be paid.

Self Assessment

Your return filed correctly, with every allowable expense.

Aesthetic VAT check

We confirm whether your treatments are exempt or standard-rated.

How we help

01

Contract and working-practice review

Part of our ir35 reviews service for agency nurses, delivered on a fixed fee.

02

status assessment

Part of our ir35 reviews service for agency nurses, delivered on a fixed fee.

03

challenge support

Part of our ir35 reviews service for agency nurses, delivered on a fixed fee.

04

structure advice

Part of our ir35 reviews service for agency nurses, delivered on a fixed fee.

What to know before you decide

Your questions answered

What does an IR35 review involve?

For locum engagements with NHS bodies, the hirer must decide IR35 status and issue a Status Determination Statement; the small-company exemption does not apply to public bodies. The test looks at control, substitution and mutuality of obligation in the actual working arrangement. You can ask the hirer to review a determination you disagree with, and it must respond within 45 days.

Want us to check this for you? Get a free review →

Can you challenge a Status Determination Statement?

For locum engagements with NHS bodies, the hirer must decide IR35 status and issue a Status Determination Statement; the small-company exemption does not apply to public bodies. The test looks at control, substitution and mutuality of obligation in the actual working arrangement. You can ask the hirer to review a determination you disagree with, and it must respond within 45 days.

Want us to check this for you? Get a free review →

What happens if I'm inside IR35?

For locum engagements with NHS bodies, the hirer must decide IR35 status and issue a Status Determination Statement; the small-company exemption does not apply to public bodies. The test looks at control, substitution and mutuality of obligation in the actual working arrangement. You can ask the hirer to review a determination you disagree with, and it must respond within 45 days.

Want us to check this for you? Get a free review →

How long does a review take?

Timing depends on the scope of the work, completeness of your records and any information needed from HMRC, NHS Pensions or your previous accountant. We confirm the documents required and agree a realistic timetable before starting. Onboarding is separate from completing the review or filing outstanding returns; neither has a guaranteed turnaround.

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Do I need a contract review for every engagement?

NHS contract income, including PCN, ARRS and UDA or orthodontic contract payments, must be accounted for in the period it is earned, with clawbacks provided for. Partners' profit shares and drawings are kept separate. Accurate accounts also drive the pension certificates each partner submits.

Want us to check this for you? Get a free review →

What evidence do you need?

We generally require your pension annual allowance statements, self-assessment returns, and business records. For NHS clinicians, total taxable income and pensionable pay details are essential. We also need identification to complete our secure remote onboarding process. Medical.Accountants provides a clear checklist of required documents once you engage our services.

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Does IR35 apply to private clinics?

For locum engagements with NHS bodies, the hirer must decide IR35 status and issue a Status Determination Statement; the small-company exemption does not apply to public bodies. The test looks at control, substitution and mutuality of obligation in the actual working arrangement. You can ask the hirer to review a determination you disagree with, and it must respond within 45 days.

Check the official guidance · www.gov.uk

Help with this question: VAT Registration & Returns for Doctors & Healthcare Professionals

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How does IR35 affect my limited company?

For locum engagements with NHS bodies, the hirer must decide IR35 status and issue a Status Determination Statement; the small-company exemption does not apply to public bodies. The test looks at control, substitution and mutuality of obligation in the actual working arrangement. You can ask the hirer to review a determination you disagree with, and it must respond within 45 days.

Help with this question: Limited Company Accounts & Corporation Tax for Agency Nurses

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Can nurses claim tax back on NMC registration fees?

You can claim tax relief on costs incurred wholly and exclusively for your work: HMRC-approved professional fees such as GMC, NMC, GDC or HCPC registration and approved royal college and union subscriptions, uniform laundering, and business mileage between workplaces. Ordinary commuting and most exam or training costs for new qualifications are not allowable. Employees can claim back up to four tax years.

Check the official guidance · www.gov.ukWant us to check this for you? Get a free review →

How much is the uniform tax rebate for nurses?

You can claim tax relief on costs incurred wholly and exclusively for your work: HMRC-approved professional fees such as GMC, NMC, GDC or HCPC registration and approved royal college and union subscriptions, uniform laundering, and business mileage between workplaces. Ordinary commuting and most exam or training costs for new qualifications are not allowable. Employees can claim back up to four tax years.

Want us to check this for you? Get a free review →

How far back can healthcare workers claim tax refunds?

You can claim tax relief on costs incurred wholly and exclusively for your work: HMRC-approved professional fees such as GMC, NMC, GDC or HCPC registration and approved royal college and union subscriptions, uniform laundering, and business mileage between workplaces. Ordinary commuting and most exam or training costs for new qualifications are not allowable. Employees can claim back up to four tax years.

Help with this question: Tax Refunds for Agency Nurses

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Quick quote

See what you could save — get a fixed fee in one working day

Three fields. No obligation. A specialist replies, not a sales team.

Packages for your working life

Accountancy packages for nurses

Self-employed income, a limited company, PAYE or a mixture: start with the support that matches how you actually work. We check your status and agree the scope and fee before starting.

Self-employed accountants for nurses packages

For genuine sole-trader income. We prepare your business accounts and Self Assessment, review allowable expenses and explain payments on account.

  • Sole-trader accounts and personal tax return
  • Allowable business expenses reviewed
  • Tax reserve and payment deadline guidance
  • MTD support scoped separately where required

Fixed fee quoted after a review

Discuss this package

Limited company accountants for nurses packages

For clinicians working through their own company. Choose Essential/Compliance, Core/Complete or Growth according to your accounts, bookkeeping and payroll needs.

