Is locum work better paid than a salaried NHS job?

Usually per hour, but not always per year. Locums are only paid for the hours they work, get no paid annual leave or bank holidays, no sick pay and no NHS employer pension contribution (23.7% of salary). A locum rate needs to be noticeably higher than the salaried hourly rate just to break even.

What locum hourly rate matches my NHS salary?

Enter your salary and the hours and weeks you expect to work as a locum. The calculator finds the hourly rate where your locum take-home pay equals your salaried take-home pay, and a second rate that also makes up for the NHS pension you would give up.

How many weeks a year do locums work?

Many locums plan for 44 to 46 working weeks to allow for holidays, bank holidays, gaps between shifts and CPD. Salaried NHS staff on Agenda for Change get 27 to 33 days of annual leave plus 8 bank holidays, all paid.

What is the difference between PAYE and umbrella locum pay?

With PAYE through an agency or staff bank, your rate is your gross pay. With an umbrella company, the rate quoted to you also has to cover the umbrella's margin, employer National Insurance and the apprenticeship levy, so your gross pay is lower than the headline rate.

Can locums pay into the NHS Pension Scheme?

Locum GPs and doctors working through a trust staff bank can often join the NHS Pension Scheme. Most agency locums cannot. This calculator assumes agency locum work has no NHS pension.

Locum vs salaried pay calculator

Compare an NHS salary with locum work at an hourly rate. See what you actually take home, the locum rate you need to break even, and what the NHS pension is worth. Uses 2026/27 tax, National Insurance and NHS pension rates.

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

Your comparison

Locum take-home vs salaried, per year +£12,720

Locum £41,877 vs salaried £29,157, before valuing the NHS pension.

£21.11locum rate per hour to match salaried take-home

£30.63per hour to also replace the NHS pension

£24.82locum take-home per hour worked (salaried £17.28)

Salaried take-home£29,157

Salaried incl. pension value£40,536

Locum take-home£41,877

Full breakdown

Per year	Salaried	Locum
Gross pay	£39,959	£54,000
NHS pension (you pay)	−£3,916	£0
Income tax	−£4,695	−£9,032
National Insurance	−£2,191	−£3,091
Take-home pay	£29,157	£41,877
Employer pension	£9,470	£0
Hours worked	1,688	1,688

England, Wales and NI tax. Pension value is employee plus employer contributions at 85%, a conservative measure of an NHS defined benefit pension.

How the comparison works

A salaried NHS post pays you for every week of the year, including annual leave and bank holidays. Locum work pays only for the hours you work. To compare them fairly, the calculator works out the annual take-home pay for each, then the hourly rate per hour actually worked.

Salaried: income tax and National Insurance on your salary, minus NHS pension contributions taken before tax. Your employer also pays 23.7% of your salary into your pension. That doesn't appear on your payslip, but it's part of what the job is worth.
Locum: your rate × hours × weeks worked. Umbrella pay deducts the margin, employer National Insurance (15%) and the apprenticeship levy before your gross pay is calculated.
Break-even rate: the locum hourly rate where your yearly take-home matches the salaried post, for the locum hours and weeks you entered.

What the hourly rate doesn't show

Salaried NHS posts come with sick pay, maternity and paternity pay, paid study leave and job security. Locum work offers flexibility and usually a higher rate. Agency locum work through a limited company may fall under off-payroll working rules: see HMRC's guidance on IR35.

Frequently asked questions

Is locum work better paid than a salaried NHS job?: Usually per hour, but not always per year. Locums are only paid for the hours they work, get no paid annual leave or bank holidays, no sick pay and no NHS employer pension contribution (23.7% of salary). A locum rate needs to be noticeably higher than the salaried hourly rate just to break even.
What locum hourly rate matches my NHS salary?: Enter your salary and the hours and weeks you expect to work as a locum. The calculator finds the hourly rate where your locum take-home pay equals your salaried take-home pay, and a second rate that also makes up for the NHS pension you would give up.
How many weeks a year do locums work?: Many locums plan for 44 to 46 working weeks to allow for holidays, bank holidays, gaps between shifts and CPD. Salaried NHS staff on Agenda for Change get 27 to 33 days of annual leave plus 8 bank holidays, all paid.
What is the difference between PAYE and umbrella locum pay?: With PAYE through an agency or staff bank, your rate is your gross pay. With an umbrella company, the rate quoted to you also has to cover the umbrella's margin, employer National Insurance and the apprenticeship levy, so your gross pay is lower than the headline rate.
Can locums pay into the NHS Pension Scheme?: Locum GPs and doctors working through a trust staff bank can often join the NHS Pension Scheme. Most agency locums cannot. This calculator assumes agency locum work has no NHS pension.

Sources

Pay scales for 2026/27 (Agenda for Change), NHS Employers. Checked 20 October 2026.
Income Tax rates and Personal Allowances, GOV.UK. Checked 20 October 2026.
Rates and thresholds for employers 2026 to 2027, GOV.UK. Checked 20 October 2026.
Repaying your student loan, GOV.UK. Checked 20 October 2026.
Pay and contributions, NHS Business Services Authority. Checked 20 October 2026.
NHS Pension Scheme employer contributions, NHS Employers. Checked 20 October 2026.
Understanding off-payroll working (IR35), GOV.UK. Checked 20 October 2026.

Last updated 20 October 2026.