2006 saw the introduction of the new NHS Dental Services Contract and the issue surrounding Associate Dentists and their Employment Status has been an issue for discussion ever since.


The big change in the 2006 contract was that the practice now owned the contract and Associates were engaged to complete the UDAs on the practice contract, rather than through their own contract with the NHS. As the practices would now set the contracts and activity for the Associates, ultimately controlling the UDA targets, the monthly payment would be the same and, therefore, a salary. Essentially the 2006 contract sought to provide for less fluctuation in income.


However, HMRC subsequently updated its Employment guidance, via ESM 4030, that so long as the standard forms of agreement for Associate Dentists were used and followed then the Associate Dentist will be assessed under trading income rules and not employment income rules. The key element of this being that the associate continues to be responsible for paying their share of laboratory and other fees.


Since 2018 HMRC has been contacting Dental Associates to assess their employment status, with the key concern being either they do not have a contract in place or, if they do, the terms of ESM4030 are not used and followed. HMRC are continuing this review, alongside the GCD, BDA and NASDAL, but believe that the CEST tool should be used by all practices when engaging an Associate. Agreements should also be reviewed with existing ones.


It is therefore important that practices understand the CEST tool, with emphasis being placed on the use of a substitute and expenses paid by the Associate and not claimed back by the practice. If the practice is following the terms of the BDA contract then the result will be that the Associate is Self Employed, but where a practice is not following the terms of the contract then they should review the engagement with the Associate.

If you would like to learn more about your trade as a dental associate then please contact us.

Written by Healthcare Client Relationship Senior Lee Jefferson.