Can I work as a locum while in a permanent NHS job?

Yes, many people do bank or locum shifts alongside a permanent post. Check your contract for rules on secondary employment and make sure total hours stay within the Working Time Regulations unless you have opted out. Resident doctors should also follow their rota and work schedule rules.

Do locums get holiday pay?

If you're paid through PAYE by an agency, umbrella company or staff bank, you're a worker and are entitled to 5.6 weeks' paid holiday a year, which may be paid as it accrues or included in your rate. If you work through your own limited company, you have no holiday pay entitlement.

How do locums pay tax?

Most locums are paid through PAYE by an agency, staff bank or umbrella company, so tax comes off automatically. Self-employed locums, such as many GP locums, and those working through a limited company must file a Self Assessment tax return.

Who is responsible for a locum doctor's revalidation?

Locum doctors revalidate with the GMC in the same way as other doctors. Your designated body is usually the agency you've worked for most in the year, or you may have a suitable person. NHS England publishes guidance for locums and doctors in short-term placements.

How to become a locum

Locum work gives doctors, nurses and allied health professionals more control over when and where they work, and often a higher hourly rate. Here's what you need before you start, how you'll be paid, and how to check it's worth it.

Updated for 2026/27
Official NHS and HMRC figures
Checked 20 October 2026

1. Check your registration

Doctors: full registration with a licence to practise from the General Medical Council. Most locum posts need at least FY2 competence. Locums revalidate in the same way as other doctors; see NHS England's advice for locums.
Nurses and midwives: current registration with the Nursing and Midwifery Council, renewed every year and revalidated every three years.
Allied health professionals: registration with the Health and Care Professions Council.

2. Get your documents ready

Agencies and staff banks follow NHS Employment Check Standards, so expect to provide:

Proof of identity and right to work in the UK
An enhanced DBS check, ideally on the update service so it can be reused
Up-to-date mandatory and statutory training
Occupational health clearance and immunisation records
Two professional references covering recent clinical work
An up-to-date CV with no unexplained gaps
Indemnity cover where needed (doctors working outside NHS indemnity schemes and GP locums)

3. Choose where to find shifts

Trust staff banks: shifts at your own or a nearby trust, usually paid at Agenda for Change or contractual rates, and often pensionable.
Recruitment agencies: access to more trusts and longer placements, usually at higher rates. Use agencies on NHS-approved frameworks.
Direct engagement: GP locums and some others contract directly with practices or providers.

4. Understand how you'll be paid

You'll be paid in one of three ways, and they're worth very different amounts for the same rate:

PAYE through the agency or bank: tax and National Insurance are deducted for you.
Umbrella company: employer National Insurance, the apprenticeship levy and the umbrella's margin come out of the rate first. Read GOV.UK's guidance on umbrella companies.
Limited company: only for work that is outside IR35. Most NHS locum shifts are inside IR35.

Compare them with the limited company vs umbrella calculator.

5. Plan for tax and pension

If you have more than one job, check your tax codes so your personal allowance isn't used twice. If you're self-employed or have a limited company, put money aside and file a Self Assessment return. Agency locum work isn't pensionable in the NHS Pension Scheme, so consider a personal pension to replace the employer contribution you'd get in a salaried post.

6. Work out whether it pays

A locum rate has to cover the paid leave, sick pay and employer pension contribution of 23.7% that a salaried NHS job includes. Use the locum vs salaried calculator to find your break-even hourly rate, and check typical rates for doctors, nurses and allied health professionals.

Frequently asked questions

Can I work as a locum while in a permanent NHS job?: Yes, many people do bank or locum shifts alongside a permanent post. Check your contract for rules on secondary employment and make sure total hours stay within the Working Time Regulations unless you have opted out. Resident doctors should also follow their rota and work schedule rules.
Do locums get holiday pay?: If you're paid through PAYE by an agency, umbrella company or staff bank, you're a worker and are entitled to 5.6 weeks' paid holiday a year, which may be paid as it accrues or included in your rate. If you work through your own limited company, you have no holiday pay entitlement.
How do locums pay tax?: Most locums are paid through PAYE by an agency, staff bank or umbrella company, so tax comes off automatically. Self-employed locums, such as many GP locums, and those working through a limited company must file a Self Assessment tax return.
Who is responsible for a locum doctor's revalidation?: Locum doctors revalidate with the GMC in the same way as other doctors. Your designated body is usually the agency you've worked for most in the year, or you may have a suitable person. NHS England publishes guidance for locums and doctors in short-term placements.

Sources

General Medical Council, GMC. Checked 20 October 2026.
Nursing and Midwifery Council, NMC. Checked 20 October 2026.
Health and Care Professions Council, HCPC. Checked 20 October 2026.
Advice and guidance for locums and doctors in short-term placements, NHS England. Checked 20 October 2026.
DBS checks, GOV.UK. Checked 20 October 2026.
Understanding off-payroll working (IR35), GOV.UK. Checked 20 October 2026.
Working through an umbrella company, GOV.UK. Checked 20 October 2026.
Self Assessment tax returns, GOV.UK. Checked 20 October 2026.

Last updated 20 October 2026.