Employment taxes support for NHS Organisations

NHS organisations manage complex workforces bank and agency staff, locums, secondments, honorary contracts, volunteers and flexible rotas. That complexity brings employment tax risk. Our job is to make the rules clear, embed workable controls and leave you with evidence that stands up to audit and HMRC.

What we help you get right

We focus on the pressure points we see most often across Trusts, ICBs and arms-length bodies: IR35/off-payroll decisions for locums and specialists; National Minimum Wage pitfalls around uniforms, deductions, unpaid time and salary sacrifice; and expenses and benefits compliance (P11D/PSA) including travel, subsistence and staff benefits. Where needed, we align finance, HR and procurement so policies, contracts and payments match the tax treatment.

How we work

We start with a short triage to locate the material risks and quick wins. Then we help you fix the root causes – updating policies and templates, training budget-holders and approvers, and shaping simple workflows (with audit trails) for status assessments, NMW checks and benefits reporting. If HMRC is already engaged, we prepare your position, negotiate where appropriate and minimise disruption to BAU.

Outcomes you can expect

Fewer surprises. Clear, documented decisions. Confident responses to internal audit, external audit and HMRC queries. Most importantly, fair and consistent treatment of staff, without accidental overspend on tax, penalties or arrears.

Typical deliverables

• IR35/off-payroll framework tailored to NHS engagements, with ready-to-use assessment records.
• NMW risk review focused on deductions, unpaid time and rostering practices – plus practical fixes that payroll can run with.
• Expenses & benefits (P11D/PSA) policy pack, travel rules and a data checklist for year-end.
• Training sessions for HR, payroll and budget-holders so compliance sticks.

Next steps

Book a 20-minute scoping call or email the CRSTAX team. We’ll confirm priority risks, set out a simple plan and give you an implementation timeline that fits NHS operational reality.