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Kwasi Kwarteng, the new Chancellor of Exchequer, delivered his first budget announcement that cut Income Tax, National Insurance, Corporation Tax, and Stamp Duty.

Prime Minister Liz Truss and three other conservative MP's published a booklet back in 2010 titled ‘Britain Unchained’ that set out their vision for the UK to be a leading player in the world economy.

The cuts outlined below may be the beginning of their vision as set out over 10 years ago when they became newly elected MP’s.


All members of the NHS pension scheme pay a percentage of their pensionable pay towards the scheme.  From 1st October 2022, the amount you pay for your pension will change and further changes are planned in 2023.  For many of you, this may result in a lower percentage paid in pension contributions.


As your private practice grows, you will need to build a team to support you. This may be a secretary or administrative support or another healthcare professional.

Unlike your work in the NHS, where these resources are likely to be already available, you will need to build your own team. The team you pick can impact the success of your private practice and can have different financial implications.


Medical Secretary

A medical secretary will likely be your first – and possibly the most important – role you recruit for. Your secretary will often be your patients’ first point of contact as they look to arrange an appointment with you.

Medical secretaries are usually either:

  • Employed by the private hospital where you work;
  • Work on a self-employed basis or via a limited company;
  • Employed by your business.

In most cases, secretaries are employed by the private hospital or the secretary is self-employed. You will be billed monthly for the hours/days the secretary has supplied or, occasionally, a per-centage of your fees. You should be provided with an invoice detailing the hours they have worked for you and then the amount.

For accounting purposes, you should keep either a physical or electronic copy for seven financial years. No employment rights Secretaries paid in this way have no employment rights from your business. This means that if they are sick or on annual leave, they should not be paid or alternatively a replacement should be provided to you.

Secretaries working in this way will often be working for a number of consultants. As your private practice grows, it may be that you find you require a secretary that works exclusively for your business. Where someone is working exclusively for you, it is likely that HM Revenue and Customs (HMRC) would class them as an employee rather than someone who is self-employed.

This status is not a choice, but a question of fact. To help you determine the status, there is a toolkit available on the HMRC website.