1. Payment and contracting of off-payroll workers (IR35)
As the rules on off-payroll workers in the public sector have changed, we recommend that the following roles fall within IR35 at NHS trusts and NHS foundation trusts:
All medical and dental training grades
All medical consultants and GPs who are working under the direction of the trust’s Medical Director
Nursing and midwifery roles at AfC bands 1 - 5
AHPs at AfC bands 1 – 5
Non-medical non-clinical roles at AfC bands 1-5
We anticipate that the following roles should also fall within IR35 but recommend that you check using HMRC’s digital tool:
Nursing and midwifery roles at or above AfC band 6
AHPs at or above AfC band 6
Non-medical non-clinical roles at or above AfC band 6 or within the very senior manager (VSM) range
For all roles, personal service companies (PSCs) or limited liability partnerships (LLPs) will not be allowed to send substitute workers to trusts when the contracted worker is unavailable.
Staff banks, including outsourced staff banks, will not be permitted to pay workers through PSCs or LLPs.
There should be no increase in rates paid by trusts for agency staff as part of this change in legislation. Trusts are encouraged to actively resist any proposed increases to rates charged by agencies and also report these to
Employment taxes and National Insurance contributions must be deducted by the trust/agency prior to remittance being sent to the worker. Trusts will have to seek permission from NHS Improvement to engage workers via PSCs or LLPs from 1 April 2017
NHS Improvement encourages trusts not to engage with individual workers through PSCs.

2. NHS Improvement support for trusts
To help trusts, NHS Improvement will be offering the following support :
The Agency Intelligence Team will help trusts check their readiness for the legislation change (this will be done via applying to engage workers through Personal Service Companies)
NHS Improvement’s Agency Intelligence Team will attend and present at the Finance Directors Forum meetings in every region on March 2017
15 March Agency Governance webinar will include best practice governance for engaging Personal Service Companies
NHS Improvement will attend the NHS Temporary Staffing Conference in Newmarket, 16 March 2017
Presentation of the agency rules
Staff will be available for questions and answers
NHS Improvement relationship managers will be trained on Personal Service Company / IR35 best practice
Additionally, NHS Improvement will work with the Recruitment and Employment Confederation (REC), the approved frameworks, and outsourced bank providers to ensure the message is consistent throughout the sector.
Any other queries or requests for support should be addressed to the Agency Rules inbox –