Locum work for doctors
This page covers the advantages and disadvantages of locum work, the differences between Locum Appointment for Training (LAT) and Locum Appointment for Service (LAS) posts and how to find work as a locum.
Why should I do locum work?
There are various stages of your medical career where you may wish to consider working as a locum. For example:
- after Foundation you may decide you need more time before deciding which specialty path to take
- specialty trainees may want a break between core and higher specialty training in uncoupled programmes
- consultants, specialty doctors and GPs may prefer the flexibility of this type of work or may enjoy the benefits of being self-employed
- independence to work where and when you choose
- a part-time locum job may give you a better work–life balance
- working fewer hours may give you more time to study for Royal College membership exams
- variety – being able to work in different hospitals
- a higher rate of pay is possible (but this must be weighed against the insecurity of temporary posts)
- some locum appointments, such as Locum Appointment for Training posts (LATs) can count towards training if you subsequently enter an approved specialty training programme
- you could combine locum work with other employment outside medicine, special interests or charity work
- earn money whilst exploring career options and possible work locations
- temporary work while you are looking for a permanent job
- irregular – possible periods without work
- if you are ill you will not get paid
- you may not get pension and maternity rights
- possible payment delays
- keeping your own accounts – as a self-employed person
- isolation and possible lack of support
- some locum appointments, such as Locum Appointment for Service (LAS) posts do not count towards training
- trainees in LAT posts are assigned both a clinical supervisor and an educational supervisor
- training opportunities are available as part of the post
According to the Gold Guide 2016:
"LAT trainees have several subsequent career options open to them:
- apply for a run-through, core or higher specialty training programme
- apply for another LAT appointment in the same or a different specialty
- seek appointment to a career post when eligible to do so."
It goes on to say:
"LAT appointments are undertaken in approved training posts, which can contribute towards a CCT once a trainee has been competitively selected for a relevant training programme. They can also be used by doctors in submitting their CESR application."
- these are temporary posts without a recognised training component
- you will not usually be assessed for the competencies required to complete a Foundation or specialty training programme
- you would have a clinical supervisor but not an educational supervisor
According to the Gold Guide 2016:
"LAS posts cannot count for CCT or CESR/CEGPR(CP) awards but may be used as part of the evidence for a CESR/CEGPR application."
Consultant, specialty doctor or GP locum posts
- after obtaining CCT you could consider a locum post to explore a particular department, practice or location before deciding on a permanent post
- some GPs or consultants may prefer the flexibility of locum posts
- there are certain employment rights attached to very long locum posts, the BMA can advise on these
- you need full registration with the GMC to take a locum post
- specialty trainees are not able to take time out of programme to do locum work. You can only take a post between core and higher training (in uncoupled programmes)
- although there is no longer any restriction on the length of time in LAT posts, no more than one year of LAT during training is advisable
- be aware that more than 18 months' experience (both in a LAT or LAS) could make you ineligible for ST1 specialty training posts. Check person specifications for specialty training carefully
Pension rights/ Tax and National Insurance (NI)
For LAT posts the pension/national insurance arrangments are usually paid as per standard employees. Essentially the LAT doctor is employed by the organisation he or she works for, the same as a trainee.
For other types of locum posts, you will be often counted as self-employed. Generally you can still pay into your NHS pension as a locum. There is a GP locums page on the NHS pensions website. For Tax and National Insurance (NI) you will need to register as self-employed. More details can be found at gov.uk: working for yourself