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Wesleyan Guide Self-Employment in the Dental and Medical Industry 10

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Wesleyan Guide Self-Employment in the Dental and Medical Industry 10 THE ULTIMATE GUIDE TO SELF-EMPLOYMENT IN THE DENTAL AND MEDICAL INDUSTRY ADVICE FROM THE NEXT STEP INTRODUCTION 02 WHAT DOES “SELF-EMPLOYMENT” MEAN IN THE DENTAL AND MEDICAL INDUSTRIES? For some, it can be the consequence of choosing a particular career path, while for others it may be due to lifestyle and financial choices. There are some key differences between being an employee and being self-employed that you should be aware of, from the availability of benefits to your tax treatment. For guidance on how to understand these differences, we’ve created this informative guide. By reading this guide you’ll learn: What it means to be self-employed How it’ll impact your career – for both medics and dentists Key considerations to ensure you are prepared Advice from self-employed professionals FACTS AND FIGURES: 03 What do you already know about becoming self-employed as a doctor or dentist? To get us started, we’ve shared a few facts and figures to help you understand. If dentists choose to become an associate in a practice, they’ll automatically be self-employed Many dentists and doctors will become self-employed because of career choices Self-employment may offer more flexibility 4.93M people in the UK 29,660 were self-employed self-employed dentists in 2019 across the UK in 2018 ONS NHS If an NHS doctor takes up private work alongside their regular role, they will earn their secondary income as self- employed Nearly Some trainees opt to 1 in 5 take a gap between of all licensed foundation and further doctors training, and may are Locums become self-employed GMC to work flexibly in the NHS From 2013 to 2017, there was an increase of almost 12,000 licensed doctors working as Locums GMC WHAT DOES SELF-EMPLOYMENT 04 LOOK LIKE? How you are self-employed can differ considerably across dentistry and medicine. Dentists Doctors WHAT DOES SELF-EMPLOYMENT 05 LOOK LIKE? What it means to be a self-employed dentist… For DF1, you’re employed by the NHS as a vocational trainee. Typically, you'll then either continue further training in a hospital as an employee of the NHS, or you’ll remain in the practice as an associate, at which point you’ll be self-employed. If you choose to go into a hospital setting, you’ll enter dental core training (DCT) and receive NHS benefits such as sick pay and pension. This is also true of associates carrying out NHS work in a practice, but to a lesser extent. Being self-employed means being treated differently for tax purposes. Dental associates are paid a gross sum each month and will be responsible for looking after their own taxes and national insurance. In summary, being self-employed allows for tax benefits for the person who is self-employed as well as the person employing them – if the associate was employed, the employer would have obligations to pay National Insurance, holiday pay as well as NHS Pension Scheme employer benefits. This could have the potential of lowering dental profitability and impact pay contracts. WHAT DOES SELF-EMPLOYMENT 06 LOOK LIKE? Below, you’ll find a diagram that maps out a typical dentist's career path. FINAL YEAR AT DENTAL SCHOOL DF1 1 year working in a practice. DCT (DENTAL CORE TRAINING) 1-3 years working in a hospital, employed by the NHS, still in a ‘training role’. Similar to core training as a hospital doctor. ASSOCIATE (WORKING IN PRACTICE) Self-employed, although still receiving NHS benefits (pension/sick pay) for the proportion of NHS work done. Private work may be available to you. CONSULTANT (WORKING IN A HOSPITAL) Employed by the NHS with full benefits. Private work may be available to you. WHAT DOES SELF-EMPLOYMENT 07 LOOK LIKE? What it means to be a self-employed doctor… All fully qualified and GMC registered doctors can work as locums; it's only FY1 doctors who can't. If you choose to become a locum or do private work, you will typically be declared self-employed for this element of your earnings. As a locum you could be contracted in the following ways: A casual worker providing your services directly to the employer (sometimes through an employer bank) A casual worker through an agency A self-employed individual that has a “contract for services” with an employer A self-employed individual who has set up their own limited company Or, in rare cases, as an employee on a fixed-term contract It’s also worth noting that locums can be appointed on different contracts. A few examples include: Three months in