Can aesthetic practitioners be self-employed whilst employed by the NHS? - Hamilton Fraser


We know that many of our members juggle medical roles in the NHS with their aesthetics work. Our COVID-19 survey revealed that many more actually returned to the NHS to provide frontline support during the pandemic – you can read their stories here. But what are the implications for self-employed practitioners of being employed by the NHS when it comes to issues such as tax? And what do NHS employees looking to set themselves up in aesthetics need to consider – can aesthetic practitioners actually be self-employed whilst they are employed by the NHS?

The short answer is “yes”. Unless there is anything in your employment contract that says otherwise, you can always take on another job or work for yourself. You must, of course, make sure that it doesn’t affect your performance in your main job so if you are an NHS employee looking to branch out into aesthetics work on a self-employed basis, you will need to make sure that your aesthetics activities run smoothly alongside your NHS work.

You may decide to set aside certain days or hours for delivering treatments in your self-employment and you will also need to allocate time to do the sales, marketing, purchasing and admin for it.

Smiling young female entrepreneur working on a laptop while sitting at a table in her home office

What do you need to do to start as a self-employed aesthetician?

1.What’s in a name?

You might want to trade under your own name or another trading name. If you are a sole trader then the legal name of your business will always be your name, but you can be more creative about your trading name. Your legal name must be on all official paperwork and invoices for the business.

Decide if you want to run your business as a sole trader or a limited company. The former is simpler but the latter gives you more flexibility about the timing of taxes when combined with another employment etc.

2. Build it and they will come?

Just opening a business doesn’t mean that you will have a queue of customers. You will need some sort of marketing. In a nutshell, you need to figure out who your target customer is and put the word out wherever it is that they usually hang out – check out our article, Digital marketing for aesthetic practitioners, for more detailed advice, but you might want to consider:

  • Telling everybody you know
  • Setting up a Facebook page
  • Setting up Facebook ads or Google ads
  • Advertising in the local paper
  • Setting up a website and a blog
  • Posting useful content that answers questions people may have about your services and your field of expertise. This will help them to recognise you as an authority in your area
  • Posting helpful information on social media and linking to your blogs
  • Setting up a referral scheme
  • Running seasonal marketing campaigns

Our comprehensive guide on Marketing for aesthetic practitioners offers lots more useful information.

3. Cover yourself

You will need professional indemnity and other insurances. Although it is not currently a legal requirement to arrange insurance cover before carrying out aesthetic treatments, the Joint Council for Cosmetic Practitioners is seeking to enforce compulsory medical insurance and indemnity cover within the aesthetics sector across the UK for all practitioners.

The financial consequences for practitioners arising from allegations of negligence relating to malpractice can amount to tens of thousands of pounds, not to mention the risks to patients should something go seriously wrong. Malpractice insurance is essential for any cosmetic professional and will protect you against any potential costs and damages you may be legally liable to pay, arising out of any insured treatments you provide or advice you give to patients. You can find out more about Hamilton Fraser’s medical malpractice insurance here.

Make sure that you stay up to date with your CPD (continuing professional development) if your business requires skills and knowledge that you are not already using in your employment. You can find out more in our article, Everything aesthetic practitioners need to know about CPD. Put processes and checks in place so that you always do a good job. This will minimise any insurance claims but also ensure customer satisfaction so that your clients keep coming back and referring you to their friends.

4. Negotiating

You will need to buy things for your business. In order to get the best deal you can shop around but you want to ensure that you get good quality for your money. Join professional groups who can help you to source the products and services that you need to run your business. But be aware of the grey market and always check to make sure that you are sourcing from a legally operating, listed and reputable supplier and keep a full audit trail of your order history. It’s important to make sure you’re not accidentally invalidating your insurance cover or putting patients at risk.

5. A place to stay

Decide where you will work. Will you have people come to your home or will you go to them, perhaps working as a self-employed mobile practitioner? Both have risks and benefits. You can claim an element of your home if you use it as an office.

Or will you rent or buy separate premises? This will potentially look more professional, may have frontage for signage and gives you somewhere to store everything. But, of course, there is a cost so you need to decide whether to do this from day one or to aim towards setting up your own premises in year two or three of your business.

individual writing down something while using a calculator

6. Tax can be taxing

Which brings us onto the subject of tax. Sole traders will need to register with HMRC by 5 October after the end of the tax year in which you became self-employed – for example, if you become self-employed in September 2021 that is during the tax year 6 April 2021 – 5 April 2022, so you can register any time between September 2021 and 5 October 2022.

If you register earlier then you will have the benefit of reminders from HMRC. If you register too late there may be penalties but these will be reduced if you register sooner. Find out more about registering as self-employed at GOV.UK.

There are thousands of pages of tax law concerning running a small business and they change each year. At the moment, there is only a requirement to submit one tax return per year but, from April 2023, MTD (making tax digital) means that sole traders will have to make quarterly submissions as well as a year-end return.

The annual tax return has separate pages for each source of income so you will need to fill out an Employment page based on your P60 and P11d from the NHS, as well as a self-employment page for your new business.

7. Bookkeeping and accounts

MTD will require you to keep digital records. It is worth investing in bookkeeping software to help you throughout the year. This can be connected to your business bank account and will save you a lot of manual input. With something like Xero, Quickbooks Online or Freeagent you can take photographs of your business bills and upload them into the software.

If you keep good records throughout the year your accounts and tax return will be much simpler so this should give you a cheaper accountancy bill. If you intend to use an accountant then register with them sooner rather than later as then you will be able to ask them any other questions as you go along.

Although your business may start as a small concern alongside your main employment it is worth doing things properly from the beginning. Whether you are just starting out in aesthetics alongside your NHS work or have been working as a self-employed practitioner for a while, business planning is key to establishing a sustainable, profitable and successful business. You can find out more in our comprehensive guide, Creating an aesthetics business plan.

About the author

Della Hudson

Accountant, founder of two businesses, mother of two teens and author of two books. Della Hudson knows her stuff so was voted one of Tide’s ‘20 female entrepreneurs to watch in 2020’. Her passion is to help business owners to understand the handful of important numbers that will help them to grow their business.

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