Doctors and Nurses Moving Abroad: UK Tax, the NHS Pension and the Departure Checklist

UK training rotations end in early August, which is why so many resident doctors and nurses fly out between August and October. The timing fits the tax rules neatly: the UK tax year runs to 5 April, so an August departure means roughly four months of UK earnings and eight months of overseas earnings in one tax year. Without relief you would be UK resident for the whole year and taxable on the lot. Split-year treatment stops that.

The main route out for hospital staff is Case 1, starting full-time work overseas. HMRC's manual sets the conditions: UK resident in the departure year and the previous tax year, non-UK resident in the following tax year by meeting the third automatic overseas test, and satisfying the overseas work criteria from departure to the end of the tax year (RFIG21040, HMRC). Meet all of that and the year divides: you are taxed as a resident on worldwide income only in the UK part, and your overseas hospital salary falls in the overseas part. Our split-year treatment guide covers the mechanics and the other cases, including Case 3 for people who cease to have a UK home.

The third automatic overseas test is the backbone. For a full tax year it requires sufficient hours worked overseas with no significant break, fewer than 91 days spent in the UK, and fewer than 31 days on which you do more than 3 hours of work in the UK (RFIG20140, HMRC); for the departure year itself the limits are scaled down by reference to your leaving date (RFIG21060, HMRC). So your first full overseas tax year, 2027/28 for an August 2026 leaver, has to be genuinely committed: a doctor flying home for a three-month UK locum block would breach the workday limit and could unravel the position back to departure day. Plan UK visits, and any UK work on them, against the Statutory Residence Test before you book.

The figures that recur through this guide, checked for 2026/27.

PAYE spreads your Personal Allowance and tax bands across a full year of expected pay, so stopping UK pay in August means your April-to-August salary has been overtaxed and most leavers are due a refund. The mechanism is form P85, which GOV.UK says is for people who lived and worked in the UK and are leaving to work abroad full time for at least one full tax year. You will need the P45 from your final NHS employer, and the claim can be made online once you have left (P85 guidance, GOV.UK).

One important exception catches a lot of medics: do not file a P85 if you will complete a Self Assessment tax return for the year you leave. The return replaces it, claims split-year treatment on the SA109 residence pages, and generates the same refund; our guide to leaving the UK: forms and your refund walks through which route applies. Note that non-residents cannot use HMRC's free online filing service for that final return: GOV.UK directs them to commercial software or paper forms (GOV.UK), a restriction covered in our SA109 online filing guide.

So who needs Self Assessment? Mostly, anyone with income outside their main PAYE employment. Agency locum work paid through PAYE generally looks after itself, but self-employed locum sessions, private practice, aesthetics work, medicolegal reports and survey income are trading income. The trading allowance exempts up to £1,000 of gross trading income a year; above that, you must register for Self Assessment by 5 October following the end of the tax year (GOV.UK). A final run of self-employed shifts before departure therefore usually makes your leaving year a Self Assessment year, and the refund arrives through the return. Letting out a UK property after you leave keeps you in UK filing permanently; see our non-resident landlord guide and our comparison of selling versus renting out your UK home.

This is the question every departing clinician asks, and the answer is blunt: for almost everyone, the NHS Pension cannot follow you abroad. Section 68 of the Pension Schemes Act 2015 prevents members of unfunded public service defined benefit schemes, which the NHS Pension Scheme is, from transferring to any pension scheme in which they could obtain flexible benefits; the only carve-out in the explanatory notes is for members who applied to transfer before 6 April 2015 (Pension Schemes Act 2015 explanatory notes).

Flexible benefits essentially means defined contribution: a pot whose value you can draw on. That covers Australian superannuation, KiwiSaver-style schemes, Gulf international savings plans and nearly every overseas arrangement you will be offered. A transfer to an overseas scheme that does not provide flexible benefits is not caught by the ban, which is the narrow theoretical QROPS route, but qualifying overseas defined benefit schemes willing to accept a transfer are rare in practice. Anyone promising to move your NHS Pension into a portable international plan is a red flag.

The general overseas transfer regime still matters for any other pensions you hold, such as a SIPP built up from locum work. A transfer overseas must go to a qualifying recognised overseas pension scheme (QROPS); transfer to anything else and GOV.UK warns of a tax charge of at least 40%. Even a QROPS transfer can attract the 25% overseas transfer charge unless an exclusion applies, broadly where you live in the receiving scheme's country or it is an occupational scheme of your employer, and transfers above your overseas transfer allowance, typically £1,073,100, are charged in any case (GOV.UK; overseas transfers guidance). Our guides on leaving a UK pension versus a QROPS transfer and foreign pensions and QROPS go deeper.

So the default is simple: leave the NHS Pension deferred, keep your overseas address current with the scheme, and check your annual statement so your record and beneficiary nominations stay correct. A deferred NHS pension is not a problem to be solved; it is a guaranteed UK income arriving at pension age, and for many emigrating clinicians it ends up the most valuable asset they own. The planning questions worth paying for are how it will be taxed between the UK and your new country when it eventually pays out, and what to do with any non-NHS pots.

