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Written by Wesleyan

General tips and advice for locuming

the-next-step
tips
doctor
5 min read
Young smiling female nurse

If you're looking to boost your income, further your career or gain a better work life balance, then locum work could be for you. We've put together a list of the benefits that come with locum work and some tips on making it work for you.

Flexible work life balance

The most obvious benefit of being a locum is that it affords you a better work life balance, as you can schedule locum hours around other commitments. There is a broad spectrum of locum work available, so you will likely be able to find a position and hours that suit you.

You could find time in the week to spend with family or explore other career opportunities in or outside of medicine, or dedicate a few months of the year to go travelling.

Earning potential

Locums are paid more in terms of hourly rate than an employed doctor. You will be paid on an hourly basis, so if you stay later than the hours agreed, then you will get paid for it. You’ll be exposed to a greater variety of clinical settings and experiences which could boost your career prospects and future earning potential.

It can also provide you with temporary work which will keep your clinical skills in use whilst you wait for a permanent position to be advertised in your specialty of choice.

Gaining clinical experience for your career path

Being a locum will gain you a wealth of clinical experience. Working in different hospitals and practices provides a unique opportunity to develop your professional skills as you glean insight into a variety of working systems, procedures and cases you might not have previously considered.

Experiencing several placements as a locum doctor can give you a good indication of whether an employer, team or specialism is suited to you before committing to a permanent position.

Disadvantages

We’ve outlined many of the exciting opportunities and advantages of becoming a locum above, but it’s important to be aware of the disadvantages too. Here are a few you should consider;

  • Self-employment means you don’t have access to employment rights such as sick pay, annual leave and maternity pay
  • Working as a locum also affects your eligibility and status within the NHS pension scheme
  • Irregular work can result in uncertainty of income
  • Taking out a mortgage or remortgaging can be much harder as a locum, as you have no guaranteed income
  • Isolation and possible lack of support
  • You will need to adjust to different work places quickly, and you will need to ensure a good induction where you work
  • Admin – and lots of it! Locums will typically organise their own invoicing, accounts and pensions, unless you work for an agency or employ an accountant to do it for you

Salary expectations

How much you get paid as a locum doctor depends on where you’re working and how you’re working, as well as the number of shifts that you do and the way that you’re paid. One thing that is consistent for all locums is that the pay is higher per hour than it is for permanently contracted staff.

As a doctor in training you’ll earn a basic salary, plus pay for any hours over 40 per week, a 37% enhancement for working nights, a weekend allowance for any work at the weekend and an availability allowance if you are required to be available on-call.

In foundation training, you will earn a basic salary of £28,243 to £32,691 (from 1 April 2020). If you’re a doctor starting your specialist training, your basic salary will be £38,693 to £49,036.

The BMA have outlined the Junior Doctor Contract which highlights the expected rates for those who locum. The report highlights that staff banks have authority to set rates of locum work.

How you get paid as a locum

Most locums operate directly with the NHS on a self-employed basis, as a sole trader or through a limited company set up by themselves. In this instance, an individual (or their LTD) will invoice a locum agency or practice directly and pay the locum agency themselves.

The role of a locum agency is to act as the go between, connecting you with jobs relevant to specifications laid out when you join.

It’s important to note that being self-employed will mean you are not entitled to the security of employment rights such as statutory sick pay, maternity/paternity pay and protection against unfair dismissal, to name a few.

This will mean you will need to compensate by setting up your own provisions in case you face sickness or an unexpected life event. You will also be left with the administrative tasks surrounding pay that would normally be dealt with by your HR department if you were an employee.

Expenses as self-employed

Due to your self-employed status as a locum, you have the advantage that you may be able to deduct the cost of the below from your income that is normally liable to tax.

  • Professional fees and subscriptions, including BMA, GMC, MDU and Royal Societies
  • Business mileage or fuel, excluding commuting to your normal place of work
  • Tools and specialist equipment
  • Courses (if they are an intrinsic part and duty of your employment)
  • Uniform expenses if no laundry facilities are provided by your employer

Wage caps

In previous years, there has never been a wage cap on a locum doctor’s pay. In 2015, NHS trusts set wage caps on the hourly rate for locum doctors, so that more money could be used for patient services and care. The rates are as follows:

  • £20 per hour for foundation doctors
  • £50 to £67 for associate specialists (depending on weekends, holidays and anti-social hours)
  • Maximum rate of £100 per hour for an emergency medicine consultant working during anti-social hours

Routes into locuming

The NHS have two routes into locuming:

  • Locum Appointment for Training (LAT)

Trainees in these posts are assigned a clinical supervisor and an educational supervisor and training opportunities are available to them as part of the post.

  • Locum Appointment for Services (LAS)

These are temporary posts and you will not usually be assessed for the competencies required to complete a foundation or specialty programme.

Where to find locum work?