Understanding Your Rights as a Locum Doctor

So you’ve made the decision to be a Locum Doctor for a year. If you were going into a fellowship or a Trust grade post then you'll probably be signing a similar contract to doctors in training, and will therefore have the same rights as a permanent employee. 

But what employee rights locum doctors are entitled to?  

In this article, we’ll explore this topic to help you understand your employee rights as a locum doctor with regards to key things like annual leave entitlement and other employment issues.‍

🏖️  Annual Leave‍

After 12 weeks of locuming with the same employer you're entitled to the same statutory paid leave as permanent employees. Instead of annual leave, you get 'holiday pay' at 12.07% of the total hours you worked. This payment is in lieu of annual leave because of the significant variety in amount of work that locums can do in any given month.

Before 2006, holiday pay was rolled up into your agreed hourly rate on your payslip however, it is now a legal requirement that your payslip defines which part of your pay is from salary and which is holiday pay. This makes it easier to keep track of whether or not you are being paid properly. You can read our full article on interpreting your payslip here.

If you have not received your holiday pay, speak to your locum agency or the HR/Payroll of the staff bank where you're working. You may find you are owed a substantial back payment for all the shifts you've worked.

Occasionally, Trusts and agencies may get away not paying out holiday pay, usually because they advertised a role with an hourly rate inclusive of any holiday pay. This is not best practice but it isn't illegal as they have technically paid you for the time. However, they would still need to separate the basic pay and holiday pay on your payslip going forward.

If you weren't told in advance of accepting work that the hourly rate is inclusive of holiday pay, and a Trust or agency later tells you that their standard practice is to 'roll it up' then you are still entitled to reclaim your holiday pay for the hours you have already worked, as you were not told about this policy in advance.

If you're having issues regarding holiday pay, either from your Trust or agency, we recommend getting in contact with the BMA or Acas for further advice about employee workplace rights.

You can read our full article dedicated to the topic of annual leave allowances for locum doctors here.

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😴  Rest Breaks‍

Your booking terms and conditions should state the rest break policy that the Trust has for locum bookings. Most Trusts don't pay for rest breaks and they'll set out rest break requirements per shift. This is usually 1 x unpaid 30 minute break for a 5 hour shift, and 2 x unpaid 30 minute breaks for a shift over 9 hours, as stipulated by the the BMA 2016 contract. Make sure to check this with the rota-coordinator or your agent prior to starting your shift as not all trusts will follow this to the book.

If you find you're not getting the rest breaks you're supposed to, it’s worth discussing this with the rota co-ordinator or booking co-ordinator.

Unless there's an extenuating circumstance, like a particularly unwell patient which prevents you from taking your break, you're likely to be told that rest breaks are compulsory and will not be paid, but this may raise an issue with unsafe working if it's a persistent problem.

🤒 Sick Pay

Depending on how they are employed, locum doctors may be entitled to NHS or Statutory Sick Pay like any permanent employee, or may not be entitled to anything at all.

Agency workers are usually not entitled to full pay for work missed due to illness, but it is worth checking your agency's terms and conditions before assuming the worst. If they've arranged a long-term locum post with a contract, there may be a clause about sick pay. 

Staff bank locum doctors generally do not get paid for cancelled work, and in the rare cases where the doctor has been paid in advance for work, the Trust will often adjust future payslips to reflect the missed work and discrepancy in pay.

Depending on the amount of work the agency or locum doctor does for a Trust, they may qualify for NHS sick pay scheme (if their locum work counts as continuous NHS service) though this is unlikely and you would need to confirm this with your Trust HR before relying on this option.

Both Agency or Staff Bank locum doctors may be entitled to up to 28 weeks of Statutory Sick Pay (SSP) if:

1. They are classed as an employee, and have already done some work for their employer. 
2. They earn an average of at least £123 per week 
3. They have been ill for at least 4 days in a row (including non-working days).

They may need to provide a sick note or certificate as evidence of their inability to return to work. 

You can read our full article on sick pay entitlements for locum doctors here, which included information about how to protect yourself if you have dependents or significant financial responsibilities.

⚠️  Notice Period‍

It's always important to check each individual position's notice period, from both your side and the employer, which should be laid out in the terms and conditions for each job you take on. 

Generally, most Trusts can cancel shifts up to 24 hours before the start time, and sometimes not even 24 hours of notice is required from them. This usually works both ways though, so the same rules would apply to you if you decided to cancel a shift. 

It’s worth remembering this when planning your schedule because, even if you have a long-term locum position booked, if the circumstances of the Trust change they could still theoretically cancel your shifts at very short notice. 

Best practice would obviously be for both parties to give a reasonable amount of notice, and most Trusts do. If they cancel at short notice too often then they'll be risking damaging their relationships with locum agencies and doctors.

👶  NHS Scheme For Maternity Leave (and pay)

Maternity, Paternity, and Parental leave for locum doctors is a complicated subject - one which we have covered in detail in this article; 'Do locum doctors get maternity pay?'

In summary though, there are a number of different maternity schemes that locum doctors may qualify for depending on their individual work circumstances. These schemes are; the NHS scheme, Statutory Maternity Pay (SMP), or Maternity Allowance. 

To qualify for the NHS scheme doctors are required to have worked 12-months of continuous service with 1 or more NHS employers at the beginning of the 11th week before the expected week of childbirth, and have stated their intention to return to work within the NHS at the end of the leave period. Locum doctors can qualify for this scheme in certain circumstances.

Locum doctors who do not qualify for the NHS scheme, may be eligible for the SMP scheme. To be eligible, they must be classed as an ‘employee’ and not a ‘worker’, so sole traders or limited company locums may not be eligible but staff bank locums may qualify. They must give their employer the correct notice and proofs of pregnancy, and satisfy two rules which you can read more about in this article; ' 'Do locum doctors get maternity pay?'

Once you find out you are pregnant, you should speak to your Trust HR department to check your eligibility for the NHS or SMP schemes. If you encounter any difficulties or feel you have been given a wrong response by the Trust, speak to your BMA representative who may be able to provide you with additional support and advice.  The BMA have some extra guidance on this here.

✅  Our Top Tips‍

    1. Check whether your hourly rate includes holiday pay and make sure this is clearly distinguished on your payslip. If it is not on your payslip, you may be owed a significant back payment.

    2. Check your Trust's rest break policy and prioritize taking them wherever possible. 

    3. Take possible unexpected sickness into account when planning your finances as a locum doctor. For extra help, see this article explaining how to make a living as a full-time locum doctor.

    4. Check the terms and conditions of your notice period when booking shifts.

   5. If you're currently pregnant, or planning for a child, speak to HR of the Trust you're working with at your earliest convenience to see what you might be eligible for.

    6. If any employment issues arise, consider taking out a union membership. They will advise you on your rights and represent you if any problems arise.

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If you follow the tips above, it will help you to make the most of your time locuming and have a positive experience. Hopefully this article will leave you with solid understanding of what employee rights you'll have as a locum doctor, which will get you well prepared when approaching your exciting new work situation.

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Specialty-Specific Guides

We're also working hard to provide you with a guide for each of the main specialties, giving you tips on how to settle into those departments. These will be especially useful if you haven’t rotated through that specialty in your Foundation Training rotations before.

Tips for Locuming in a New Specialty – General Medicine

Tips for Locuming in a New Specialty – General Surgery

Tips for Locuming in a New Specialty – Orthopaedics

Tips for Locuming in a New Specialty – Paediatrics

Tips for Locuming in a New Specialty – Obstetrics & Gynaecology

Tips for Locuming in a New Specialty – Emergency Medicine

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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.