Drafting a self-employed professional agreement for healthcare: this is what should be included

Drafting a self-employed professional (ZZP) agreement for the healthcare sector involves combining standard ZZP agreements with the specific rules of the healthcare sector: in addition to the assignment, the rate, and the absence of a hierarchical relationship, you stipulate how the quality of care is ensured (Wkkgz), that the healthcare provider is BIG-registered and insured, and how responsibilities are distributed under the Wtza. The basis remains a contract for services (Article 7:400 of the Dutch Civil Code), but the healthcare context determines which additional clauses you need to maintain independence and withstand enforcement against bogus self-employment.

The short answer

1. Assignment and rate: the care tasks, the rate per service or hour, invoicing.
2. Independence: no authority, entrepreneurial risk, substitution within authority.
3. Quality: working according to standards, complaints and incident procedure (Wkkgz).
4. Authorization: BIG registration, competence, and professional liability insurance.
5. Responsibility: division under Wkkgz and Wtza, confidentiality and privacy.

Drafting a self-employed healthcare contract: the assignment and the care tasks

Begin with a clear description of the care tasks. Describe the activities the care provider performs, for which client group, and within which frameworks, without prescribing the method of execution in detail. Formulate based on results and professional standards: the care provider delivers responsible care in accordance with applicable guidelines. Establish the rate per service or per hour, including the payment term and the method of invoicing. A market-rate entrepreneurial fee underscores the independent position.

Also arrange the scheduling in a way that suits the assignment. Services are scheduled in consultation, not unilaterally imposed via a fixed roster. The more the deployment resembles that of a permanent employee on a duty roster, the greater the risk that the relationship will be viewed as an employment contract.

The provisions that safeguard independence

The core of every self-employed professional agreement holds up in healthcare as well. Include:

• No hierarchical relationship. The care provider organizes the work at their own discretion, within the professional and safety frameworks.
• Entrepreneurial risk. No continued payment during illness or vacation, own insurance and own liability.
• Replacement. Rule whether the care provider can be replaced by an equally qualified and competent colleague.
• Multiple clients. Confirm that the care provider is free to work for other care providers as well.

The unique aspect of healthcare is that instructions regarding quality and safety are permitted and even required under the Wkkgz, whereas direction regarding working hours and methods actually points to authority. Make that distinction explicit: the healthcare provider establishes quality frameworks, but does not, as an employer, determine how and when the care provider works.

Quality, authority and responsibility

This is the care-specific core of the agreement. Record the following points:

• Quality (Wkkgz). The healthcare provider works in accordance with professional standards and protocols, cooperates with the complaints and disputes procedure, and reports incidents and calamities.
• BIG and competence. The healthcare provider holds a valid BIG registration where required and is authorized and competent to perform the acts, including reserved acts.
• Insurance. Valid professional liability insurance is mandatory.
• Division of responsibility. The healthcare provider remains ultimately responsible for quality under the Wkkgz; the healthcare professional remains subject to disciplinary action for their own professional practice under the BIG Act.
• Wtza. Specify who bears which notification or permit obligation.

Do not forget privacy and confidentiality. The healthcare provider processes special personal data, so include agreements regarding confidentiality, record-keeping, and the processing of client data in accordance with privacy regulations.

Practical example. A home care organization draws up an agreement for an independent caregiver. It states that she is BIG-qualified for the agreed-upon procedures, works according to the organization's guidelines, reports incidents, and has professional liability insurance. At the same time, it states that she schedules shifts in consultation, also works for others, and may be replaced by a qualified colleague. This combination guarantees both quality and independence.

Common mistakes

• Just use the standard self-employed professional model. Without the care-specific provisions regarding quality and competence, the agreement misses its purpose.
• Fixed schedule. Scheduling as a permanent employee undermines independence.
• Responsibility unclear. No clear division between ultimate responsibility under the Healthcare Quality Act (Wkkgz) and specific disciplinary responsibility.
• Privacy forgotten. No agreements regarding the processing of client data.

Honest recommendation

For a simple, short-term assignment of a BIG-registered healthcare professional who demonstrably works for multiple clients, you can often draft the agreement yourself. Include the assignment, the rate, the self-employment provisions, confirmation of BIG registration and insurance, quality agreements, and privacy clauses, and ensure that the practice aligns with them. In that case, you do not necessarily need a lawyer.

Engage legal assistance as soon as the involvement becomes structural, the division of responsibilities under the Wkkgz and the Wtza becomes complex, or when you have multiple self-employed professionals working on similar positions. In the healthcare sector, quality, client safety, and the risk of additional assessments carry significant weight, and a sector-specific agreement that is actually implemented as such prevents problems later on.

Want to know more? View the self-employed agreement for healthcare, first read what a self-employed agreement for healthcare is , and discover what it costs to have a self-employed agreement for healthcare drawn up.

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