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Direct Engagement 2018-01-31T10:21:23+00:00

Direct Engagement

Save 20% on your medical locum spend, with a different approach to Direct Engagement that’s fully IR35 and Criminal Finance Act compliant.

A better way…

Our fundamentally different approach to direct engagement saves Trusts and Health Boards 20% on their medical locum and locum AHP spend.

Our model sees Brookson Medical Care Services fully employ each of the agency sourced locums with each Trust / Health Board procuring our Medical Service that carries no VAT.

This results in less employment risk for the NHS, reduced onus and effort for the already stretched NHS resources and no NHS-level pension liabilities.

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Delivers 20% VAT savings on locum Doctors and AHPs

Fully IR35 and Criminal Finance Act 2017 compliant

Only provider to deliver VAT savings via a medical service

Reduced employment law risk for the NHS

Reduced internal effort for the NHS

No NHS-level pensions to be funded by the NHS

Direct Engagement savings calculator

Enter your annual spend (gross) on locum medics and locum AHPs.

Total Savings

With our Direct Engagement model you would save:

View full breakdown Contact Us


Annual spend (Gross)

Annual spend (Net)

VAT savings

Brookson Fees

amount at 4% excl. VAT

amount at 3%

Total Brookson fee incl. VAT

Brookson Fees

amount at 4% excl. VAT

Total Brookson fee incl. VAT

A quick video explainer…

How it works

Supported by our in-house legal and accountancy teams, the traditional Direct Engagement model has been reimagined for the changing world of healthcare.

The Brookson Direct model is the only one to deliver VAT savings via a medical service, where locums are fully employed by Brookson. This results in less risk for the NHS Trust / Health Board, reduced onus and effort for the already stretched health service resources and, we believe, a more robust tax position.

All of this is fully compliant to the latest and strictly enforced HMRC tax obligation rules, including IR35 and Criminal Finance Act 2017 – making us the obvious choice for the healthcare sector.

With our model you can employ the same great locums, via the same recruitment agencies – simply at an overall reduced cost.

  • 20% VAT saving

  • Workforce review

  • Required assurance

  • Seamless integration

  • Effective management


The services of locum doctors and Allied Health Professionals via our Medical Service are VAT exempt. Additionally, VAT is recoverable on agency recruitment fees incurred.


Direct Engagement savings can be applied to all agency supplied locum Doctors and Allied Health Professionals. Our Solutions Team can help you quickly understand your savings potential, along with any areas of risk that can be mitigated by working with Brookson Direct.


The first stage of our approach is to analyse all expenditure on registered healthcare professionals. We engage with all key suppliers determining the current way of working for your engaged labour and compute any potential savings.


We understand the complexity and issues when working with public sector IR35 and Criminal Finance Act 2017 compliance. Our in-house team of specialist solicitors provides full support and advice ensuring your flexible workforce meets your required assurance, or notify you if not.


With our Direct Engagement you continue to utilise the search, selection and compliance skills of a recruitment business, while moving to a more appropriate engagement method for VAT treatment. In doing this you have visibility on key worker information required to prevent substantial penalties for not engaging off-payroll workers correctly.


We implement and support our Direct Engagement model through our innovative and effective vendor management system. This utilises leading management and administrative software analysis tools.