How to Find Work as a Locum Doctor: Bank vs Agency

If you’re looking to pick up work as a locum doctor during an F3 or locum year, you’ll either be working through the hospital’s own Staff Bank or finding work via one or more locum agencies.

This article will explain how each of these works, will weigh up the pros and cons against each other including registration, payment, and access to shifts, and will answer a number of frequently asked questions to help you decide the best option for you.

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Locum Agencies

These are organisations that specialise in filling vacant hospital shifts with locum doctors.

If you register with an agency, you’ll be assigned a recruitment consultant who will be your point of contact. The good ones are experts who know the locum market inside-out, and will guide you through the process of finding the right locum jobs for you. They know which hospitals will have shifts, who pays the most, and where the work might be easier or more difficult. It’s a bit like working with an estate agent who understands the local area when looking to buy or rent a flat.

Agencies are private, profit-making companies, and they charge Trusts fees for filling shifts and managing compliance. That means they’re motivated to ensure you’re working as much as possible, but will also aim to place you in shifts where they can earn higher fees. You can find our more about the relationship between Trusts and locum agencies in this article here.

Recently, the NHS has clamped down on profiteering for agencies by capping pay rates, and through improved adherence to procurement frameworks which limit how much commission they can charge.

When you work with an agency, they are responsible for ensuring you’re eligible to work, so they’ll perform all of the compliance required before you can start - including DBS checks, Occupational Health, and Right to Work, amongst others. They’ll also ensure that remains up to date throughout the year. You can find a much more detailed explanation of this here.

In some cases, the agency will pay you directly (then bill the hospital later), and in others you’ll be paid directly by the hospital through a process called direct engagement.

Choosing agencies with good reputations who can provide access to the types of shifts you’re looking for is critical. Messly have developed a new service to help you find out which agency is best suited to your own unique situation and preferences, all before you sign up with them. Click here to find out how it works. To find out how we compare to signing up with agencies directly, click here.

Agencies are great for:

⏳   Getting registered quickly. Agencies are motivated to get you fully compliant quickly, so they’ll help you through the process and come to meet you to check original documents. It’s still a painful process, but it’s much easier with this extra assistance.

📅  Long-term placements. Agencies can help to book you into long-term roles to help fill a rota gap. These longer-term shifts are normally around 3-6 months, and there is sometimes the opportunity to extend these further in the same hospital. ‍

🕵   Finding work easily. Your recruitment consultant will liaise directly with Medical HR in your target hospitals to find vacancies, and will also book you into the shifts you want. This can save you a huge amount of time and effort, and help to provide more stability and guarantee you work elsewhere if it dries up in one location, so that you can still meet your financial goals.‍

💰   Getting paid promptly. Most agencies will pay you weekly. By comparison, some Staff Banks will pay you monthly with a mid-month cut-off date for timesheets, so it can take up to 45 days to receive the money in some cases.‍

🗺️   Wider work opportunities. Being registered with an agency means they can find you work at any and all of the Trusts they work with. They’ll send updates by email, usually on a daily basis, with new shifts that have come in. This means you can explore the different specialties, departments and hospitals - so that you make a good decision about where you work in the future for your F3 year…and if you decide to go back into training, you’ll be in a better place to pick your specialty and location. Through a Staff Bank, you’ll only get work in that one Trust (although shared or collaborative banks are becoming more common). ‍

🤝   Negotiating rates. Being part of both a Staff Bank and an agency gives you access to a greater number of shifts. You can use this to your advantage and instruct your agency to only look for locum shifts with higher paying rates than your own Bank. This means that you can keep working at your Bank and work at other Trusts when it’s worth your while. Over time you’ll learn the different “Market Rates” for your grade and experience at the various Trusts which can help you negotiate your own hourly rate, either directly with your bank or through your recruiter with the other Trusts you work at.‍

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Staff Banks

A 'Staff Bank' is the Trust's pool of doctors, many of whom will have rotated through the Trust before, who are eligible to pick up locum jobs at their hospitals.

This is the first port of call for hospitals to fill vacancies. If the shifts aren’t filled through the Staff Bank, shifts will then be shared with agencies. This means that working via the Staff Bank gives you first pick of the best work opportunities, whereas agency shifts can often be during unsociable hours and more ad-hoc.

In this situation you’ll be working directly for the Trust, so they’ll be responsible for the compliance process. This is largely the same as the process run by agencies, but without the urgency and extra support of an agency it can be lengthy and arduous, often taking between two and three months. Sometimes even finding the right contact person can be a challenge in itself! Some Trusts are great, but many are terrible in this regard.

You’ll also be dealing with the Medical HR team directly to find about upcoming shifts. Some will share these by email, others use a booking app such as Locum’s Nest.

Staff Banks are great for:‍

🏥   Saving the NHS money. The agency fee to Trusts for their services increases the overall cost to the NHS as a whole, whereas there is no ‘middle man’ if you work directly with the Trust.‍

📋   Access to shifts (maybe). A well-run, well-organised Staff Bank will fill most of their shifts directly, with the agencies only picking up the scraps. However, in many cases the Trust will actually send the majority of their shifts to agencies, meaning the agencies have good access to work at their hospitals. There’s a reason the vast majority of shifts are filled by agencies!

