Career guide
How to become an agency or locum nurse in the UK: NMC registration, DBS, revalidation, framework agency vs NHS bank, and how self-employed nurses get paid.
A locum or agency nurse covers clinical work on a session-by-session basis for the organisations that need them, as a self-employed professional rather than a salaried employee. This guide walks through everything you need to do to start, in order, and the common pitfalls that catch people in their first year.
Guide | 6 steps
You need a current NMC registration and must complete revalidation every three years: 450 practice hours, 35 hours CPD, reflective accounts, and confirmation. Agencies ask for evidence of your next revalidation date before placing you.
NHS Professionals and individual trust banks handle most NHS locum nursing on PAYE. Agency nursing runs through framework-compliant agencies at capped rates. A small amount of direct private-sector locum nursing exists (insurance medicals, occupational health, specialist clinics).
NHS England caps framework agency nurse rates. Off-framework rates are higher but most trusts decline these. Expect Band 5 standard shifts at £22–£25/hr + unsocial hours uplifts (weekends, nights, bank holidays).
You’ll need a recent enhanced DBS, Basic Life Support, Moving and Handling, and Safeguarding (level 2 or 3 depending on role). Most agencies provide mandatory training modules; budget 2–3 days every three years.
NMC practice hours are tracked by revalidation year, not tax year. Keep a simple spreadsheet or use Sessional to log every shift with date, hours, and workplace. Missing the 450-hour minimum can mean a lapsed registration.
Most agency nursing is PAYE through the agency or umbrella. No self-assessment needed. If you work directly and invoice private clients, you’re self-employed and need a tax return. IR35 doesn’t usually bite unless you’ve set up a limited company.
Once you are registered
Log every session with its date, rate, and workplace, send invoices that chase themselves, keep your documents current, and watch your tax reserve build as you go.
Checklist | Documents
Sessional sends reminders 30 days before each expiry.
Checklist | First year
Related
Last reviewed April 2026. Rates and regulator details change. If something looks off, let us know.
From the first booking
Keeps the records, does the sums. Filing and advice stay with you and your accountant.
Sessional tracks every session, invoice, expense, and document from day one. No card to start.