How To Make A Living as a Full-Time Locum Doctor in 2023

Locuming is famously lucrative. It's well-known that hourly rates are much higher than a substantive salary. Many doctors now choose to take a year out of training, usually at the end of F2, to do a locum year to fund a house deposit, three-plus months of travel or just put away a nest-egg for a rainy day.

But, of course, being without a stable job brings with it some financial uncertainty...

In this article, we’ll explain how much you might expect to earn from locum work, set out the key financial and work-related issues to consider, and share some tips to help manage your finances successfully.‍

If you are concerned about how your finances will stack up as a locum doctor, this article is for you!

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💰   Expected Salary

We've created the Locum Doctor Salary Calculator to help you work out how much your could earn annually, based on your grade, specialty and region. But, in summary, you can expect to earn between £35 and £45 per hour gross pay for SHO locum posts. That will vary by Trust, by speciality and by region, but most shifts will fall into this range. The hourly rate is considerably higher for Registrars and Consultants, and you can view these on our Locum Pay guide, here.

More popular jobs and competitive areas, such as London, have rates at the lower end of the range.

If you are working with a locum agency, they will recommend a rate for you to set based on what locum doctors have been paid in that Trust previously. If you're working with a bank, they should share their standard bank rates if you contact them.

Be aware that it can be worth accepting a slightly lower rate if there’s competition for a post you’re after, especially if it’s a long-term position.

You’ll need to have around two shifts per week – between 20 and 25 hours – to have the equivalent of £40,000 gross annual pay. This is on the assumption of working 47 weeks per year, taking into account bank holidays and 27 days of annual leave where you won't be paid. ‍

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🤑   Financial Considerations

The inherent financial uncertainty means it's critical to do some financial planning before you start. Whether taking the locum route is right for you or not will have a fair bit to do with your personal financial situation.

Before making your decision you should first assess your fixed expenses, such as your bills, mortgage or rent, and so on. Then factor in any financial aspirations you have, perhaps saving for a house or a fund for travelling one day. This will enable you to figure out how many shifts per week you’d need to work in order to cover these costs.

If you’re planning on moving cities for your F3 year, it’s also worth checking out Numbeo, a free cost of living calculator, so that you can track how the move will affect your monthly outgoings. Or if you are planning an extended holiday or looking to go travelling, remember you won’t be receiving any pay during that time so you’d need to carefully plan your finances with that in mind as well.

We also suggest that you plan a backup fund to cover you if you ended up struggling to find work for a period of time or became ill. As a locum doctor, you won’t be entitled to the same Sick Pay requirements as those in substantive NHS posts. This means, for the majority, you may only be entitled to Statutory Sick Pay (SSPP) which equates to £99.35 per week. However, it’s worth checking with your Bank or Agency if they offer anything else. Find out more about your entitlements as a locum doctor in this article here. Additionally, locum jobs can be cancelled at any time by the hospital, even if you’re in a long-term position.

On another note, most locum jobs are paid as direct engagement with the trust, via PAYE, so taxes, national insurance, pension funds, and student loans are all taken out automatically. Checking your tax code is always important, especially if locuming in more than one trust, because there can often be errors in this situation. Read our article 'Decoding your payslip' to learn the basics about your payslip and how to identify any issues with it. We'd also strongly recommend downloading MySBSPay, an app for NHS workers (locums included) to access and review all their payslips.

🥼   Work Considerations

The more flexible you can be with the work you’re willing to do, the more likely you are to do well financially as a locum doctor.

Unfortunately, it’s unlikely that you’ll find yourself in the dream situation of working whatever hours you want, in the specialty you prefer, in your local hospital, on a long-term basis. Nowadays that’s just not realistic, with so many people now taking F3 years and looking for work!

We’d suggest thinking carefully about the following points and decide which factors you can be flexible on to gain a better idea of how you’ll fare as a locum doctor:

- Which specialties am I willing to work in? Am I happy to move between specialties based on where the work is? Remember most locum jobs will be covering on-calls rather than ward work and clinics, so it's helpful to be happy to work in specialties with lots of on-call work.

- Can I be flexible with the type of shifts I take? Am I willing to work nights/weekends, or do my personal circumstances make that hard?

- Am I happy to work in more than one hospital, or will I only work in one?

- Will I travel to pick up shifts? Is this feasible with my transport options, including cost-wise? Would I be willing to do a run of shifts somewhere further away and stay in hospital accommodation or a hotel? This can often be financially beneficial compared to ad hoc shifts, but can be difficult to maintain depending on your lifestyle, family commitments, and so on.

You might need to be prepared to take on more shifts when they’re available to accommodate for times when the availability of work isn’t as good.

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✅   Recommendations and Tips

1) Set your goals. Regardless of the route you take for your locum year, you should have a clear plan of what you want to achieve. See this article for some more detailed thoughts.

2) Review your finances. Identify your financial goals and fixed costs, and use that to work out how many shifts per week you think you’ll need on average. If that feels high, you'll want to be answering 'Yes' to some of the work questions above to ensure you have enough flexibility to pick up enough work.

3) Ask yourself hard questions. Take a look at the work considerations above and be honest about what your preferences are.

4) Spread your net wide. Think about signing up to a few different agencies, or internal banks, to maximise your chances of hearing about available shifts. Messly’s new service helps you find the right agency or bank for your circumstances quickly, with no hassle. You create a profile, set out exactly what shifts you want, and you’ll get pitched by agencies you have the shifts you want. If you want to go ahead, you can share your contact details and if not they can’t contact you again. See here for more info!

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5) Be proactive. You should also use your existing contacts to research the work that might be available in your area, and speak to your rota co-ordinator to let them know you’ll be available and looking for work.

6) Save hard early. You should also try to be as strict with yourself as possible at the outset, and make sure you put away savings to build a nest egg. If anything with your circumstances changes – whether locum work dies down, a hospital cancels a long-term position, or you do fall ill and can’t work – then your fixed costs would be covered for a period of time by your savings. The recent COVID-19 pandemic has demonstrated just how important and valuable that kind of forward-planning can be, especially as in some areas and specialties there have been far fewer locum positions available.‍

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Best of Luck!

If you do follow these steps, and if your fixed costs and your work flexibility allow, you’re likely to be able to make a great salary whilst working fewer hours. As long as you plan ahead carefully and cover all the bases, you’ll be able to achieve what you’re aiming for and have a great locum year.

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For more finance-related articles, why not check out the following:

👉 Managing Your Finance as a Locum Doctor‍

‍👉 Tips to Increase Your Locum Pay

‍👉 Our brand new Locum Doctor Salary Calculator

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This article is part of a wider series of resources and guides that are designed to support you as a locum doctor, covering areas such as getting your first job, managing your finances, understanding your rights, and many more. Visit our Locum Doctor Hub for everything you need to know about locuming today.

Additionally, if you're considering an F3 year, you might also find it useful to look through the selection of resources we've put together in our F3 Resource Hub.