Guides · Updated 13 October 2026

VAT for locums. When it applies.

Most locums never register for VAT. It is still worth knowing where the line is, because the rule looks back over the last 12 months, not the tax year.

A calculator, a pen and paper on a desk

The threshold

You must register for VAT if your taxable turnover for the last 12 months goes over £90,000, or if you expect it to go over £90,000 in the next 30 days. It is a rolling 12 months, so check it as the year goes on, not only in April.

Example: Going over the threshold in July

During July: Your last 12 months of taxable turnover pass £90,000 for the first time
By 30 August: You must register, which is 30 days from the end of July
From 1 September: You are registered, and charge VAT from this date

This follows the example GOV.UK gives.

What counts

Taxable turnover is the total value of everything you sell that is not exempt from VAT. It is your income before expenses, not your profit. If everything you supply is exempt, you do not have to register.

Why healthcare needs a closer look

Some services provided by registered health professionals are exempt from VAT, and some are not. HMRC's guidance treats providing care differently from supplying staff. Which side your locum work falls on depends on what you supply and to whom, so this is one to settle with an accountant before you get near the threshold.

Registering by choice

You can register voluntarily below the threshold. It is rarely worth it for a locum whose costs are small, but an accountant can tell you.

How to watch the total

At the end of each month, add up the last 12 months. Not the tax year, and not January to December. A year with a few busy months can cross the line well before April.

What changes if you register

You add VAT to your invoices, show your VAT number on them, and send VAT returns through compatible software. Your fee to the workplace goes up by the VAT unless you agreed otherwise, so tell them before it happens.

Where Locbase fits

Locbase keeps a running record of what you have earned from every workplace, which is the figure you need to watch. It does not tell you whether your work is exempt.

Questions

Do locums charge VAT?

Only if they are VAT registered and the service they supply is taxable. Most locums are below the threshold. Whether your work is exempt is a question for an accountant.

What is the VAT threshold?

£90,000 of taxable turnover in the last 12 months, or expected in the next 30 days.

Is the VAT threshold based on profit?

No. It is based on taxable turnover, which is what you charge before any expenses.

Is the VAT year the same as the tax year?

No. The test looks at any rolling 12 months, so it has to be checked month by month.