Why locum healthcare professionals deserve better tools than a spreadsheet

My dad has been a GP for 45 years.

Every Sunday evening, without fail, he would sit down at the kitchen table with a spreadsheet. He would log the sessions he had done that week, work out what each practice owed him, write the invoices, calculate his NHS pension contributions, and try to remember which expenses he had forgotten to note down.

He is a doctor. He spent his career diagnosing conditions that would have baffled most people, navigating the complexity of primary care, and filling gaps in the NHS workforce that would otherwise have gone unfilled. And yet the administrative layer of his working life, for four and a half decades, was a spreadsheet and a Sunday evening ritual he never quite got on top of.

I built Sessional because of those Sunday evenings. But the more I looked at the problem, the more I realised it was not just my dad.

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The locum workforce is enormous and almost entirely invisible to software

Nobody publishes a clean count of UK locums, which is part of the problem: they sit outside the payroll figures that get counted. What we can say is that across 17 regulated professions, a large number of clinicians are self-employed, working across multiple organisations, issuing invoices, tracking expenses, managing professional documents, and trying to plan their tax with no payroll department to help them.

This workforce is essential. It fills the gaps that would otherwise close GP surgeries, leave hospital wards short-staffed, and deprive communities of pharmacy cover. It is not a fringe category, and every organisation that has ever needed cover at short notice knows it.

And yet the tools available to them are, with very few exceptions, either nothing or a spreadsheet.

The exceptions that do exist are almost entirely single-profession. There are tools for GP locums. There are tools for locum pharmacists. They are siloed by profession, often outdated, and none of them cover the full picture: bookings, invoices, expenses, professional documents, pension forms, and tax planning in one place.

A locum nurse who also picks up shifts as a healthcare assistant has no tool. A physiotherapist moving between NHS trusts and private clinics has no tool. A sessional dentist managing their own bookings, invoices, and GDC registration has no tool beyond whatever they cobble together in Google Sheets.

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The admin burden is not a minor inconvenience

There is a tendency in conversations about locum work to treat the administrative side as an afterthought. The real work is the clinical work. The admin is just paperwork.

This is wrong, and anyone who has done locum work knows it is wrong.

When you are self-employed, the administrative layer is your business. Getting it right means getting paid on time, staying compliant with HMRC, keeping your professional registration current, not accidentally underselling yourself because you lost track of a session from three weeks ago. Getting it wrong means chasing unpaid invoices, missing expenses at tax time, letting an indemnity certificate expire, and arriving at self-assessment with a box of receipts and no idea what the number is going to be.

The Sunday evening spreadsheet is not a minor inconvenience. It is an unpaid second job that sits on top of a clinical career that is already demanding. And it falls disproportionately on the people who chose locum work precisely because they wanted more control over their time and professional life.

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The tools that do exist were not built with locums in mind

Most of the software that locums end up using was built for someone else.

Xero and QuickBooks are excellent accounting tools. They were built for small businesses and their accountants. Using them as a locum means wrestling with interfaces designed for someone who sells widgets, not someone who invoices NHS practices for clinical sessions. They do not know what a Form A is. They do not know the difference between a GMC number and a GPhC registration. They do not know that a locum GP's rate might be hourly, sessional, or daily depending on the organisation. They are generic tools, and their genericness is a constant friction.

So most locums fall back on the spreadsheet, and the spreadsheet is honest about what it is: a grid that does exactly what you tell it and nothing else. It will not tell you a Form A is outstanding. It will not notice that an invoice is 28 days overdue. It will not know that your indemnity certificate expires next month. It holds the numbers you remembered to type, on the evening you remembered to type them, and every gap in it is a gap in your records.

That is the fight worth picking. Not with any particular product, but with the idea that a professional running a real business should be doing it in a grid on a Sunday night.

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What good looks like

A locum healthcare professional should be able to open one application and see: what sessions they have coming up, what invoices are outstanding, what their tax reserve should be right now, whether any of their professional documents are about to expire, and what their earnings look like for the year so far.

They should be able to generate an invoice from a completed session in under a minute, with their bank details pre-filled and the correct rate already there. They should be able to log a mileage expense on the day, not try to reconstruct it in January. They should be able to store their indemnity certificate, their DBS check, and their revalidation documents in one place with alerts when anything is due for renewal.

For GP locums, they should be able to generate an NHS Pension Form A or B from the data they have already entered, not transcribe it by hand from a spreadsheet.

None of this is technically difficult. It is not artificial intelligence or blockchain or any of the things that attract investment and press coverage. It is careful, patient, profession-aware software built for the actual workflow of an actual locum, not the workflow of a generic freelancer.

The reason it has not been built properly until now is that the locum healthcare workforce is not a market that attracts attention. It is not glamorous. It does not have a loud lobby. The people in it are busy doing clinical work and do not have time to campaign for better software.

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Why this matters beyond the individual

There is a broader point here that is worth making plainly.

The NHS is structurally dependent on locum labour. That is not a criticism of the NHS; it is a reality of a healthcare system that cannot predict demand with perfect accuracy and cannot afford to carry permanent overcapacity. Locums make the system flexible. They cover gaps that would otherwise go unfilled and harm patients.

If we make it easier to be a locum, we make it easier for more healthcare professionals to choose locum work, or to combine locum work with other professional activities. We reduce the administrative friction that leads some locums to give up and go salaried. We make the locum workforce more stable, more professional, and more sustainable.

That is worth caring about beyond the software.

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My dad does not spend Sunday evenings on a spreadsheet anymore.

That is a small thing. But small things, done properly, across tens of thousands of people, add up to something worth building.

Sessional is free to start at sessional.co.uk.

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Will Stocker is the founder of Sessional, a workspace for locum healthcare professionals.