  • Statutory accounts and Corporation Tax return
  • One director return for salary and dividends from the same company
  • Confirmation statement support; filing fee extra
  • Bookkeeping, VAT and payroll according to your chosen plan

Company packages from £45.83 + VAT / month

Compare company packages

Personal tax return packages for nurses

For employed clinicians, partners and people with mixed income who need a return. We check whether Self Assessment is required and reconcile the relevant income, expenses and pension tax information.

  • Self Assessment requirement checked
  • PAYE and other income reconciled
  • Eligible employment expenses reviewed
  • Pension tax work agreed separately where needed

Fixed fee quoted after a review

Discuss this package

Employment status is determined by the facts, not the package you choose. PAYE, umbrella and partnership arrangements may also apply. A limited company does not override IR35 or off-payroll rules, and not every employed clinician needs a tax return.

Overpaid tax?

Tax refund support for nurses

We review tax codes, eligible professional expenses and overpaid tax, then prepare a claim where you qualify. A refund is not guaranteed; HMRC decides the claim.

£249 + VAT

For refunds up to £5,000, our fee is £249 plus VAT. For refunds above £5,000, add 5% of only the amount above £5,000 to the £249 fee. VAT applies to the total professional fee.

Example: a £6,000 refund means £249 + £50 = £299 plus VAT.

Professional fee, excluding VAT

£249

Ask about a tax refund

This illustrates the fee only, not whether you qualify or how much HMRC will refund. We agree the claim scope and payment terms before work starts.

What's included

Limited company packages — compare what's included

Essential/Compliance

For locums, salaried GPs and dentists with a limited company

from £45.83 + VAT /month

  • FRS 105 or FRS 102 1A statutory accounts
  • Corporation tax return (CT600) and tax computation
  • Confirmation statement preparation and filing support
  • One director Self Assessment return
  • Deadline reminders ahead of every filing date

Core/Complete

For private practice, consultants and associate dentists

from £62.50 + VAT /month

  • Everything in Essential/Compliance
  • Monthly bookkeeping and bank reconciliation
  • Quarterly Making Tax Digital VAT returns
  • Director payroll with RTI filing and pension submissions
  • Quarterly review call on numbers and tax position

Growth

For clinics, dental practices and growing medical teams

from £75.00 + VAT /month

  • Everything in Core/Complete
  • Payroll for up to five employees

Prices exclude VAT. Making Tax Digital quarterly updates available as an add-on. Compare fees

Why clinicians trust us

Chartered accountants who know the NHS

  • ACCOTAX has served over 5,000 clients.
  • Regulated chartered accountants (ICAEW and ACCA).
  • Founded by Waqas Sagar ACA FCCA FMAAT, with 18+ years' experience.

Reviewed by Waqas Sagar ACA FCCA FMAAT

Chartered accountant and founder of ACCOTAX. Last reviewed October 2026.

Get my fixed-fee quote

How it works

  1. 01

    Free call

    A 15-minute chat about your income, structure and deadlines.

  2. 02

    Onboarding in 48 hours

    We set up your records, software and HMRC agent access.

  3. 03

    We handle the rest

    HMRC, NHS Pensions and every deadline, with reminders before each one.

Free resource

Get the nurse expenses checklist free

Tell us where to send it and we'll email it to you.

Your questions, answered

Do agency nurses need ir35 reviews?
For locum engagements with NHS bodies, the hirer must decide IR35 status and issue a Status Determination Statement; the small-company exemption does not apply to public bodies. The test looks at control, substitution and mutuality of obligation in the actual working arrangement. You can ask the hirer to review a determination you disagree with, and it must respond within 45 days.
What does ir35 reviews for agency nurses include?
For locum engagements with NHS bodies, the hirer must decide IR35 status and issue a Status Determination Statement; the small-company exemption does not apply to public bodies. The test looks at control, substitution and mutuality of obligation in the actual working arrangement. You can ask the hirer to review a determination you disagree with, and it must respond within 45 days.
How much does it cost for agency nurses?
Our packages for agency nurses start at £45.83 + VAT a month, with Core at £62.50 and Growth at £75 + VAT. The right package depends on your income sources, whether you trade through a company and any payroll, VAT or pension work. We confirm the exact fee in writing before any work begins, so there are no surprise invoices.
What are the deadlines for agency nurses?
Many agency nurses must file a Self Assessment return: you need one if you have untaxed income such as private, locum or self-employed work. A high PAYE salary alone does not require Self Assessment for 2026/27; check HMRC's current criteria and any notice to file. The online filing and payment deadline is 31 January after the tax year ends. Under the non-MTD rules, late filing normally triggers an initial £100 penalty, with further penalties for longer delays. A different regime applies from the tax year you join MTD for Income Tax.
Can I switch to you mid-year?
Switching takes minutes on your side. You sign our engagement letter, we contact your previous accountant for professional clearance and records, and we take over HMRC and Companies House authorisations. You can switch mid-year; we pick up from the last filed return.

Speak to a specialist today

Leave your details and we'll call you back, or book a free review straight away.

Book a free 15-min tax review

Related healthcare expertise

General information for the 2026/27 tax year, prepared from the official guidance linked below. It is not personalised tax or regulated financial advice. Rules and circumstances can change; confirm your position before acting.

Official sources referred to on this page: HMRC off-payroll working rules (GOV.UK); HMRC Check Employment Status for Tax (CEST); NHS Employers IR35 guidance; HMRC uniform and flat rate expenses (GOV.UK); NMC fee tax relief (HMRC List 3); HMRC umbrella company guidance; HMRC P87.

Official guidance

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