How Hospitals and Locum Agencies Work Together

Starting out as a locum doctor can be a daunting experience, so we've worked on a comprehensive set of articles and resources here to help you navigate your way through the process!

This article will help you understand how hospitals and locum agencies work together to fill their vacant shifts. This detailed explanation will allow you to be fully informed when choosing which agencies to sign up with yourself.

A refresher: How do hospitals fill their shifts?

When a hospital has a vacant shift, often the first thing they’ll do is advertise it on their internal Staff Bank. This is the Trust’s pool of doctors who have signed up to find out about vacant shifts in their hospital, usually by email. Staff Banks are usually made up of current doctors or people who’ve rotated through there before, but you can still register even if you’ve not worked there before.

If they don’t manage to fill the shift that way first, they’ll put it out to a group of locum agencies and ask them to fill it. The agency charges the Trust a fee for finding a locum doctor to fill their shifts, and for managing the doctor’s bookings, timesheets, pay, and compliance. You can register to work through one or more agencies who will find you shifts at multiple Trusts in your area.

Of course, there are pros and cons of working through the internal Staff Banks and through locum agencies. To help you choose which is best for you, we’d suggest having a look at our article which goes into detail on those pros and cons.

To learn more about the whole process of registering with a locum agency, see our article on that topic here.

Which agencies do the hospitals use?

From the hospital’s perspective, they want to work with an agency that is reliable, fills their shifts quickly, manages their compliance properly, and communicates with them effectively.

There are three ways which hospitals will work with agencies:

✔️  Preferred agencies and tiers

Some hospitals will use a tier system for this, called an agency cascade. This is where their priority agencies are placed into Tier 1, going down to Tier 4.

In this system, the shifts will be offered to each tier in order, so if the agency has a good reputation and a good relationship with the Trust, it will get offered the vacant shifts to fill first in Tier 1 before other agencies.

This tier system can change regularly based on how the agencies are performing for the Trust. So, if a top-tier agency is struggling to fill shifts, or if agencies in the lower tiers are filling more shifts, then the Trust may adjust its agency cascade.

In this case, if you have a particular hospital in mind, it’s important that you’re registered with an agency that has a preferred relationship with that hospital to ensure you’ll get regular access to work there.

✔️  Master Vendor

Some hospitals will instead have a “Master Vendor” agency, where they have one agency as the main locum doctor supplier. This agency is tasked with filling any of the shifts they can, and then becomes responsible for sharing any shifts that they haven’t been able to fill to other agencies.

If this applies, you should ideally be working with the Master Vendor agency themselves.

✔️  The old-fashioned way

Often the agency system can also be managed based on the kind of personal relationships that the agencies have with the rota co-ordinators, so the above systems might not be used reliably (or even at all in some cases).

It’s much harder to know which agencies will have access to work here, so it’s best to speak to other doctors to find out who they used.

How do I know which agencies to choose?

If you have a particular hospital in mind that you'd like to work at, it’s worth speaking to the rota co-ordinator of the department to ask which agencies they work with most regularly. You can also ask colleagues for advice about which agencies are best to work with, from their personal experience.

Another way to choose an agency is to use Messly’s service, where pre-vetted agencies “pitch” you through the system, offering you their available shifts matched specifically to your own unique preferences. This all happens before you’ve shared your contact details with them, and helps you to quickly decide which agencies would be best for you. For more information about Messly’s service, check out our article here.

If you'd like to learn more information about we we differ from agencies, or how to go about choosing an agency, then you'll find helpful articles in the respected links.

Our Top Tips

    1. Find out which are the top tier/master vendor agencies at your preferred Trusts, if they use those systems

    2. If they don’t use those systems, ask the relevant rota coordinators and colleagues for advice

    3. Messly’s service can help you to simplify the process by letting agencies pitch you their shifts before you sign up with them - and we hope to include information for each Trust on who their top tier/master vendor agencies are soon!

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This article is part of a wider series, supporting doctors like yourself with a comprehensive set of guides to ensure your F3 year is a success. These guides cover everything from initial planning, options for moving abroad, help with finding work, and tips for making the most of the experience. Click here to visit our F3 Resource Hub to explore the full list of guides and articles.‍