Contracts and appointments
When is a locum appointed?
A locum SAS doctor can be appointed to cover annual, study, sick, maternity or adoption or other types of leave for any senior clinicians (SAS doctors and consultants) and to provide cover for temporary vacancies. The length of appointment can vary from a few weeks to several months.
Locum appointments should only be made to cover a substantive post and the use of long term locums should be avoided. Locums have no automatic entitlement to be appointed to the substantive post when it is filled.
How long is a locum contract?
Locums should be appointed for a maximum initial period of 6 months. Any extension beyond that should be subject to a satisfactory review by the employer and in consultation with the relevant college. Contracts can be extended by a maximum of 6 months (making the locum contract 12 months in total).
The Departments of Health have agreed that employers must not use locum appointments as long-term solutions to staffing problems. If you are appointed for longer than a year you should contact the BMA for further advice as you are missing out on career progression and potentially career development.
Terms and Conditions of Employment
Locum doctors make an invaluable contribution to the National Health Service and should be contracted under the correct terms and conditions of service.
- As a locum SAS doctor
Apart from the differences detailed on this page, all sections of the TCS for 2008 Associate Specialists and Specialty Doctors apply to locum appointments.
Locum specialty doctors must have full registration with the GMC and must have worked for a minimum of 4 years in full time postgraduate training, at least 2 years of which have been in the relevant specialty.
- As a locum consultant
In certain circumstances SAS doctors can be employed to work as locum consultants. In these cases the provisions of Schedule 22 of the Consultants Terms and Conditions of Service will apply. (In Scotland, the provisions of Section 11 of the 2004 Consultant Contract will apply)
Specialist registration is not required to work as a locum consultant.
- Locum SAS doctors
Associate Specialist weekly rate: £1148.80 (£114.88 per PA)
Specialty Doctor weekly rate: £844.80 (£84.48 per PA)
- Locum Consultants
Those SAS doctors working as a locum consultant, who have never held a substantive consultant post, will be paid at the bottom of the consultant salary scale. We are aware that for some Associate Specialists, taking a position as a locum consultant could result in a salary drop. In these cases NHS Employers have recently agreed that these doctors should receive pay protection, with their starting salary in the locum appointment being fixed at the threshold in the scale next above their previous rate.
NB. In Wales, discussion is currently ongoing with the Welsh Government to agree locum rates to be implemented nationally but until agreement is reached the normal rates apply.
Job planning - hours, leave, supervision and appraisal
Job planning and inductions
In all locum posts doctors should be provided with an induction which is appropriate to the post and the length of the appointment. For doctors working in longer term locum posts a job plan should have been agreed by the time the doctor takes up the post. An initial job plan review should take place three months into the post. Objectives should be agreed as part of the job planning process and locums should have the same access to resources, e.g. for administrative support and continuing professional development, as other SAS grade doctors.
Locum doctors should be offered appropriate supervision. There is a handbook and suggested mandatory training published by NHS Professionals for England.
Organisations will also have their own policies and procedures appropriate for their services.
Locums, and any agency they have been supplied through (if applicable), must be given feedback on their performance after every assignment. A model report form was included in the 1997 Code of Practice (1998 Code in Scotland), although agencies may use their own.
Many agencies and locum doctors report that such feedback is not being provided. The provision of feedback will become increasingly important as revalidation of doctors is introduced by the GMC - it will be part of the evidence base a locum doctor will need to revalidate and retain their licence to practise.
If you are a locum doctor who has not had an appraisal you should contact a BMA adviser
Doctors are under a professional obligation not to work when their ability or competence is impaired through working excessive hours.
Agencies and employers must ensure that the Working Time Regulations on hours and rest breaks are applied to the locum doctors working for them. To do this they should make enquiries of hours across all employments and assignments.
Specialty Doctors and Associate Specialists working as locums will be entitled to 5 weeks annual leave (or 6 weeks for specialty doctors who meet the criteria detailed in schedule 17, paragraph one of the TCS) and 6 weeks annual leave respectively per twelve months of continuous locum service*. Leave should be taken during the occupancy of the post wherever possible. If this is not possible, leave may be carried to the next appointment or the doctor may receive payment in lieu for the leave which has not been taken.
Locum doctors in either grade should also be entitled to any public for statutory holidays falling due within the period of their contract.
*service as a locum in the employment of one or more NHS organisations uninterrupted by the tenure of a substantive appointment or by more than two weeks during which the practitioner was not employed in the NHS.
Returning to a substantive post
The incremental date for a locum is the date of taking up the appointment.
Where a doctor has held a substantive appointment as a SAS grade doctor before beginning locum service all service in the locum post as a Specialty Doctor, Associate Specialist (or higher grade) will count towards incremental credit when you return to a substantive Specialty Doctor post as if it had been in a substantive post.
For doctors who have not held a substantive post in the Specialty Doctor or Associate Specialist grades, locum service of three or more continuous months’ duration in these grades or higher grades shall count towards incremental credit at the rate of one half on substantive appointment to that grade.
Contract checking service
Free contract checking service for BMA members (not a BMA member?)
Phone: 0300 123 1233 - 8.30am to 6.00pm weekdays (not UK-wide bank holidays)
Online enquiry: online enquiry form
Web chat: speak live with a BMA adviser
BMA Contract Checking Service
PO Box 27107