Moving from a salaried post or completing your vocational training and stepping into locum practice is one of the most significant transitions a GP will make. Done well, it offers genuine clinical freedom, competitive earnings, and a level of work-life control that salaried employment rarely provides. Done without adequate preparation, it creates compliance gaps, tax complications, and income instability that can take months to unravel. This guide walks you through every step you need to take before booking your first session.
Before You Start: What You Need in Place
Transitioning to locum work is not something you can do overnight. The steps below typically take four to eight weeks to complete in full if you are starting from scratch. Planning ahead — ideally while still in your salaried post — is strongly recommended so that you are placement-ready from day one.
You must hold a current GMC registration with a licence to practise and be on the GP Register, having completed your MRCGP and CCT. Log into GMC Online and confirm:
- Your licence status is shown as Granted
- Your GP Register entry is current
- Your contact details and designated body are up to date — your designated body will need to change when you move to locum work
- Your revalidation date and the responsible officer linked to your record
If you are moving from an NHS employer, notify your current designated body of your intention to leave so your revalidation record transfers correctly.
All practising GPs must hold adequate professional indemnity. The main providers for locum GPs are the MDU, MPS, and MDDUS. Key points:
- The NHS Clinical Negligence Scheme for GPs (CNSGP) covers NHS-funded work — but you still need top-up cover for Good Samaritan acts, medico-legal work, and private sessions
- Notify your existing provider you are moving to locum work — your premium classification will change
- Ensure your cover explicitly includes every setting you plan to work in (GP surgery, OOH, UTC, etc.)
- Budget approximately £3,000–£7,000 per year for comprehensive locum indemnity
Locum GPs can operate as a sole trader, through a limited company, or via PAYE through an umbrella company or agency. Since April 2017, NHS organisations have been responsible for assessing IR35 status — and the vast majority assess NHS locum GP engagements as inside IR35, eliminating most of the tax efficiency of a limited company for NHS work.
- Sole trader — simplest structure, income via self-assessment. Recommended for most GPs primarily doing NHS work
- Limited company — only beneficial if you have significant private, medico-legal, or non-NHS income that may fall outside IR35
- Umbrella company / PAYE — minimal admin, but typically least financially efficient
Speak to a specialist medical accountant — not a general accountant — before deciding. The wrong choice can cost thousands.
If operating as a sole trader or through a limited company, register for self-assessment promptly — late registration carries a financial penalty. From day one, set aside 25–30% of gross earnings for tax to avoid a large unexpected bill at the end of your first tax year. Keep a clear record of all income, expenses, and payment dates.
Every practice that books you will require sight of a compliance pack before your first session. Standard requirements include:
- GMC certificate and current online registration confirmation
- Enhanced DBS (Disclosure and Barring Service) certificate — renewed within the last three years
- Proof of right to work in the UK
- Indemnity certificate showing current cover dates and scope
- Mandatory training certificates: Basic Life Support, Information Governance, Safeguarding Children Level 3, Safeguarding Adults Level 3, Fire Safety, Manual Handling
- Two satisfactory references from recent clinical supervisors
- Occupational health clearance (including immunisation status)
Working with SHR Group means your compliance pack is managed and maintained centrally — we verify, store, and present your credentials to clients so you are not resubmitting this information for every new booking.
Locum GPs can access the NHS defined benefit pension through the GP SOLO arrangement. You declare your NHS pensionable earnings quarterly and pay both employee and employer contributions yourself. This is administratively demanding but the long-term value of the NHS pension — given its defined benefit structure — is significant and should not be sacrificed without careful consideration.
Many experienced locum GPs cite failure to pension consistently as one of their biggest financial regrets. Set up a direct debit for your estimated quarterly contributions from the outset.
As a locum GP without a fixed employer, you must ensure you are connected to an appropriate designated body so your annual appraisals are received and your revalidation recommendation can be made. Options include NHS England (as prescribed body of connection), a local GP chamber, or connection via the NHS Performers List. Update this in GMC Online as soon as you leave your salaried post.
The fastest and most reliable route to building a consistent locum diary is registering with a specialist primary care recruitment agency. SHR Group maintains active relationships with hundreds of GP practices, PCNs, and urgent care providers across the UK. We match you to sessions based on your location, availability, clinical interests, and rate requirements — and we manage your compliance centrally so you can focus on clinical work.
Do not wait until you have left your salaried post to start this process. Steps 1–6 can be completed while still employed. Aim to be fully compliance-ready and registered with an agency at least two weeks before your intended start date — this gives practices enough time to verify your credentials and book you for sessions.
Your Compliance Checklist at a Glance
✅ Locum GP Pre-Start Checklist
- GMC registration with licence to practise — confirmed current
- GP Register entry — confirmed current
- Designated body updated in GMC Online
- Indemnity insurance in place — correct cover type and dates
- Trading structure decided — sole trader, limited company, or umbrella
- HMRC self-assessment registration submitted
- Enhanced DBS certificate — issued within 3 years
- Proof of right to work document
- Mandatory training certificates — all current
- Two clinical references — confirmed and available
- Occupational health clearance
- GP SOLO pension arrangement set up
- Registered with a specialist locum GP agency
How Much Can a Locum GP Earn?
In 2025, experienced locum GPs in England typically earn £85–£115 per hour for standard GP surgery sessions, with higher rates available for OOH, urgent care, and premium or hard-to-fill locations. Working seven full sessions per week at £90/hr equates to approximately £142,000 gross per year — though net take-home after indemnity, tax, and pension contributions will typically be £70,000–£85,000.
Remote and rural practices often pay above the standard rate due to limited local supply. Urgent treatment centre and OOH providers typically pay a premium given the unsocial hours involved. Your rate will also increase as you build a reputation with practices and accumulate experience across different primary care settings.
What to Expect in Your First Three Months
Most new locum GPs find the first three months the most challenging — the combination of getting compliant, building a diary, adapting to different practice systems, and managing your own tax and invoicing is genuinely demanding. Here is what to expect:
- Weeks 1–2: First sessions likely through your agency while you build direct relationships with practices. Expect to spend extra time at the end of sessions familiarising yourself with practice systems (EMIS, SystmOne, Vision).
- Weeks 3–6: Practices that value your clinical work will begin requesting you directly. Ask your agency consultant to pass on feedback and flag you as available for repeat bookings at practices where sessions went well.
- Months 2–3: Your "anchor sessions" — regular weekly or fortnightly bookings at two or three practices — begin to form. These become the foundation of a stable, predictable diary. By month three, most GPs who have followed a structured approach have a reliably full diary.
Ready to Start Your Locum Career?
SHR Group supports GPs at every stage of their locum journey — from compliance set-up and credential management to finding the best-paying sessions in your area. Register today and speak to a specialist consultant within 24 hours.