First NHS Payslip: Payroll Setup, ESR, and Avoiding Emergency Tax: IMG guide for UK practice (2026)

Key points

If you don’t have a P45, your employer uses HMRC’s Starter Checklist to set you up on PAYE correctly.
Your “first payslip problems” are usually data problems: wrong address, wrong NI status, missing starter declaration, or bank details mismatch.
ESR Employee Self Service is where you typically view payslips and keep personal details accurate—check it early, not after payday.

The NHS payroll mental model

Think of payroll as a pipeline: (1) HR identity/right-to-work checks → (2) PAYE setup (P45 or Starter Checklist) → (3) ESR profile accuracy → (4) payslip. If any step is incomplete, you get delays or “emergency” tax outcomes.

The “first-month payroll” checklist (do this in week 1)

1) Confirm payroll has your correct legal name + date of birth

Match your passport exactly. Even minor spelling differences can cause system mismatches across HR, ESR, and HMRC reporting.

2) If no P45: complete the HMRC Starter Checklist

This is the standard route for new starters or people without a P45. It helps your employer set the right tax code and student loan status.

3) Provide bank details early (and double-check formatting)

Sort code + account number. Ask payroll what they accept (PDF statement, screenshot, bank letter). Send it once, clearly labelled.

4) Activate ESR Employee Self Service and verify your personal details

ESR is commonly used for payslips and personal information updates. Check address, contact details, and bank details workflow (where available) to prevent “missing pay” surprises.

5) After first payslip: review tax code + deductions

If you think you are on an incorrect tax code, raise it early. Most issues resolve once HMRC has full starter information and consistent records.

Documents that prevent 80% of payroll delays

P45 (if you have one) OR HMRC Starter Checklist completed.
NI number (or proof you applied, if pending).
Right to work evidence (as requested by HR).
Bank details (sort code + account number) with clear proof.
Current address and contact details (consistent across forms).

Copy-paste email to payroll (new starter, no P45)

Subject: New starter payroll setup — HMRC Starter Checklist + bank details Hi [Name], I’m a new starter and do not have a P45. I have completed the HMRC Starter Checklist and attached it, along with my bank details (sort code/account number) and proof. Please confirm if anything else is required to ensure correct PAYE setup before the first payroll run. Thanks — Dr [Name].