Pay problems: reducing your risk | Association of Anaesthetists

Pay problems: reducing your risk

Pay problems: reducing your risk

Starting a new training rotation can be nerve-racking. Is the department friendly? Will the on-calls be manageable? But sometimes the most worrying aspect of a new job comes at the end of that first month – will I get paid correctly, or at all? Doctors have had to rotate frequently between several different hospital employers for many decades, but aside from the ‘lead employer’ model available in a few regions, little exists to make these transitions smoother. I have been in contact with HR managers and HMRC for advice on how best to help reduce the effects of these frequent employer changes on your tax code, and therefore increase the likelihood of being paid correctly.


The HR department of your new employer will require a certain amount of information to allow them to ‘open’ an employment account for you. It can be frustrating to have to continually keep supplying the same information, and I often wonder how many copies of my passport and bank statements are floating around the country. Three documents are required for an identity and address check. At least one proof must be a photo ID. Have a scan of your passport saved to your smartphone or computer, the same for your driving licence if you hold one. Supplying proof of address is becoming increasingly challenging in a world of ‘paperless’ communication. Try to keep at least one utility bill (these contain minimal personal information when compared with a current account bank statement) as a paper statement to ease this process. These documents must be sent as PDFs and not photographs. If you do not have a ‘scan’ app on your smartphone, download one. This will convert photos to multi-page PDFs to send to HR. Don’t forget that you will need to supply these same proofs in person on your first day, so remember which bill you sent! You will need to provide any visa proofs that may be required for your employment if applicable.

Other essential information includes documentation to be sent to payroll. This varies from employer to employer but will include a joining form with your personal information, bank account details, your declaration of previous service (also called an indemnity form) and a request for your most recent payslip. This is particularly relevant if you are paid according to a nodal point pay progression, or receive a Section 2 pay protection premium. Equally important is your ‘new starter’ HMRC form, which is explained below. To be deemed safe to work, and therefore eligible to be paid, you will also need to be cleared by occupational health, so these forms cannot be ignored. Your PDF proofs of vaccination and blood test results from previous employers can be requested and sent on.

There are a few important points worth noting. Firstly, forms that request a signature must be printed and signed by hand, then scanned before sending back. Merely writing your name in a calligraphy font or adding an electronic signature is not acceptable! Secondly, if you are returning from out-ofprogramme (OOP) employment or maternity leave or are on a supported return-to-work, you are strongly advised to call the HR department as additional documentation may be required. This is also true for less-than-full-time trainees and any trainees that have had a last-minute change of rotation. Finally, the workload strain that many of us experience on the front line is mirrored in non-clinical departments. Whilst HR departments will do their best to process everything, the time between induction day and the payroll cut-off date can sometimes be only a few days, so sending in your information prior to starting puts you in the best position to be paid on time.


When you leave a job a P45 is generated by your employer, usually after your final salary payment. If you start a new job, the tax code on your P45 will be used by your employer to work out how much tax needs to be deducted from your salary. Without the P45, you may end up paying too much or too little tax. Unfortunately, frequent rotations mean that the P45 procedure will not manage to keep up with you. Without your P45, your new employer is obliged to use a tax code that does not consider your personal circumstances and earnings, or taxes already paid. When it does finally arrive, you should send on Parts 2 and 3 to your new employer as soon as possible. Since you will be starting your new rotation before your P45 is available, your new employer will send a ‘starter checklist’ form (previously P46) that lets HMRC know that this is now your only job and aids your employer to allocate a tax code. Given the rotational dates of ‘the first Wednesday of the month’, you are likely to receive payment from two employers. This will very likely mean you will underpay your tax, and a correction will occur in the following month. HMRC could not give any suggestions on how to prevent this, so it would seem that some element of incorrect pay is sadly inevitable. HMRC have suggested that employees call them to notify them of the change of employer in advance, and that the P45 procedure can be expedited by employees requesting their P45 from payroll on the day of their final salary payment and informing HMRC of the details. This could prevent P45 delays pushing tax issues into more than the first month. Understanding your tax code is also important - please see ‘Decoding your tax’ in this issue.

Just when you thought that the problems were all over, pay issues can also occur even after you have left a hospital. Your department should notify HR in advance of the end of your rotation. This information is then cross-referenced to the training information grid the hospital receives from Health Education England (or devolved educational board) and the employment should be correctly terminated. If this does not occur, you might find yourself being paid by two employers, which is sadly not as much fun as it sounds, creating havoc with your tax code. As you approach the end of your rotation, confirm with your department that you have been flagged as a ‘leaver’.

Whilst getting paid correctly can seem like a bit of a lottery, it is worth spending some time to ensure the odds are in your favour.

Thanks to HMRC and an HR department for this valuable information.

Karen Stacey
Elected Member, Association of Anaesthetists Trainee Committee
Locum Consultant Anaesthetist, Imperial College Healthcare NHS Trust