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

If you're working as a locum doctor, you're still entitled to the same statutory paid annual leave as permanent employees on a pro rata basis. And once you've worked 12 weeks with the same employer, you'll be entitled to the same benefits as those employed directly through the trust (i.e. Trainee and Staff Grade Doctors).

Most NHS Trusts will prefer to pay 'holiday pay' at 12.07% of the total hours you worked, in lieu of annual leave entitlement to locum doctors. This is due to the difficulty of scheduling this with intermittent and short-term working arrangements.

Prior to 2006, this will was previously rolled up into your agreed hourly rate on your payslip (known as 'rolled up holiday pay'). However, legally, your payslip must now clearly state which parts of your pay are from salary and which parts are holiday pay, which will allow you to easily keep track of this. You can read our full article on interpreting your payslip here.

If you find that you are not receiving holiday pay, then you should raise this at the first instance with either your locum agency, or the HR/Payroll of the staff bank where you are working at. As a result of doing so, you may find a substantial back payment for all the shifts you've worked.

Occasionally, Trusts and agencies may get away with this. This is usually because they would have advertised that the hourly rate was inclusive of any holiday pay 'before' you agreed to any work. Whilst doing this is not best practice, it isn't illegal as they have technically paid you for the time. However, they would still need to separate this on your payslip going forward.

However, if you are not told this in advance of accepting work, and a Trust or agency later tells you that their standard practice is to 'roll it up' then in despite of this, you would be entitled to reclaim your holiday entitlement for the hours you have already worked.

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

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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

If you were to ever become ill, or need to self-isolate, then you need to know what you’d be entitled to, and you should plan your finances accordingly.

It’s worth checking your terms and conditions for each job, but usually as an agency worker you wouldn’t be entitled to pay for missed shifts if you were to need to take time off sick. 

If you were doing Bank shifts, this may change. Some Bank workers have been paid by the Trust for shifts they had booked in advance which they could no longer work. In this situation, it’s best to find out what happened from colleagues who’ve been in a similar situation before, and ask the HR department for advice.

Should you become unwell, both agency and bank workers may be entitled to Statutory Sick Pay (SSP) providing you meet certain criteria, which you can find more about on the .gov webpage here. As an FYI, this is paid at £99.35 per week and can be paid for up the 28 weeks.

We'd recommend discussing sick pay benefits with your recruiter or bank prior to joining as there may be additional sick pay benefits that you might be entitled to.

⚠️  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)

To qualify for Maternity leave and pay under 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. You can read more about this here.

But does locum work count as continuous service? The answer is yes, at least for bank workers. If you do a certain number of hours with a bank over a period of time (decided by each individual trust), then this can be considered continuous service. But as there are so many nuances with this we would recommend that you speak to your HR department to confirm your entitlements.

Locuming through an agency is a separate matter and we’ve heard stories from some locum doctors being denied the NHS Maternity scheme, whilst others have been successful. Again speak to your HR and locum agency as even if you do not qualify, there might be other schemes that you could be eligible for, such as Statutory Maternity Pay and Maternity Allowance. 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.

    2. Check your rest break requirements and try to take them wherever possible. 

    3. Take your sick pay into account when planning your finances. 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 in 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.