A locum GP is someone who temporarily takes the place of another GP if the GP is on leave or shortage of GP. Usually they are self-employed and sometimes they conduct their work via a locum agency or their own limited company. Locum GPs are also generally paid fees for their work, differing from employees.
As a locum there are varied roles; contracts can be set to cover anything from ad hoc sessions to a long- term maternity cover, whilst they can also cover a single service or a range of services.
Locum GPs can be engaged to work for a variety of healthcare providers including NHS, private practices and out of hours providers.
GPs engage in locum work for a variety of reasons. It can be conducted as part of a portfolio career or even to fit around family commitments. Newly qualified GPs can find it helps to assess different types of working environments or geographical locations whilst considering longer-term positions.
Locum work brings increased flexibility and a high degree of autonomy, though patient continuity of care can be more difficult, and you have fewer working entitlements. For example, a locum GP is not entitled to sick pay, maternity/paternity pay or holiday pay, which are only available in a salaried role.
You should also be aware that the rules surrounding ill health and death in service benefits are different as a locum GP compared to salaried roles and it is important to gain specialist financial advice on these differences.
You can begin working as a locum at any time once qualified. You will need to ensure that you are registered with HM Revenue & Customs (HMRC) as a self-employed individual, which can be done either online or Accountant. You will also need to ensure you are included on the GMC’s GP Register as well as the National Performer’s List.
A contract will be required and there should be a clearly defined final agreement in writing, signed and dated by both parties. The contract should include details of your fees, timetables and core responsibilities for you and the engager. It should also include a substitution clause which states that you, as the locum, are responsible for finding a replacement if you are unable to conduct the work.
This must also be a contract for services (rather than a contract of service, which is the case for salaried GPs) and state that you are conducting the work in a self-employed capacity, with tax and National Insurance (NI) to be met by you. It would be beneficial to have a standard contract which can be subject to changes to suit the provider if mutually agreeable.
Do I pay tax on this work?
As a self-employed locum you will be required to submit an annual Self-Assessment Tax Return (SA100). This will include all your income during the tax year (ending 5th April each year) be it from a salaried role, locum work and any interest, dividends or rental income. Your total income is used to determine the amount of tax and NI for which you are liable in the year. The liability is paid in two ‘payments on account’:
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