Employment in the private sector

Are you unsure about becoming self-employed, or setting up your own practice?

You may prefer to work for a private clinic, or become employed by a private practice.

Employment gives you a regular income, and you will get experience outside the NHS. You can then use this experience to get a better insight into private practice and make an informed choice about whether to become self-employed.

Employment...the benefits:

  • you will usually get a regular, guaranteed income, together with holiday, sick pay and maternity pay
  • you won’t have to worry about how to get referrals
  • you’re less likely to have to complete your own tax return
  • tax and NICs are deducted at source via PAYE, meaning that you won’t be caught out by an unexpected tax bill
  • you won’t have the start up costs incurred when you become self-employed
  • you won’t have to worry about overheads
  • you can focus solely on patient care
  • your employer may pay for some training
  • you will have someone to turn to if there are problems

Employment...the downsides:

  • you have to rely on someone else to generate the business that will keep you employed
  • you have to take instruction and will have less freedom to make your own decisions
  • you will have less choice about the hours you have to work
  • you will have less choice about the services you provide or the patients you treat
  • you may have to work with people you don’t like

Can I be self-employed and employed at the same time?

Absolutely. You can continue to be employed, for example part-time by the NHS, and run your private practice at the same time:

  • you’ll pay Income Tax and Class 1 National Insurance on your employed earnings through PAYE
  • when you fill in your Self-Assessment form, you will need to complete separate Employment pages to tell HMRC about your earnings from employment and the tax that has been deducted through PAYE
  • make sure you keep your pay slips!
  • you should also let your employer know that you are self-employed
  • if using an accountant, this may result in more work on their part, resulting in higher charges - discuss having a fixed fee arrangement with them so you are aware of your costs

If you would like to find out what’s involved in becoming self-employed, read our article about becoming a sole trader.

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