Key takeaways
- Employed healthcare workers can claim tax relief on professional fees and subscriptions paid to bodies on HMRC's List 3 — including the GMC, NMC, GDC, GPhC, HCPC and the royal colleges — at their marginal rate of tax.
- Claims can be backdated four tax years, so a first-time claim covering registration fees, royal college subscriptions and indemnity can be worth a meaningful refund.
- Flat rate expenses cover uniform laundry for nurses and other healthcare staff with no receipts needed — the amounts are modest and vary by role on HMRC's flat rate list.
- Employees can claim mileage relief at 45p per mile (first 10,000 business miles, 25p after — 2025/26) for unreimbursed journeys between work sites, but never ordinary commuting.
- Self-employed locums and private practitioners deduct a far wider range of expenses — indemnity insurance, equipment, update training, home office and accountancy fees — under the 'wholly and exclusively' rule.
Most doctors, nurses and other healthcare workers pay for things out of their own pocket that HMRC will give tax relief on — GMC or NMC registration, royal college membership, laundering a uniform, driving between sites. Yet a large share of those entitled never claim, and because claims can be backdated four tax years, the refunds left unclaimed are often worth hundreds of pounds.
This guide explains what you can claim for the 2025/26 tax year, the crucial difference between employed and self-employed claims, and how to actually get the money back. It's written by the team behind GoForma's specialist medical accountants service.
Employed vs self-employed: two different expense regimes
Before anything else, work out which regime you're in, because the rules are completely different.
If you're employed — which covers most NHS doctors, nurses, midwives, paramedics and allied health professionals paid through PAYE — an expense is only deductible if it's incurred wholly, exclusively and necessarily in the performance of your duties. That word 'necessarily' makes this one of the strictest tests in UK tax law: it isn't enough that the spending helps you do your job, or even that your employer expects it.
If you're self-employed — locum work invoiced directly, private practice, aesthetics clinics, expert witness work — you can deduct anything incurred wholly and exclusively for the business. That's a noticeably more generous test, which is why a locum can often deduct expenses an employed colleague in the same hospital cannot.
Plenty of healthcare workers are both at once: a salaried hospital doctor with private clinic income, or a nurse doing PAYE agency shifts alongside self-employed aesthetics work. In that case you apply each set of rules to each income stream separately.
| Expense | Employed (PAYE) | Self-employed (locum / private practice) |
|---|---|---|
| Professional fees (GMC, NMC, HCPC, GDC, GPhC) | Yes — if the body is on HMRC's List 3 | Yes — business expense |
| Medical indemnity (MDU, MPS, MDDUS) | Often — allowable List 3 claim where you pay personally | Yes |
| Uniform laundry | Flat rate expense only | Actual cost for genuine uniform / protective clothing |
| Travel between work sites | Yes — mileage relief on unreimbursed business journeys | Yes — business travel |
| Ordinary commuting | No | Usually no — depends where your business is based |
| Training and CPD | Rarely — very strict rules | Yes, if it updates existing skills |
| Exam fees for new qualifications | No | Generally no — a new skill is treated as capital |
| Equipment you must buy for work | Sometimes — must be necessary for the job | Yes |
| Home office | Very rarely | Yes — a reasonable proportion |
| Accountancy fees | No | Yes |
If you work through your own limited company, a third set of rules applies — the company claims the expenses rather than you personally. Our locum doctor tax guide covers that setup in detail.
Professional fees and subscriptions (List 3)
The most valuable claim for most employed healthcare staff is tax relief on professional fees and subscriptions. HMRC allows the deduction where the organisation appears on its approved list of professional bodies — known as 'List 3' — and the registration or membership is necessary for your role, or directly relevant to it.
List 3 includes the bodies most healthcare workers pay:
- General Medical Council (GMC)
- Nursing and Midwifery Council (NMC)
- General Dental Council (GDC)
- General Pharmaceutical Council (GPhC)
- Health and Care Professions Council (HCPC)
- The medical royal colleges (RCGP, RCP, RCS, RCoA and others)
- Unions and professional associations such as the BMA and RCN, where listed
Relief is given at your marginal rate of tax. A basic-rate taxpayer gets 20% of the fee back; a higher-rate taxpayer gets 40% (Scottish rates differ slightly). So a higher-rate doctor paying £1,000 a year across GMC retention, a royal college subscription and a defence organisation gets roughly £400 a year back — and because claims can be backdated four tax years, a first-time claim covering the full period can be worth well over £1,000.
Medical indemnity deserves a special mention. Subscriptions to the defence organisations — the MDU, MPS and MDDUS — are deductible for the self-employed as a straightforward business expense, and they're also an allowable List 3 claim for many employed doctors who pay personally for cover their employer doesn't provide.
