How to become a locum GP in the UK

Step-by-step

1. 1

   Hold the right GMC registration

   You need full GMC registration with a licence to practise, plus entry on the GP Register. Provisionally registered or fully registered without a licence is not enough. If you’ve been out of the UK for a while, check your licence status before accepting any bookings.

2. 2

   Get on the NHS Performers List in England (or equivalent)

   Every GP delivering NHS primary care in England must be on the National Performers List. Scotland, Wales, and NI run their own equivalents. Applications go through PCSE in England and can take 6–12 weeks, so start before you hand in notice anywhere. Keep a certificate or screenshot of your entry: practices will ask for it.

3. 3

   Secure medical indemnity

   All NHS clinical negligence is now covered by the Clinical Negligence Scheme for GPs (CNSGP) in England. That’s only the NHS work. You still need discretionary indemnity from MDU, MPS, or MDDUS for private work, good-Samaritan acts, coroner’s inquests, GMC support, and disciplinary representation. Don’t skip this.

4. 4

   Decide sole trader vs limited company

   Most new locum GPs start as sole traders for simplicity. A limited company can save tax above roughly £60,000 gross (outside IR35), but adds real admin. Don’t form a company just because a colleague did. Read our IR35 guide before you decide.

5. 5

   Open a business bank account and set your rate

   A separate account keeps bookkeeping clean. Set a minimum session rate before you start offering. It’s much harder to push a rate up than to hold it. Check our UK locum GP rates benchmark for current figures.

6. 6

   Find your first bookings

   Options: direct approach to local practices and PCNs (highest margin), joining a GP chambers/federation, agency bookings (lowest admin, lowest margin), or a digital platform. Most established locum GPs mix two or three of these. Start with practices you already know.

7. 7

   Set up NHS pension (optional but usually worth it)

   NHS locum work is pensionable if you submit Form A (per session) and Form B (monthly). Miss the Form B deadline and you forfeit pensionable service for that month. Sessional automates the forms. If you opt out of the NHS pension, you’ll want a private SIPP instead. Don’t just leave the money in cash.

Documents to have ready

• GMC certificate of registration + licence to practise
• Performers List entry confirmation (PCSE in England)
• Indemnity certificate (MDU/MPS/MDDUS)
• Enhanced DBS certificate (within 3 years)
• Basic Life Support / Safeguarding training within the last 12 months
• MMR and Hepatitis B immunity evidence
• Right to work documentation
• Up-to-date CV + appraisal summary

Keep expiry dates tracked. Sessional sends reminders 30 days before each document lapses.

Common first-year pitfalls

• Missing the NHS Pension Form B monthly deadline. Losing a whole month of pensionable service
• Accepting a rate without checking if it’s sessional or hourly (a 4-hour session at "£85/hr" is £340, not the £120 session rate some practices offer)
• Forgetting to set aside 30% for tax and Class 4 NI
• Not tracking business mileage at 45p per mile. Easily £500–£2,000 of deductible expenses missed in year one
• Assuming discretionary indemnity is automatic; the paid-up membership is what matters