How to set up as a GP locum in the UK

A practical guide

Becoming a GP locum is one of the more straightforward career transitions in medicine, but the administrative side of it is not well documented anywhere. Most GPs figure it out through a combination of asking colleagues, searching forums, and making mistakes. This guide tries to put the key steps in one place.

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Step 1: Make sure your registration is in order

To work as a GP locum you need full GMC registration, a licence to practise, and to be on the GP Register. If you are coming from GP training you will have all three on completion. If you are returning to locum work after a break you may need to check your licence to practise is still active and that your revalidation is up to date.

You will also need a designated body for revalidation purposes. As a locum without a permanent employer this is often your local NHS England area team or a GP chambers. NASGP has good guidance on this if you are unsure.

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Step 2: Sort your indemnity

Locum GPs need their own professional indemnity insurance. The state-backed NHS indemnity scheme covers certain NHS clinical work, but it does not cover everything, and it does not cover you for claims made after you have left a role. Most locums hold additional indemnity through one of the three main providers: MDU, MPS, or MDDUS.

The cost varies depending on your session volume and any higher-risk work such as out-of-hours or minor surgery. Get quotes from all three. It is a legitimate business expense and fully claimable against your tax bill.

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Step 3: Register as self-employed with HMRC

Most GP locums operate as sole traders, at least initially. You need to register for Self Assessment with HMRC if you have not already done so. You can do this online through the government website. Do it as soon as you start locum work rather than waiting until the end of the tax year.

Once registered, you will submit an annual Self Assessment tax return covering your locum income, minus allowable expenses. You will pay income tax and Class 4 National Insurance on your profits, plus Class 2 National Insurance as a self-employed person.

If your locum income is likely to exceed around £40,000 to £50,000 profit consistently, it may be worth exploring a limited company structure for tax efficiency. Get advice from an accountant who specialises in medical professionals before making that decision.

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Step 4: Open a dedicated business bank account

You do not have to do this as a sole trader, but you should. Keeping your locum income and expenses separate from your personal account makes your Self Assessment significantly easier and reduces the chance of missing something at tax time. Most high street banks offer business accounts, and there are several challenger banks that are free or low cost for sole traders.

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Step 5: Set up your NHS pension

GP locums can contribute to the NHS Pension Scheme, and most should. Contributions are made through Forms A and B: Form A is completed by each practice after each session, recording your pensionable earnings. Form B is your annual summary, which you complete and submit to NHS England by 30 September each year.

The pension is one of the most valuable financial benefits available to GP locums and is worth the administrative overhead. Missing Form A submissions or submitting Form B late means losing pension contributions that you cannot recover. Keep on top of it session by session rather than trying to reconstruct it at the end of the year.

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Step 6: Find work

The main routes for finding GP locum work are direct approaches to practices, GP chambers, and booking platforms. Lantum and LocumDeck are the two main platforms in England. Many experienced locums also build a list of practices they work with regularly and book directly, which removes platform fees and gives more control over terms.

When you start out, casting a wide net makes sense. As your reputation builds in a local area, direct relationships become more valuable.

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Step 7: Set your rate and your terms

Your rate is negotiable. Look at what other locums in your area are charging and use that as a starting point. NASGP publishes annual rate surveys. Your cancellation terms are also worth thinking about upfront: what notice period do you require, and what happens if a practice cancels inside it? Having this written down before you need it saves difficult conversations later.

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The admin layer

Once you are set up, the ongoing administrative work is: logging sessions, generating invoices, tracking expenses, managing your pension forms, keeping your documents current (indemnity, DBS, appraisal), and planning for your tax bill.

Most locums do this with a spreadsheet. It works, but it is time-consuming and easy to let slip. Sessional (sessional.co.uk) is built to handle this in one place, including NHS Pension Form A and B generation for GP locums. Free to start.

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This guide reflects the position as of 2025 and 2026. Registration requirements, pension rules, and tax thresholds change. Always verify current requirements with the GMC, NHS England, and HMRC directly.