Locum

The word comes from the Latin locum tenens, meaning someone holding a place. In UK healthcare a locum is a clinician who fills a post or shifts on a temporary basis. Locums are most often discussed for doctors, but nurses and allied health professionals also work temporary shifts, usually called bank or agency shifts. In the USA the term locum tenens is used for physicians who cover temporary assignments.

In the NHS there are three common ways to work as a locum:

• Staff bank: an NHS trust's own pool of workers who pick up extra shifts.
• Agency: an employment agency supplies the locum to the trust.
• Fixed-term locum post: the trust employs the locum directly for a set period, for example as a locum consultant or locum specialty registrar.

1. Full GMC registration with a licence to practise. Locums are held to the same standards as permanent doctors.
2. A designated body and responsible officer for revalidation. Most licensed doctors link to one organisation that provides annual appraisal; for locums this may be a locum agency that is a designated body.
3. Pre-employment checks, including identity, right to work, DBS and occupational health.
4. The right immigration status. GOV.UK says that on a Health and Care Worker visa you can work up to 20 hours a week in another job, as long as you still do your sponsored job and the extra work meets the stated conditions, and that NHS bank shifts and overtime in your sponsored role do not need a visa update. Check the current GOV.UK page before taking agency or other locum work.

Bank and agency rates are set locally. For trusts, NHS England's agency rules include price caps on what a trust may pay per hour for agency workers and a requirement to use approved frameworks; the caps do not apply to bank staff or staff employed on fixed-term contracts. National guidance does set some locum rates. From 1 April 2026, NHS Employers Pay and Conditions Circular (M&D) 1/2026 R2 says locum consultants should be employed on the 2003 consultant contract, and gives short-term SAS locum rates in England of £1,221.57 a week for a specialty doctor (MC76) and £2,002.22 a week for a specialist (MC71).

Short locum shifts rarely give the supervision, appraisal and continuity that a new international graduate needs. Most start in a substantive or fixed-term locally employed doctor post, which also supports a later application for specialty training. Fixed-term locum posts directly employed by a trust can be different, as they work like ordinary fixed-term jobs.

• No responsible officer, which leaves you unable to revalidate.
• Breaching visa conditions by taking extra work outside your sponsored job.
• Gaps in appraisal evidence when working across many sites.