Interpreting the BMA’s Junior Doctor Locum Rate Guidance in 2023
In February 2023, the BMA published an updated locum rate card for junior doctors.
These are the hourly rates that, according to the BMA, locum junior doctors ought to be paid for their locum work to fairly value their time. These rates are, in some cases, an 80% increase on the current market rates.
It’s great that the BMA are advocating for much higher pay rates for locums. But this has caused uncertainty amongst locum junior doctors about what hourly rates are typically paid and therefore what rates they should be asking for from their locum agency or staff bank.
In this article, we will:
👉 Explain the BMA suggested rates, and how they compare to current market rates
👉 Advise locum doctors on how to interpret these rates
👉 Give recommendations for how to improve your hourly rate as a locum doctor
⏰ What are the hourly rates proposed by the BMA?
You can read the guidance in full here.
📈 How do they compare to current market rates?
For locum SHOs the BMA guidance rates are 80% above the current rates paid to locum junior doctors working in the NHS. For locums working at Registrar and Senior Registar levels, the BMA guidance rates are around 40% above current market rates.
Here is a detailed comparison by grade, looking at Weekday 8am-5pm hours only.
Current Market Rates (March 2023): £30-35
BMA Guidance: £62
Current Market Rates (March 2023): £35-42
BMA Guidance: £72
BMA Increase: +82%
Current Market Rates (March 2023): £42-48
BMA Guidance: £82
BMA Increase: +78%
Current Market Rates (March 2023): £61-69
BMA Guidance: £93
BMA Increase: +39%
Current Market Rates (March 2023): £66-73
BMA Guidance: £103
BMA Increase: +44%
A few points to note:
The market rates data is based upon Messly’s Locum Salary Calculator. This takes data from over 80,000 individual locum jobs which have been offered to doctors using Messly’s locum finding service since January 2021. These are averages and designed to guide you as to the most common rates achieved by locum doctors. Rates can vary significantly between hospitals in a similar region, within the same department from week to week, as well as variation nationally by specialty.
For SHOs, a lower rate of £36 is common in London due to the Pan London Rate Cap.
These calculations of the increase in the BMA guidance are based on the mid-point of market rates provided.
🤔 How should locum doctors interpret these rates?
It’s important for locum doctors to put the BMA rates into context.
These are the BMA’s in-house view on what locum hourly rates ought to be. They are advocating for significantly higher pay for locum doctors, in parallel with the campaign for pay restoration and associated strike action.
This is a theoretical exercise, based on their assessment of the value of doctor’s time. Unfortunately they have not laid out a methodology for this or provided any supporting notes in their guidance.
It should not be seen as guidance on what the rates to expect as a locum, nor as market research as to what rates are commonly paid by Trusts to locum doctors.
We have seen some doctors misinterpret the rate card in this way, and feel like a Trust or locum agency is misleading or tricking them when quoting a rate which is below the BMA rate card, but in fact in line with market rates.
We fully support these rates, and hope that NHS Trusts accept that these rates are fair compensation for locum doctors. However, you should be aware that these rates are significantly different to what is commonly paid to locum doctors at the moment.
❓ How are locum rates set by Trusts?
To give you some more context, we will outline how locum rates are set by Trusts.
Firstly, you should know that rates are set by each Trust individually. They do this by following guidance set by NHS England. These tend to set the range for what a Trust is prepared to pay a locum doctor, and can impose penalties for exceeding these rates. The most well-known of these is the Pan London Rate Cap, which sets rates for pay in London. You can read more about this here.
Within this range, the rate which is paid for a particular shift or block of shifts varies with the forces of supply and demand.
For example, the hourly rate will increase if:
👉 a shift is still unfilled at the last minute and the department desperate
👉 the department is already especially understaffed
👉 there have been a lack of applicants and the available doctors are holding out for a higher rate
And conversely, you should expect a lower hourly rate if:
👉 the department has a number of applicants to choose from
👉 the department can cope without a locum doctor for that shift
These factors will often change from week to week. This explains how one department might be offering more one week, and less a week later.
🤯 How have Trusts reacted?
In the first month since the BMA published their locum rate card, there has not yet been a noticeable change in locum rates paid to junior doctors at a national level.
We can’t comment on individual cases, but in general Trusts are likely to have been made aware of the guidance, but are still sticking to their existing rates.
💰 What rate should you work at as a locum? Should you follow the BMA guidance?
This is entirely your choice. This is one of the benefits of locum work - you can set the rate which you think is fair value for you time, and only work if and when you can achieve that rate.
This might change over time, and you might choose to enforce your desired rate flexibly. For example, you might want a significant premium for night shifts if you find these particularly taxing, or be happy to work at a slightly lower than normal rate at a favourite department where you enjoy the work.
If you choose to follow the BMA guidance, you should bear in mind that you are asking for a rate which is significantly above the current market rate, as explained above.
This is entirely within your rights, but you should be aware that you may not receive many offers of work, unless there are unusual supply and demand factors in place such as you being the only available locum.
For doctors using Messly’s locum-finding service, we will allow you to set your desired rate at these levels, but will inform you of the disparity with current rates so that you are aware of the possible implications.
We hope that the BMA’s work in this area has an impact, and that this results in a change in the guidance to Trusts on the hourly rates which should be paid to locum doctors.
We will keep this article updated should there be any change.
⬆️ What can locum doctors do to increase locum rates generally?
Some posts online have encouraged doctors to collaborate locally to force Trusts to increase their rates to meet the BMA guidance.
This would effectively act as an informal withdrawal of service - not technically a “strike” as you are not contractually obliged to work as a locum if you’re not in a contract - but aim to have a similar effect of forcing Trusts to increase rates.
In practice, these efforts have proved hard to coordinate. There is often someone willing to work at the current market rate, which is their choice if they personally see that as fair compensation for their time, which undermines the action.
❓ What can I do to get a higher rate myself?
At a personal level, there are a number of things you can do to increase your hourly locum rate.
We’ve written an in-depth blog on this, which you can find here.
In summary, the key points are:
👉 Focus on high-paying shifts, areas, and specialties
👉 Keep your options open
👉 Ensure your CV stands out
👉 Know your worth, and negotiate!
On the final point, your locum agency will do what they can to negotiate higher rates on your behalf, and the BMA guidance will certainly be a useful negotiation tool for that. You can read more about negotiating rates here.
🛠️ Other resources
To learn more about locum rates, check out the following articles:
📊 Locum Doctor Salary Calculator: Our free calculator lets you work out how much you could earn annually as a locum doctor, based on your grade, specialty, and the region you work in.
💲 Locum Rates: What Can I Expect?: A guide to help you anticipate the sort of rates you'll be paid as a locum, including a general overview of the UK pay rates and an explanation of the pan-London rates.
🏙️ Locum Rates in London: This articles explains the difference between the rates for locum doctors in London and elsewhere in the UK, exactly where those rates apply, how much you can expect to be paid, and your options if you want to earn more.
💰 How to Make a Living as a Full-Time Locum Doctor: Exploring how much you might expect to earn from locuming as a full-time SHO, highlighting key financial and work-related considerations you should be making, and providing advice to help manage your finances.
💯 SHO Locum Rates: Which Specialties Pay Best?: An in-depth breakdown of the rates you can expect to be paid as a locum SHO based on specialty.
🗺️ Do SHO Locum Rates Vary Across the UK?: Exploring whether the rates available to locum doctors vary across the different regions of the UK.
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