In the world of general practice, flexibility and autonomy are two of the biggest reasons many doctors choose to work as GP locums. The freedom to choose where and when to work, to explore different practices, and to balance work and life on their own terms is a major draw. But hidden in many agency agreements is a restrictive term that undermines that freedom — the exclusivity clause.
An exclusivity clause means that if a GP locum is introduced to a practice through an agency, and later accepts a permanent position or additional fixed-term sessions at that practice without the agency’s involvement, the agency can claim the right to charge a significant fee. In some cases, this fee can be as high as 15% of the GP locum’s annual salary. These clauses are often tucked into contracts and can have far-reaching effects that many GP locums don’t realise until it’s too late.
Exclusivity clauses in GP locum agency contracts might seem like just another bit of legal jargon, but they carry significant consequences. They can limit your career freedom, place financial burdens on practices, and ultimately hurt the healthcare system. (That’s why in the past they’ve been called ‘Trojan horses’).
By being aware, asking questions, and supporting ethical agencies, GP locums can reclaim the independence that drew them to locum work in the first place.
Exclusivity clauses: risks to GPs
While agencies may argue that exclusivity clauses compensate them for the initial introduction to a practice, in practice, these clauses often serve to restrict GP locums and protect agency profits at the expense of doctors and practices alike.
Loss of opportunity
A GP locum may work several sessions at a practice, build rapport with the team, and find that it’s a great fit. Naturally, they might consider joining the practice permanently or agreeing to more sessions directly. But if the agency’s exclusivity clause is still in effect, the practice could face a substantial fee just to hire someone they already know and trust.
The result? Practices may hesitate to offer a role to a GP locum they would otherwise happily bring on board. The agency, having done nothing beyond the original introduction, effectively blocks the GP locum from progressing in their career.
Loss of autonomy
A big part of the appeal of being a GP locum is the autonomy. GP locums want the freedom to choose where to work, test out different environments, and make decisions based on what works best for them. Exclusivity clauses strip away that flexibility.
They tie a GP locum’s hands, making them subject to terms that may stop them from working where they want, when they want, even if the agency has had no recent involvement in the arrangement.
Financial and legal risks from exclusivity clauses
In some cases, the clauses don’t just apply to the practice — they can apply to the GP locum too. Agencies may threaten to pursue a GP locum for fees or damages if they find out they’ve taken work at a practice without going through the agency.
This creates unnecessary pressure and turns a simple working relationship into a potential legal headache. Some GP locums have received letters demanding payment or threatening legal action, simply for continuing work at a practice they were introduced to.
Impact on the NHS
Exclusivity clauses don’t just harm individual GP locums — they also have a damaging effect on the broader healthcare system. At a time when general practice is struggling with recruitment and retention, creating barriers between willing GPs and willing practices is the last thing the NHS needs.
These clauses reduce flexibility in the system. They prevent long-term relationships from developing naturally between GP locums and practices, and they can keep practices understaffed simply because they can’t afford to “buy out” a GP locum they already know and trust.
Agency alternative: LocumDeck
A growing number of GP locums and practices are turning to alternatives like LocumDeck — the NASGP’s platform created by GPs, for GPs.
LocumDeck allows GP locums to connect directly with practices, cutting out the middlemen and avoiding restrictive agency clauses altogether.
In our terms of use for practices, we explicitly say: “For the avoidance of doubt, this clause does not prohibit the Practice from offering a Platform User a salaried or partner position in its own Practice.”
It’s completely free for practices to use, and gives GP locums full control over their bookings, terms, and availability. For our members, it’s a fairer and more transparent way to work.