⏰  Working ad-hoc in a singular location. If you’re only planning to work in 1 hospital for the entirety of your F3 year, and don’t mind if shifts are sporadic, then working solely for a bank might be in your best interest. You’ll be able to liaise directly and check in with your staff bank or rota-coordinator for available shifts whenever you have the the time to locum.

🙂   Building relationships. You’re likely to get a fuller induction and feel more like a part of the team when part of a Staff Bank. If you’re working consistently in the same place it will arguably provide a better experience, and you’ll build up stronger relationships than if you were moving between different jobs.

📚  Getting free appraisals. Most banks will provide you with a free appraisal providing you meet their requirements for hours worked in each month. They may also provide you with a free ePortfolio, or extend your previous one, for you to log all of your learning events which you will need for your annual appraisal. You can find more about appraisals here.

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Answering Your Burning Questions

Which is… easier to get started?

Agencies. Whilst you’ll require the same documentation either way, agencies are more motivated to get you fully compliant quickly. Medical HR teams are typically not as proactive. You can find out more about the timeline for these in our article here.‍

Which gives me… priority access to shifts?

It depends. As explained above, a well-run, well-organised Staff Bank will fill most of their shifts directly, with the agencies only getting the undesirable shifts which will often come at short notice.

Unfortunately, that’s not always the case though. Some Staff Banks are poorly managed, meaning it can be very challenging to get registered, and they'll only publish shifts sporadically or you will need to call up the rota co-ordinators. In those cases, there's little benefit to working with the Staff Bank over an agency.

Which gives me… wider access to work?

Agencies. Being registered with an agency means they can find you work at any and all of the Trusts they work with. They’ll send you regular emails with all their latest shifts and opportunities. As mentioned earlier, a Staff Bank will only allow you to work in that one Trust (or you might end up in a shared or collaborative bank if you’re lucky).

Which is…better for long-term placements?

Agencies. Agencies are better at finding middle to long-term placements often between 3-6 month blocks to fill in rota gaps. Whilst this is also possible with banks, you’ll have to negotiate these yourself with the rota-coordinator. But often shifts are released en masse and it can be a scramble to book these yourself, so you end up with a mix n’ match of shifts.‍

Which gives me… better support?

Staff Banks. When you have a direct relationship with the Trust, you’re likely to get a more personable experience, a better induction, and feel more like a member of the team. However, it’s important to remember that once you’re working in a hospital, the strength of your relationships will be based on the quality of your work more than how you booked the shifts. Read more in this article, which provides tips about how to approach your first day as a locum doctor in a new hospital and make a good first impression.‍

Which gives me… better pay?

It depends. Pay rates vary from hospital to hospital, and even between departments within the hospital, based on the levels of demand and how many willing locum doctors there are. Neither Staff Banks nor agencies consistently pay more than the other. However, through agency work you’ll be able to move around to find higher paying work if you’re comfortable doing this. If you're interested, you can check out this article for tips on increasing your locum pay.‍

Which is best... overall?‍

In our opinion, that depends on how well-run the Staff Banks are at the hospitals you want to work at. An effective, efficient Staff Bank that’s easy to join and fills most of their shifts directly is a much better option than an agency, and has the added benefit of saving the NHS money.

However, if the Staff Bank isn’t organised or managed well, nearly all shifts will go to agencies any way and you’ll be much better looked after working with them.‍

I'm still unsure… What should I do?‍

Luckily, in this case, you can have your cake and eat it too.

As a locum doctor, you’re a freelance worker responsible for finding shifts for yourself, so you should  find as many paths to good, well-paying shifts as possible.

That means registering with Staff Banks of those Trusts where you’ve worked before, or places you know you’ll definitely want to access lots of shifts... but only if you know that the Staff Bank is well-organised. We must say, as a word of warning, that once you’re registered with the Staff Bank agencies cannot find you work there, so this is a commitment to working only through the Staff Bank at that Trust.

You should also register with a small number of agencies so they can also be proactively looking for suitable shifts that meet your needs.

The key challenge is recognising that all the locum agencies will claim to have access to the best work at the best rates. You’re going to need to know which ones have the right work before you register with them, and you’re not sure who will genuinely look after your best interests.

Messly’s new service has flipped the process around to put you in control, allowing you to find locum work quickly and easily on your terms. You create a profile which says exactly what kinds of work you're looking for, where in the country you want to work, and what rates you expect, and let the opportunities come your way.

You'll then be ‘pitched’ by multiple agencies, offering you relevant shifts matched to your specified needs and preferences, and you only register with the ones you like. You can read more information about our new service before you get started here.

Still have more questions?

We've created a video to help give more information about Banks and Agencies, as well as more general questions about locuming, find this video here. If you'd prefer to read it instead, check out our article here.

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.