Career guide

How to become a locum physician associate in the UK

7guide steps

Guide to locum Physician Associate work in the UK: statutory GMC regulation, the Leng Review scope debate, PANE recertification, and where PA demand exists.

At a glance | Regulator

General Medical Council (GMC)
statutory GMC registration as a Physician Associate required

A locum physician associate 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.

Typical rate
Typical UK locum physician associate rate (2026): NHS bank £21–£27/hr, agency £28–£42/hr, primary care direct £30–£45/hr. Market is structurally constrained by scope and prescribing limits.

Guide | 7 steps

Step by step.

01

GMC statutory registration

GMC registration for Physician Associates and Anaesthesia Associates opened on 16 December 2024 with a two-year transition window. From 13 December 2026 it becomes a criminal offence to use the title or practise without GMC registration. Apply now: voluntary registration is open, the previous Faculty of Physician Associates (FPA, RCP) PAMVR closed in December 2024, and waiting risks a backlog as the deadline approaches. Your reference number is a seven-digit identifier prefixed with the letter A (e.g. A1234567).

02

Pass the PARA exam

GMC registration evidence requires a pass in the Physician Associate Registration Assessment (PARA), or its predecessor the Physician Associate National Examination (PANE), within the last 24 months, with both parts passed within 18 months of each other. The RCP runs PARA on the GMC's behalf. Older qualifying routes are handled case-by-case under GMC transitional guidance. Revalidation rules for PAs are still being designed by the GMC and have not started; expect annual appraisals and at least 12 months' notice of your first revalidation submission.

03

Secure a Responsible Officer / designated body

Under the new GMC regime, every PA needs a designated body for appraisal and revalidation. NHSP or a CQC-registered agency can act as your prescribed connection. Without one, you cannot revalidate.

04

Understand the scope and prescribing limits

As of 2026 PAs cannot independently prescribe in the UK. Post-Leng Review, trust-level scope of practice documents are being enforced more strictly. Before any booking, check the host’s scope-of-practice document and supervising clinician arrangement.

05

Register with medical locum agencies + PCNs

Holt Doctors, Medacs, and ID Medical all run PA desks. For primary care, approach PCNs and GP practices directly – primary care PA locum rates (£30–£45/hr) are typically better than acute trust bank.

06

Sort indemnity separately from employer cover

CNST covers employed NHS work. Hold personal indemnity with MDU, MPS, or MDDUS – they all now have PA-specific products. Scope and indemnity terms have tightened post-2024 in response to high-profile cases; confirm terms explicitly.

07

Document supervision carefully

PA locum work exists inside a supervisory relationship. Keep written records of your supervising clinician arrangement at each booking. This is both a regulatory expectation and your main medico-legal protection.

Once you are registered

Once you are registered, keep the admin in one place.

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.

Every session tracked from logged through to paid

Checklist | Documents

Documents to have ready.

  • 01GMC PA registration certificate
  • 02PA National Examination (PANE) certificate
  • 03PA MSc qualification
  • 04Enhanced DBS (on Update Service)
  • 05Occupational health + immunisations
  • 06CSTF / mandatory training certificates
  • 07ALS / ILS certificates as appropriate
  • 08Indemnity certificate (PA-specific cover)
  • 09Scope-of-practice document from most recent employer
  • 10Appraisal evidence

Sessional sends reminders 30 days before each expiry.

Checklist | First year

First-year pitfalls.

  • •Assuming the old FPA voluntary register still counts. It doesn’t – GMC registration is mandatory
  • •Scope-of-practice drift where a trust asks you to perform tasks outside their local scope document
  • •Primary care work without clear written GP supervision arrangements. Medico-legally exposed
  • •Accepting rates that treat PAs as Trust Grade doctors where local demand has softened post-2024. The market is turbulent
  • •Confusion with patients about PA vs doctor role. Post-Leng this is a regulatory flashpoint

Related

Last reviewed April 2026. Rates and regulator details change. If something looks off, let us know.

From the first booking

Run your locum work like a business. Minus the accountant.

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.

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