The Locum Guide

Getting Started

Starting out locuming can be daunting but, with a little guidance from us, you will hopefully enjoy it as much as we do.

Before you start locuming, it’s a good idea to think about what you want to achieve;

  • Is this a transition between training jobs and you want to get more experience?
  • Is this a way to test out which speciality is best for you?
  • Is this a time to build up some savings to go travelling or save for a deposit on a property?

These are just a few possible reasons and they are all perfectly valid.

Knowing this at the beginning will give you clear goals and help you pick the right kind of jobs for you 

Joining An Agency

Locum agencies work as a middle man between you and the hospital. You will need to sign up and complete the mandatory training but, once this has been done, you can take up jobs in nearly any hospital in the country without the hassle of the paperwork. 

There are a number of locum agencies. They vary in size and some hold special contracts so they get specific hospitals jobs first etc. 

For this reason we recommend joining two agencies and sticking with medium to large companies. This way it gives you the best access to jobs. It’s normally easier to join the two agencies at the same time to minimise the admin.

Visit our Locum Agencies page to find brief descriptions of each agency & to refer yourself and earn a big referral bonus

Locum agencies normally allocate you a personalised agent who will be recommending you jobs. When you have your initial discussion with them, be clear on what specialities, locations and shift patterns you are willing to work. Knowing these beforehand helps both you and your agent.

They will often ask what rate of pay you are looking for. This does vary by location and speciality but we have given some rough rates in our locum price cap section below.

Finally, make sure you take advantage of the locum agency referral bonuses.

Agency Referral Bonuses

Locum agencies are always looking to increase the number of people on their books and so, to help with this, they offer pretty big bonuses to people that refer their friends.

Whilst this is often great for the person referring, sadly it is not great for the person being referred. To make things more fair, we have arranged some special SELF referral bonuses with the agencies.  Now you can get hundreds of pounds for just signing up and working with the agency you want to work with!

We have negotiated special self referral bonus rates with the locum agencies we regard as the best in the market currently.

Visit our Locum Agencies page to find brief descriptions of each agency & to refer yourself and earn a big referral bonus

Using A Hospital Bank

Hospital Banks are also an option and they do have their perks. They do however also have some disadvantages. 

Each NHS hospital trust runs its own locum bank which allows them to fill vacant shifts more easily, often by current and previous members of staff. 

The perks of working via a hospital bank;

  • Familiarity with the IT systems and hospital layout as shifts are all in the same trust
  • If using one singular hospital bank for the majority of your locuming they will allocate you someone to carry out your yearly appraisal . 
  • NHS Pension will be taken directly from your paycheck (unless you opt out).
Disadvantages of working via a hospital bank;
  • Limited quantity and variety of available jobs
  • Rates of pay are usually fixed with little room for negotiation.
  • Pay rates often less generous than via agency*
  • If joining more than one locum bank it often requires repeating the mandatory training
  • Lacks allocated agent
*Pay rates can vary

Locum Price Cap

In April 2016, alongside the new junior doctors contract, a locum price cap was introduced. This initially was only really followed in London and called the ‘Pan-London’ rate.

Below are the current “standard rates” most hospital locum banks work to, especially in London.  These rates have however become more common across the country with A&E shifts for SHO’s often paying ~£5 ph more than these rates.

locumcap table 300x254 - Locuming Guide

The rates via locum agencies and sometimes via hospital locum banks are often higher than this and depends on your location, supply and demand,  type of shift (ward/on-call/nights) and your negotiating skills.

This negotiation is done by yourself if working through a hospital bank or by your locum agency for you.

Roughly; SHO (F2+) should get £35-75 (average around £50) and Reg (ST3+) should get £50-100 (average £70)


When it comes to indemnity, it is very similar to when working in an NHS hospital as a trainee. If you work for an NHS trust or board, or a Health and Social Care Trust in Northern Ireland (HSC), you receive indemnity through a clinical negligence scheme which also cover locum doctors.
It is however strongly recommended that you have your own indemnity which covers work not covered by the NHS or HSC indemnity. It also gives you personal access to medico-legal support and advice and covers you for the (limited) private work you may be involved in.
All the large medico-legal agencies can provide locum doctor indemnity. This is a different kind of policy to the cover you hold as a trainee, so be careful to check and update your provider as it may invalidate your cover if not correct.
We found MPS was by far the best priced as they offered a rate of £79* per year for a hospital Locum doctor. This was much better than quotes we received from the other main medico-legal agencies.
* may vary depending on circumstances, accurate at the time of writing.


Yearly appraisals and 5 yearly revalidation is a part of all doctors lives, and unfortunately, this is no different for locum doctors. This becomes a greater challenge as locum doctors don’t often have the structured environment which makes appraisals slightly easier. 

The GMC is very clear that all locum doctors should have yearly appraisals. The difficulty with this is that often as a locum doctor you are moving between departments and hospitals regularly. This raises the question of who acts as your responsible officer for your appraisal. 

Our appraisal page has answers to the most frequently asked questions and explains the key things you need to do to ensure a smooth pass through your appraisal with the least amount of preparation time. 

Appraisals are an expensive process to undertake, often costing over £600. We have arranged a special rate of £275 for doctors appraisals with Medical Appraisals

Tax and Expenses

Claiming expenses is often neglect by doctors.

Though we as doctors have a number of expenses which we incur to allow us to work. 

For each of these, the HMRC allows for these to be tax-deductible. 

For example; GMC fees are ~£150 ( first 5 years of registration) for this you could claim back £30, £60 or £67.50  depending on your tax bracket (20%, 40% or 45% respectively)

The process of claiming for these is actually quite simple and many people can claim thousands of pounds back in a matter of minutes. 

We have a list of common items which can be claimed and have outlined the process on our tax page. We also have a few helpful tips to keep your tax bill down (such as avoiding the hidden 60% tax band)