The UK side is broadly the same whichever corridor you take: split year on departure, non-residence maintained by the day limits, NHS Pension deferred at home. What differs is the arrival side.

For arrival-side detail, see our guides to moving to Australia, New Zealand, Canada and Dubai, plus British expats in the Gulf and pensions when moving to the Gulf.

Your National Insurance record stops building the day your NHS payslips stop, and gaps now mean a smaller State Pension later. GOV.UK confirms you can pay voluntary contributions from abroad to protect your State Pension whether or not you ever come back, though they do not cover health insurance where you live (GOV.UK). The application is form CF83, and the decision inside it is which class you pay.

Class 2 is the prize. At £3.65 a week for 2026/27, a full qualifying year costs under £200, against £18.40 a week, nearly £960 a year, for Class 3 (GOV.UK). To pay Class 2 abroad, HMRC's NI38 guidance requires that you are working abroad, that immediately before going abroad you were ordinarily an employed or self-employed earner in the UK, and either 3 continuous years of UK residence at some point or sufficient contributions already paid (NI38, GOV.UK). A doctor going straight from an NHS contract into a Sydney hospital job typically fits squarely; Class 3, with its own conditions in NI38, is the fallback.

Two wrinkles. First, if a UK employer sends you abroad temporarily, you may have to keep paying ordinary UK National Insurance for the first 52 weeks; that applies to secondments rather than resignations (GOV.UK). Second, check your State Pension forecast before you apply so you know how many qualifying years you already hold. Our guide to voluntary National Insurance from abroad covers whether the top-ups pay for themselves; for most people with a partial record they do, many times over.

Most clinical leavers carry a student loan, and the loan follows you. GOV.UK is clear: you must tell the Student Loans Company if you are leaving the UK for more than 3 months, and you will be expected to keep repaying unless you can give proof, such as a recent bank statement, that your overseas income is below the threshold. Thresholds differ by country: for 2026/27, the Plan 2 lower threshold in the UAE is £23,510 against £29,385 in the UK (Plan 2 overseas thresholds, GOV.UK). Ignore this and arrears stack up and must be paid on top of normal repayments, and coming home without updating your details can leave you paying at the wrong country's rate (GOV.UK).

The fix is ten minutes' work: update your details with the SLC before you fly, provide salary evidence when asked, and update them again if you change country or come back.

Registration fees are one of the few tax reliefs clinicians reliably qualify for, and the move is the moment to sweep up anything unclaimed. GOV.UK allows employees relief on professional fees they must pay to do their job, and on annual subscriptions to bodies on HMRC's approved list where membership is relevant to it. You cannot claim where your employer paid, for bodies not on the approved list, or for life memberships, and claims go back up to 4 earlier tax years, through your Self Assessment return if you file one (GOV.UK). Four years of GMC or NMC fees, royal college subscriptions and defence body premiums add up, so claim while the relief still has UK income to bite on.

Once you are non-resident with no UK employment income, UK relief on ongoing fees stops being worth anything, so keeping or dropping UK registration becomes a professional decision rather than a fiscal one: it turns on whether you plan UK locum work on visits, which carries the residence-day risk covered above, and how hard restoration would be later. Overseas regulators' fees and exams belong to the new country's system, not HMRC's.

Many NHS leavers return, and the length of the absence drives the outcome. Come back within 5 years and the temporary non-residence rules apply: HMRC's helpsheet HS278 treats certain gains made while away, broadly on assets owned before leaving, as arising in your year of return, so selling shares during a three-year stint in Auckland does not escape UK Capital Gains Tax (HS278, GOV.UK). Our guide to returning to the UK and temporary non-residence covers the traps.

Stay away long enough and the rules flip in your favour. A consultant who spent 12 years in Perth and comes home can qualify for the 4-year FIG regime, which requires at least a 10-year period of non-UK tax residence immediately before returning. For up to 4 years, foreign income and gains, including overseas dividends, interest, rental profits and business profits, can be claimed tax-free through Self Assessment, though foreign earnings are not eligible and claiming costs your Personal Allowance for the year (GOV.UK). Timed well, that window is the moment to realise offshore gains and restructure before full worldwide taxation resumes; see our guides to the FIG regime for returning British expats and the regime itself. Keep clean records of your residence history from departure onwards; you may one day need to prove every year of it.

Horizon UK Tax Solutions is a founder-led Chartered Tax Adviser practice with over 10 years' experience, including 7 at a Big Four firm, and UK departures are the core of what we do. For a clinical move we confirm the split-year position against your actual dates, handle the P85 or the final Self Assessment return and the refund, run the Class 2 versus Class 3 decision and the CF83, review any non-NHS pensions, and set up the record-keeping that protects a future return.

Fees are fixed and agreed upfront, never hourly surprises: personal tax returns from £350, non-resident and expat returns from £550, and complex returns from £750. Whether your leaving date is booked or still a job offer, start with a free 30-minute clarity call or read about our relocation planning service. The cheapest time to fix a departure is before it happens.