hospital Training appointments in hospitals Single session appointments e.g. in general practices Longer appointments to cover maternity leave, illness or sabbaticals WHAT DOES SELF-EMPLOYMENT 08 LOOK LIKE? Below, you’ll find a diagram that maps out a typical doctor's career path. FINAL YEAR AT MEDICAL SCHOOL F1 Employed by the NHS. F2 Employed by the NHS. F3 Option to take a year out between Foundation and further training. You may be self-employed taking on locum work. FURTHER TRAINING Core/specialty/general practice (GP) Employed by NHS. CONSULTANT Fully trained and specialised. Likely working in and employed by NHS. May take up private work (self-employed). As a locum, you're very much there as a It depends on what you want - with service provision, so you're paid to just do locumming, you get paid more but you're not everything. If you want to go and learn more guaranteed work. In more permanent positions, then a clinical fellowship might be more suited you get a rota, annual leave, and people get to to you. know you more too, so they help you and take Harry Spiers, F2 in Manchester you under their wing. Peter Jones, F2 in Manchester WHAT BENEFITS CAN I GAIN? 09 Self-employment benefits Dentists Doctors You can decide when and how you work You can gain experience in new specialities and departments You’ll be able to work at more than one dental practice You can decide where, when and how you work You’ll be able to claim back spend on business expenditures You’ll have no obligations to work for an (see next section for full details) employer There is an opportunity to earn a You can work for more than one employer higher salary You can fit work around your lifestyle There is an opportunity to earn a higher salary If you’re planning to have time off work, that might be the time to transition to private dentistry, or to transition into self-employed jobs. Dr Beth Rushworth KEY CONSIDERATIONS FOR 10 SELF-EMPLOYMENT Moving from being employed to self-employed can seem daunting. To help you prepare for the transition, we’ve identified the key considerations you need to bear in mind when thinking about self-employment as a doctor or dentist. KEY CONSIDERATIONS FOR SELF-EMPLOYED DENTISTS: The amount of NI tax you and your employer will pay will be impacted by your employment status You won’t benefit from protections contained in employment legislation such as the right not to be unfairly dismissed Your practice will not be under obligation to offer you regular work You will not be paid overtime, as you’ll be paid a percentage of the fees you earn You will need to provide your own equipment and materials – and factor in costs for those materials – to perform work You’ll be responsible for any losses from your work, and you’ll be required to correct any unsatisfactory work in your own time Your pay may be inconsistent month-to-month if your workload varies You’ll have to provide a locum if you are unable to work, as you are contracted to do a certain amount of hours KEY CONSIDERATIONS FOR 11 SELF-EMPLOYMENT KEY CONSIDERATIONS FOR SELF-EMPLOYED DOCTORS: Employers will have no obligations to offer you work, and it is up to you to arrange your own work You’ll have to provide your own equipment Locums who set up as a limited company cannot pay into the NHS Pension Your pay may fluctuate month-to-month depending on the work you have available to you, and you might have cash flow problems whilst you wait for invoices to be paid You won't get paid annual leave, or guarantee of sick pay or maternity leave Make sure you consider what perks of certain jobs you’re going to get. For example, with private jobs you don’t necessarily get a pension, or maternity pay which you do with the NHS. So, if you’ve got big financial commitments coming up, potentially a salaried job might be better because it’s more predictable. Dr Beth Rushworth KEY CONSIDERATIONS FOR 12 SELF-EMPLOYMENT Financial management considerations: Dentists Doctors Salary Salary You’ll receive monthly schedules from your You’ll need to negotiate and set your own fees. practice principal showing your monthly earnings Typically, locums will charge a fee based on the and deductions. You must keep these as proof of number of hours worked, and you’ll need to make your income, as well as proof of business sure you agree with your place of work what your expenditure. It’s also worth seeking advice for fee covers. You’ll need to invoice each place of bookkeeping to keep it up to date. You will not work, detailing the hours you’ve worked. You will receive any sick pay, unless you are an associate not receive any sick pay.
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