Last updated: 16 October 2026
Are associate dentists employed or self-employed?
Most associate dentists are treated as self-employed. HMRC has long accepted that associates working under the BDA model associate agreement are self-employed, because they bear financial risk, are paid a share of fees, and can have their own patient lists. However, status depends on the actual working arrangements, not just the contract. If a practice controls hours, sets treatment, fixes pay regardless of income and bears all risk, an associate could be an employee. Recent tribunal decisions and the IR35 rules mean practices should review contracts carefully.
Factors that support self-employment
- Paid a percentage of fees earned, with a share of bad debts
- Pays laboratory fees or a share of them
- Freedom over working hours and holidays
- Can arrange a locum substitute
- Has their own professional indemnity insurance
Factors that point to employment
| Factor | Points to employment |
| Fixed daily rate whatever the earnings | Yes |
| Practice sets the diary entirely | Yes |
| No right of substitution | Yes |
| Practice pays all costs | Yes |
| Holiday pay and sick pay | Yes |
Tax for self-employed associates
Self-employed associates file Self Assessment returns, paying income tax and Class 4 NIC at 6% between £12,570 and £50,270 and 2% above. They can claim expenses such as indemnity, GDC fees, courses and equipment. From April 2026, those with income over £50,000 must keep digital records under MTD for Income Tax.
NHS pension
Associates in NHS dentistry can join the NHS Pension Scheme as practitioners, even though self-employed. Contributions are tiered and deducted by the practice.
Example
Dr Patel works four days a week at a practice under a BDA-style contract, receiving 50% of fees after lab costs. She has her own indemnity, takes holidays when she chooses and can send a locum. In 2026/27 her fees share is £110,000. She’s self-employed and pays tax and Class 4 NIC through Self Assessment, after deducting £8,000 of expenses.
Associates using a limited company
Some associates trade through a company. If the arrangement would be employment without the company, IR35 applies. Small practices aren’t responsible for status decisions under off-payroll rules, so the associate’s company must decide.
Common mistakes
- Relying on the contract title rather than practice
- Not paying payments on account
- Missing NHS pension paperwork
- Ignoring IR35 when using a company
Records to keep
Keep the associate agreement, fee statements, lab invoices and evidence of working arrangements.
The BDA model agreement
The British Dental Association model associate agreement sets out fee splits, notice periods, lab fee sharing and the associate’s right to engage a locum. Using it, and following it in practice, gives the strongest support for self-employment. Practices that change terms, such as guaranteeing a minimum daily payment, should check the effect on status first.
Payments on account
New self-employed associates are often surprised by their first January tax bill, which includes the balance for the first year plus a first payment on account for the next. Setting aside around 30% of income from the start avoids cash flow problems.
Frequently asked questions
Are dental nurses self-employed?
Usually employees, but it depends.
Does VAT apply to dental fees?
Most dental care is exempt.
Can I deduct my GDC fee?
Yes.
What is CEST?
HMRC’s employment status tool.
Related: employed or self-employed with a company, professional fees relief and umbrella deemed payments.
Talk to Accotax
Want this handled for you? Our team at Accotax can help with associate dentist status advice. See our contractor accountants service, or contact us for a free, no-obligation quote.
This page is general guidance based on HMRC rules for the 2026/27 tax year, checked against gov.uk on 16 October 2026. It is not personal advice, so speak to an accountant about your own situation.
