Revealed: how locum doctors work as private firms to earn up to £1,700 a shift at hospitals

Locum doctors are setting themselves up as private companies to maximise the “lucrative” rates hospitals are being forced to pay to staff their A&E departments, the Standard can reveal.

The stand-in medics use the device to avoid paying higher rates of income tax as they earn up to £110 an hour, according to a consultant in charge of one of the capital’s busiest emergency departments.

They are able to “pick and choose” when and where to work and typically take home more than the salary paid to the consultants in charge of the department.

Kathryn Channing, clinical lead for emergency medicine at Croydon hospital, told a London Assembly investigation into the A&E crisis: “The financial benefits of being paid by the hour far outweigh [taking a staff job].

“They set themselves up as PLCs. They can pick and choose when they want to work... it’s far more lucrative.”

She told the Standard that Croydon was like most other London NHS trusts in having to pay higher agency rates for temporary staff to keep its casualty ward safe.

“The ballpark figure for a senior registrar is around £80 to £85 per hour,” Dr Channing said. “The agency will take a cut of that, between £10 and £20 per hour. Consultants average £100 to £110 per hour, with the agency taking £20.

“A lot of doctors not in full-time work have recognised: ‘Why should I go on to a NHS salary when I can make that level?’ When they set themselves up as private companies, they are only paying 25 per cent tax on that. It’s not everybody but it’s becoming more commonplace.

“They are quids in. They can pick and choose when they work, and they can work it around childcare. The agencies help them revalidate [as doctors] amd provide tax advice. It’s a whole package. We can’t compete with that.

“They are good people, and they’re getting a good rate for working a nightshift, but it’s difficult to justify it. I’m not sure what the solution is.”