Two conditions apply to every fees claim: you must have paid the fee yourself (if your employer pays or reimburses it, there's nothing to claim), and the body must actually be on List 3 for the year you're claiming — check HMRC's published list if you're unsure.
Uniform, laundry and equipment for employed staff
If you wear a recognisable uniform — scrubs, a tunic, anything you'd only wear at work — and you have to wash, repair or replace it yourself, you can claim a flat rate expense for laundry without keeping any receipts.
The conditions: your employer requires the uniform, provides no laundering facilities you could use, and doesn't reimburse the cost. The flat rate amounts are set by HMRC and vary by role — nurses, midwives and ambulance staff have their own rates on HMRC's flat rate expenses list, and there's a modest standard allowance for everyone else. Because relief is given at your marginal rate on the flat rate (it isn't paid out as cash in full), the annual value is small — but it's automatic once it's in your tax code, it renews every year, and it can be backdated four tax years like everything else.
Nursing staff required to wear particular shoes or tights at work can usually claim an additional small flat rate for those too — again, the current amounts are on HMRC's list.
Equipment is treated separately. If you must buy equipment to do your job — a stethoscope, surgical scissors, a fob watch — and your employer doesn't provide or reimburse it, you can normally claim the full cost. The test is still 'necessarily': kit that's genuinely required for the role qualifies; things that are merely useful don't.
Mileage and travel
Employees who use their own car for work journeys can claim mileage relief using HMRC's Approved Mileage Allowance Payments (AMAP) rates. For 2025/26 these are 45p per mile for the first 10,000 business miles in the tax year and 25p per mile after that.
What counts as a business journey:
- Travel between sites during the working day — hospital to clinic, surgery to nursing home
- Community visits — district nurses and health visitors driving between patients
- Travel to a genuinely temporary workplace, such as a short secondment
What never counts: ordinary commuting between home and your usual workplace. Driving from home to the same hospital every shift is not claimable, however long the journey.
If your employer reimburses mileage at less than the approved rate, you can claim Mileage Allowance Relief on the shortfall. A community nurse who drives 3,000 unreimbursed business miles in 2025/26 has a claim of £1,350 (3,000 × 45p) — worth £270 to a basic-rate taxpayer or £540 at higher rate.
For the full rules, see our guide to claiming business mileage, or put your own numbers into our mileage claim calculator.
Training and exam fees
This is where the employment rules bite hardest. As an employee, you generally cannot claim tax relief on training courses, CPD or exam fees — even royal college membership exams, even where passing them is essential to progressing in your career. HMRC's long-standing position, repeatedly upheld at tribunal, is that training prepares you to perform your duties rather than being incurred in the performance of them — so the 'necessarily in the performance of' test fails.
The practical workaround is to get your employer to pay. Employer-funded work-related training is exempt from tax as a benefit, so a study budget or course funding from your trust is far more tax-efficient than paying personally and hoping for relief that won't come.
The self-employed get a better deal, with one important boundary: training that updates or maintains your existing expertise — clinical update courses, CPD for revalidation, conference fees in your specialty — is deductible. Training that gives you a completely new skill or qualification is treated as capital and generally isn't.
If you have both employed and self-employed income, the same course can be deductible against your locum profits while remaining non-claimable against your salary — another reason the employed/self-employed split matters.
How to actually claim
For employed staff, the route depends on the size of the claim:
- Expenses of £2,500 or less in a tax year: claim online using form P87 through your Government Gateway account. HMRC will usually adjust your tax code or send a refund, and you can include up to four previous tax years in one claim.
- Expenses over £2,500 in a tax year: you'll need to register for and file a Self Assessment tax return.
- Already filing Self Assessment (locum income, high earnings, rental property): claim your employment expenses through the return rather than a separate P87.
If you're self-employed, all business expenses go through your Self Assessment return as deductions from your trading income.
Whichever route you use, keep:
- Annual fee receipts or confirmation emails from the GMC, NMC, royal colleges and defence organisations
- A mileage log: date, start and end point, miles, purpose of the journey
- Payslips or a P60, plus anything showing your employer did not reimburse the cost
- For the self-employed: invoices and receipts for every expense claimed
One warning: claiming yourself is free and genuinely straightforward, so be wary of tax rebate agents who take a large cut of any refund — some charge 30% or more for filling in the same P87 you could complete in twenty minutes.
It's worth getting an accountant involved when your position stops being simple: mixing PAYE employment with locum or private income, working through a limited company, large backdated claims, or earnings near the thresholds where pensions and the High Income Child Benefit Charge start interacting. GoForma's specialist medical accountants work with doctors, nurses, locums and private practitioners every day — book a free accounting consultation and we'll tell you what you can claim, and whether it's worth backdating.