Imagine being your own boss as a nurse.
Working when you want, as often (or as little!) as you like.
No manager to ask permission from, no rota to keep in mind.
Picking up shifts when you need to.
It's all possible when you become an independent nurse.
Also known as an agency nurse, you work for yourself rather than a single employer when you're an independent nurse. You do this by picking up shifts at different workplaces, either full-time, or in addition to a job you already have. You find shifts by signing up to an agency, or a recruitment platform like Florence.
Why? To bring more freedom, flexibility and control to your life.
If you’d like to start working for yourself, but you’re not sure how, this post will show you what to do to get set up. Read on to discover how to sort out getting paid, how to find shifts, and how to maintain your career once you begin.
Also included is advice from real independent nurses who have chosen to work through Florence. Understand more about why Florence is good for nurses.
Setting up as an independent nurse
There are several things you’ll need to have in place before you can start working as an independent nurse. First, you’ll need to sort out how you will receive payment for your work, and how to pay your taxes.
Many nurses opt to be paid through their own limited company, as there are lower associated taxes. This requires more maintenance and admin than other methods.
The alternatives are to be paid via an umbrella company, or PAYE. Both mean taxes are taken care of for you, but you pay a higher rate. Each option will be explained in more detail below.
Being paid via a limited company
1. Register as a limited company
Registering your limited company at Companies House costs £12,and is relatively straightforward (it takes only few hours’ prep work). After this, you’ll spend around 15 minutes per month keeping your company records up to date. For more on what to do to get your limited company set up, read the government’s step-by-step guide here.
2. Open a business bank account
Apply online or visit your local bank branch to open a business account in your name. This isn’t legally required, but does make it easier for you to separate and identify your earnings.
This will help when it comes to filling out your annual tax return (which is required if you’re working through a limited company), as it makes managing your accounts and records much simpler.
If you don’t want a business account, then a separate bank or savings account will still allow you to account for and manage your earnings.
3. Get an accountant
This might sound extravagant if you’re newly setting up, but many accountants offer reasonable rates.
For a small fee, it could be worth using a professional so you can avoid time-consuming paperwork and account management.
4. Get insurance
Indemnity insurance covers the financial cost of any claims brought against you in your professional life. It’s essential to get insurance that adequately covers your practice before working as an independent nurse.
You can purchase cover from a number of independent organisations, for example UNISON. However, you’re likely to be covered already if you’re a registered member of the RCN. Understand more about the RCN’s indemnity scheme here.
How do I pick up shifts through my limited company?
Once your limited company is set up, you can sign up to a nursing agency or Florence to find shifts. To sign up to either you will need to provide your NMC PIN, proof you have completed mandatory training, and undergo background checks. Specific requirements vary between agencies, but you can see a checklist of all that is needed for Florence here.
After you have finished the registration process, you’ll be able to pick up shifts through your organisation and be paid via your limited company.
Want to skip some steps?
You may want to avoid the time and paperwork associated with managing your own taxes.
If so, the alternatives are to get paid via an umbrella company, or PAYE. Both options mean paying a higher rate of tax than via a limited company.
Alternative 1: get paid via PAYE
PAYE stands for ‘pay as you earn’, and is the government's system for collecting tax from UK employees. If you sign up to Florence, or an agency that offers this payment method, you can choose to get paid via PAYE.
Getting paid by PAYE means your income tax, National Insurance and student loans are paid from your earnings before they reach your bank account. You can be 100% sure you are paying the correct taxes, and you don’t need to use an accountant, or take out your own indemnity insurance.
With Florence you can get paid either via PAYE or your limited company.
Alternative 2: get paid via an umbrella company
Umbrella companies act as employers for nurses working on fixed term contracts. If you opt to get paid via an umbrella company, they will collect your earnings and pay you after deducting tax, National Insurance, any student loan payments, and their own fee.
You don’t need an accountant, but you may still need to sort out your own indemnity insurance if using an umbrella company. Some provide cover, some do not.
Usually, umbrella companies have agreements with nursing agencies, so if you sign up to an agency that offers this payment method, you may automatically work with the partnered umbrella.
You could also sign up to an umbrella company directly and find shifts without an agency.
Note, Florence does not work with umbrella companies. You may only get paid via PAYE or your limited company if signing up to Florence.
Nurses’ tips for setting up your limited company
“Don’t rely on accountants to do everything for you. It’s important to have some knowledge and awareness of significant dates.”
Linia R, RGN
“I work as a limited company, as it’s easier to stay on top of taxes. With Florence, I can keep track of what I’ve been paid and how much I’m earning. A business account is essential for independent nurses, and a good professional relationship with your accountant is important.”
Amos S, RGN
“I use an accountant and tax services company. Accountants are useful if you work a lot as it’s easier to see your expenses and your income is also clearer to see.”
Mujidat L, RGN
Still unsure whether to take the plunge?
It can feel scary to start working for yourself full-time. If you are already employed, remember you can pick up shifts as an independent nurse without giving up your current job. Choose to go full-time later, if it suits you.
Managing your earnings as an independent nurse
You’ve followed the steps above, and have started to book shifts as an independent nurse. What’s next? If you’ve chosen to work through a limited company, follow the tips below to stay on top of your earnings and taxes.
