There is no doubt that many of us throughout the pandemic have spent more time looking at ourselves and our reflections than at any other time in our lives. As many of us increased our use of online meeting programs such as Zoom and Microsoft Teams to continue to run our practices and stay connected, this has also meant many of us have been, potentially only subconsciously, looking at ourselves and becoming more aware of our appearance. Covid-19 has been said to have created a 'zoom-boom', as this increased use of Zoom and similar products has been said to have increased the demand for plastic surgery and injectables around the world.

In our work with medical clinics we have witnessed an increase in practices looking to offer cosmetic injectable procedures to the market, preferring treatments delivered by registered nurses rather than beauticians. The financial benefit of offering these services, that have become more mainstream than ever, are an attractive proposition for many practice owners.

In Australia, nurses in general practice are typically hired as employees however if you are considering offering cosmetic injectable services and wish to test the market before committing long-term, engaging a nurse with an Independent Contractor Agreement or Independent Services Agreement may be ideal. That is, where their role falls outside of the classifications in the Award.

Below we explore how to engage a cosmetic injectable nurse with an independent contractor agreement or an independent services agreement in a way that will benefit both the nurse and your practice.

Nurse Independent Contractor Agreement: Benefits for the practice

The benefit of engaging an injectables nurse as an independent contractor instead of as an employee is that if you want or need to terminate their services at any point, you can without consequences as you are not bound by the requirements of the Fair Work Act, as you would be with an employee. Independent contractors are also ineligible for the many leave entitlements.

Nurses as contractors are managed in a very similar way to a contracted GP in terms of the support that the practice offers them such as taking bookings and for consumables etc.

Like all independent contractors, your nurse can be engaged in that way for as long as you wish, as long as they are genuinely contractors. As a general guide, that is, that they:

  • Have control and independence over when and how they work
  • Provide their own equipment (unless specialised equipment, or a shared resource)
  • Can engage subcontractors (we customise agreements to ensure that any subcontractors must be approved by the practice)
  • Pay a service fee to your practice
  • Have their own Professional Indemnity Insurance & Public Liability Insurance (we ensure a warranty is built into the agreement to cover validity and other specifics).

Each of these elements need to be covered in the agreement and there must be no doubt that the agreement is beneficial to both the practice and the contracting nurse. It must also include details of how any disagreement or dispute is to be managed and clearly outline the expectations of both parties to the agreement.

Essential in this process is seeking legal advice from professionals well versed in all of the obligations required of your regulated health service in addition to the eligibility and training requirements of the registered nurse to undertake these procedures.

When adding a new service like cosmetic injectables to your practice, it may be uncertain how popular this new service offering will be. Having the flexibility that a nurses independent contractor agreement provides is often the most beneficial way to test the market, without the obligations that come with an employee. However, it is not without risk.

Considerations for practices

Just like hiring a doctor as an independent contractor, this does not remove your practice from any legal risk, in particular, in relation to the nurse's conduct. While as an independent contractor they will require at least two types of insurance - which we take into account when drawing up these agreements to meet each practices' unique needs - you must not overlook the need to ensure your insurance cover extends to include the services they provide.

While having an injectables nurse as an independent contractor may initially be wise, you will need to revisit whether the independent contractor model will be beneficial long-term, or if having them as an employee will be more financially viable as the business grows.

How common is it for nurses to be independent contractors?

Just as doctors who are engaged as independent contractors can enjoy benefits like increased flexibility of hours, so too can nurses. It's not uncommon for nurses to identify that the independent contractor life allows them to effectively manage their risk of burnout. For this reason alone it is an increasingly appealing avenue.

While they need to have their own ABN and are responsible for their own insurance, tax and superannuation, they have the benefit of increased control and independence over their hours and can subcontract if required to meet patient demand. The other considerable benefit is that your practice provides them access to a location where their target market frequents, in addition to administrative support for a fee.

The 'In-between': Individual Flexibility Arrangements (IFAs) for Nurses

IFAs are written agreements that can be used by both employers and employees to change clauses in a registered employment agreement or Award clauses to suit employer or employee needs better.

Both the IFA and an independent contractor arrangement can be beneficial in that they offer the ability to work more flexible hours, and nurses under those agreements often say it facilitates a better work-life balance.

The effect of both of these alternatives can result in increased career satisfaction, quality of service and patient experience. To find out more about when IFAs may be worth considering in your clinic and if they are worth the investment, you can read our article about this here.

Your first steps to engage a cosmetic injectable nurse

Your injectables nurse can be engaged as a contractor with either an independent contractor's agreement or an independent services agreement. However, if their role and responsibilities are covered by the Nurses Award, then neither the IFA or independent contractor or services agreements will be an appropriate arrangement. Our team regularly provide advice about what will be most suitable based on the unique needs of each practice.

We know that getting the employee versus contractor piece right is essential for practices because no practice wants to be at risk of sham contracting and the legal and financial consequences that come with getting it wrong. To ensure that your risk is mitigated and all vital elements are included in your independent services agreement, peace of mind and surety can only come from seeking specialist legal advice and ensuring your agreements are regularly reviewed. As regulations change, practices need to ensure they are compliant and choose the most beneficial avenues when hiring and engaging people in their practice.

Take a look at our fasttrack solution independent services agreement for nurses or reach out to us to learn what will be best suited to your needs.