According to an industry body, out-of-hours GP providers are being targeted by HM Revenue & Customs (HMRC), which is pursuing some for historic tax liabilities and questioning whether the doctors on their books should be classed as employees rather than self-employed.

Urgent Health UK, which represents out-of-hours groups, claims that if tribunals uphold the taxman’s case, these groups will have to raise their prices by around 30 per cent, making it even harder to recruit GPs. In addition, many of these groups are already facing high indemnity costs and are having to compete with seven-day GP access schemes.

Self-employed GPs can claim tax relief on certain expenses and may benefit from lower National Insurance (NI) and pension scheme contributions, while the organisations themselves pay lower NI employer contributions.

However, according to the taxman, out-of-hours GPs are claiming to be self-employed when they are de facto employees, because they are subject to the same control and directions from their managers as standard employees.

A spokesman for Urgent Health UK said that the extra requirements put on GPs means that they are moving increasingly towards employee status because there is more control exercised on them in one way or another.

If self-employed GPs were re-classified as employed by the organisation, it would have to pay 13.8 per cent employers NI contributions on any income over £155 per week. This could well cause the organisation to reduce the rate it pays to GPs, making recruitment and retention even more difficult.

HMRC has denied that it is specifically targeting doctors but a spokesman said that it works “continually” to ensure that tax status rules are adhered to. He added that if employment status does not accurately reflect the underlying reality, leading to the wrong tax being paid, the department will intervene.