Dental update: Hygienists - do your self-employed engagements need a bit of polish?

Published: Tuesday 21 September 2021

It has long been accepted that dental associates working under the terms of a HMRC approved British Dental Association (BDA) contract are self-employed. We see a large number of self-employed dental hygienists working under a similar assumption that they are also self-employed, without being aware that the reassurances offered to associates by the BDA contract do not apply to hygienists. 

That said, it does not mean that hygienists are not self-employed, but that care should be taken to ensure that they genuinely are. The risk is that where a business engages with a self-employed individual, if HMRC were to enquire into their status and find that they are being treated more like an employee, then it is the business, not the individual, that could be liable for the tax and NIC, plus the other issues surrounding employment rights (holiday pay, sick pay, pension etc).

HMRC are increasingly focusing on employment status and with the proposed amendments to HMRC’s guidance on dental associates in April 2023, it seems logical that the whole sector may come under increased scrutiny.

We would recommend a timely review of any hygienist engagements to ensure you are not exposing your business to potential tax costs in the face of an HMRC review.  All hygienist engagements should initially be reviewed using HMRC’s CEST toolkit (link below) which should give you a status determination.

HMRC have said that, providing the answers to the CEST questions reflect the day to day working practices, then the determination can be relied upon. You should ensure that you keep a copy for your records. If, however, the determination is not as expected, please do not hesitate to get in touch. Our team of dental experts would be happy to discuss employment status and areas of concern or can assist with a review of hygienist engagements.

For further information, please contact Partner, James Morter at or Director, Nigel Utting, at or call 01242 680000.

Content image: /uploads/team/unknown.jpg James Morter
James Morter
Partner, Corporate Finance, Audit, Dental
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Content image: /uploads/team/unknown.jpg Nigel Utting
Nigel Utting
Partner, Dental
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