1. Record your earnings and spending
Document your business earnings, outgoings and expenses accurately. Maintaining an account book so that you can easily record everything earned and all costs, is essential and will make your life much easier.
2. Keep receipts
Keep receipts for essential expenditure and items, as a non-taxable portion of your income. This might include receipts for shoes/uniforms, washing/laundry expenses, mandatory training/study day costs, travel, professional membership and insurance fees.
If you need assistance with storing receipts, you should register with our friends at 1tap.
3. Complete annual tax returns on time
Submit your tax return on paper by tax returns October 31st each year.
Online tax returns should be submitted by January 31st each year. Not filing a tax return on time can result in a fine.
4. Set a portion of your earnings aside
It’s a good idea to set some money aside each month to cover the annual tax you are liable to pay. This will make it easier on you when it comes to paying your tax, and will prevent you having to pay a hefty lump sum all at once.
Pay rates for independent nurses
The chance to earn more is a strong reason to choose to work as an independent or agency nurse.
Naturally, you’ll want to know how much extra money you can get before you start.
There isn’t a one-size-fits-all answer. Pay rates offered for shifts will depend on location, required skill-set, time of year (e.g. you can expect higher rates for less desirable shift times, such as Christmas) and other factors relevant to the shift and care setting. In general, independent workers are able to earn a higher hourly rate than equivalent permanent staff, due to the need the care provider has to fill the shift.
If you’re being paid via a limited company or umbrella, use a take home pay calculator to know your potential earnings after tax when considering a shift. If you’ve opted to be paid via PAYE, the rate you’re given is what you keep.
Looking after your career as an independent nurse
Nurses love the earning power and flexibility of working independently. However, you can encounter challenges when choosing this line of work.
The nature of the role is managing yourself - your time, your training, and your own career development. You need more self-reliance than when working at organisations, which have built-in development paths and support structures for employees.
Once you’re working independently, one challenge is to stay on top of your training and the requirements for NMC revalidation. Another is finding outside help when you need it. Follow our solutions below to help you stay in control of your career as an independent nurse.
Stay on top of training and revalidation
Revalidating and completing training as an independent nurse can be more challenging if you don’t prepare for the process. If you know what you need for revalidation, however, you will be able to plan the work into your practice as an independent nurse.
Take a look at our post on revalidation to refresh yourself of the requirements.
Who can confirm my revalidation when I work for myself?
Build a good professional relationship with colleagues you work with in different settings. Your confirmer can be any NMC registered nurse, or another regulated healthcare professional (list of professions here). You may find it harder to get a staff member to sign off on your reflection if you’ve only worked somewhere once or twice, so try to find regular shifts in the same places.
How can I find a reflective discussion partner?
Reach out to nurses that you’ve worked with before, or others looking for a reflective partner in online nursing groups - you can return the favour for each other. Try the [‘independent nurse network’](hyperlink to FB page) on Facebook for this.
How do I complete CPD?
Participatory learning takes up most of your CPD hours, and requires interaction with other professionals. Complete participatory hours through online discussions on Twitter - @WeNurses hold around 500 tweetchats a year.
Click here for their upcoming tweetchats so you can join in.
You can update your mandatory training using free resources such as Florence Academy, which is CPD-accredited.
How do I prove I’ve worked my 450 hours?
Keep a record of your shift hours worked. This can be in any format you’re comfortable with - such as in a Google spreadsheet, or printed and placed in a folder.
Real nurses’ tips for revalidation
“For revalidation, I will do my reflection with a home I work at regularly and collect feedback from residents I’ve cared for.”
Philip J. Johnson, RGN
“You have to find a balance between working and keeping your training up to date. The advantage of working for myself means I can take a week out to update my training. I’ve revalidated twice now, with the most recent one being this June.”
Nursing is incredibly rewarding, but it can also come with an emotional burden. Long hours, high pressure and distressing situations can be a professional reality, whether you’re employed or independent.
As an independent nurse, you won’t work in one place with regular colleagues, which makes you more vulnerable to facing issues alone. Know that help is out there if you need it.
The RCN is the first source of support for the majority of nurses. They can provide legal, financial and mental support to nurses that are registered members - and can also cover your indemnity insurance.
Cavell Nurses Trust supports working and retired nurses, midwives and HCAs through times of financial, personal hardship. If you’re a registered nurse you can apply for financial help from Cavell for free.
This guide should give you the tools to start on your path as an independent nurse.
If you have any questions about becoming an independent nurse, consider having a chat with the team at Florence - we’re happy to help! Call us on 0203 911 2555, email us on [email protected], or speak on live chat here (hit the purple button in the bottom right of your screen).
If you like the sound of independent/agency nursing, your next steps should be these:
- Figure out how you want to get paid - by limited company, umbrella company or PAYE
- If using a limited company, choose how you want to manage your tax payments - through an accountant, or by yourself.
- Open a business account, or another separate account to manage your earnings
- Decide how you will find shifts - through Florence, an agency, or both.
- Start the sign up process with your chosen organisation, after sorting out your way of getting paid.
If you sign up to Florence you can stay in control of finding and booking your shifts. Payment is fast and simple, and it takes a third of the time to register than with a traditional nursing agency.
You could be picking up shifts next week, if you start sign up today.
Enjoy the freedom of being an independent nurse.