Setting locum rates for freelance GP locums

What should my locum rates be?

There are perhaps two aspects to working out what rates you should charge GP practices as a GP locum. Firstly, there is what is a fair rate given the costs that you will incur, and secondly, there is what is the market rate for someone with your experience based on the service you provide.

NASGP's locum rates calculator covers the first of these areas very well. When calculating a rate, the calculator takes into account the other expenses that you have to pay for that can catch out many inexperienced locums. Items that people might miss include professional memberships, NHS appraisal and also accountancy and tax advice. It's all about thinking and behaving as a business, and to be sure that you cover all of the costs of providing your service. Our calculator is a great way to ensure that you include everything.

The second route, that of ascertaining the 'market rate', is more difficult now that the BMA doesn’t publish suggested rates (see historical context below). The move away from publishing rates was made because of legal concerns about anti-competitive behaviour, and was done very much to introduce fairness so that locum rates would not be artificially determined by the BMA - an organisation which has historically been led predominantly by those who contract locum services.

Rates are impacted by many factors: your skills and level of experience might come into it; short notice, urgent bookings can attract higher fees; some locums vary their rates during periods of high demand; the supply and demand for locum cover in an area. There's no one-size-fits-all.

If you can’t find a direct comparator for your experience amongst locums, as is often the case given the legal difficulties in discussing rates with colleagues ("You must not discuss the prices you’re going to charge [practices] with [other locums]."), then consider benchmarking your rates around what you would expect to achieve for the workload and number of sessions in a similar fairly-paid salaried post. Then factor in an allowance for your professional and personal running costs and an allowance for leave (annual, sick and study) and this should help you arrive at a ballpark sessional or hourly rate. This is the basis of how the NASGP locum rates calculator works. Even then, you may be flexing this figure for different practices and at different times.

Having arrived at a rate you think is reasonable, test it by seeing what response you get from practices. One tip - NASGP's LocumDeck includes an Instant Book option which enables locums to effectively test locum rates on different practices in different areas, presenting these in LocumDeck as Instant Book sessions. By experimenting with different rates for sessions offered in advance, that can be booked instantly by practices, locums can determine what the 'market' is happy to pay for their services. This route also has the advantage of not requiring direct negotiation skills, which few doctors have experience of or training in.

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More FAQs on defining and setting your locum rates

Complete NASGP's locum rates calculator to help you work out your baseline hourly or sessional locum rate. Once you've done this, you can then tailor the rate according to your experience, skills and different practices you work in.

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We've created a calculator to help you arrive at a ballpark figure taking into account covering your professional and personal running costs.

But in addition to your circumstances, there may be local factors at play which could influence your locum pay environment. If you’re new to an area or new to locuming, how do you work out what rates to charge?

Simply asking around is not option, with anti-competition laws being quite clear about the illegality of discussing rates with fellow GP locums.

Local factors that may affect locum pay

  • Supply of locums - the more locums, the more potential for downward pressure on rates. We hear this from members in the more vibrant towns and cities, perhaps with a local GP training scheme that then attracts and retains lots of GPs to start out as locums.
  • Presence of a dominant practice-facing online platform or agency. We hear from members that having one of these in your area can sometimes skew the pay and conditions of local independent locums in a downwards direction.

So how can LocumDeck’s Instant Book help?

With Instant Book, the whole point is that you carefully pre-define your booking parameters for each practice, including the pay rate, in advance, and then publish your terms and availability and wait for bookings. So you can make calculated judgements about the pay you would like to receive and use Instant Book to do the talking for you. Bear in mind too that the Instant Book process itself will add to your ‘value’, as practices are being offered a speedy, transparent way of booking a GP - a task that might otherwise cost them significant workload and resources.

Here’s how you can use Instant Book to experiment with your rates

  • Add a local practice to your LocumDeck address book where you haven't recently worked.
  • Set a sessional/hourly rate for that practice at the level that you'd like to be booked at.
  • Activate that practice for Instant Book.
  • Add 'Committed Availability' to your LocumDeck calendar as far in advance as possible.
  • As and when practices Instant Book you, you’ll soon be able to use your judgement if your rates are too high or two low, and you’ll be able to adjust your rates accordingly.

If you run this experiment for a range of practices and add availability over a range of periods in advance, you’ll soon start to build a picture of the local factors that may affect your rate decisions.

Our experience of using Instant Book is that once practices have used it, they return to it as their favoured booking method, further cementing its value to them. It is a win-win tool - locums have more control over their work and pay, whilst the practice saves significant resources in finding and directly booking locums.

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Other points to consider with your locum rates

Before you agree a rate, it is vital that you also agree the full details of the terms and conditions (see NASGP’s model T&Cs). The technicalities of this are too long for this article but it is the principle that is key.

The terms under which you earn your rate are arguably as important as the rate itself.

Key things to think about include being clear about pension contributions, about exactly what services you are required to provide, and where and how and when you can expect to get paid.

For a deeper read on factors to consider when setting your terms and implementing this into your booking process, take a look at NASGP's Thriving as a GP locum handbook.

The final part of this is the actual negotiation itself. Obviously, how your rate gets negotiated will change with each particular practice. That said, the principles of negotiation do not change whether it is carried out on the phone, by email or any other means of communication.

Working for the NHS means that most doctors have very little experience of negotiation, which can make this an anxious experience. As with most things in life, negotiation is a learned skill, so don’t worry, you’ll get better at it!

The internet has some very useful resources which can help with this. Locum rates are not as fluid as day rates that are paid to freelancers in the private sector; however, the advice that is available to freelancers is still highly applicable. For example, this guide to assertiveness for freelancers has a great chapter on negotiating your rates.

Clear Terms and Conditions that protect our professional standards, autonomy for GPs to determine their safe working boundaries and giving clear written confirmations of work agreed in advance are all key reasons why NASGP developed LocumDeck, which is provided as part of NASGP membership.

Set your own rates and terms using NASGP's LocumDeck, our online booking and invoicing tool that's free to NASGP members and allows you to fully customise every aspect of your locum work. LocumDeck's optional Instant Book feature allows you to completely bypass the negotiation phase which can be time-consuming and error-prone for both practice and GP.

  • predefine your terms and booking parameters in advance
  • tailored to each individual practice
  • publish your availability
  • wait for the work to come to you, on your terms

Learn more about Instant Book with our LocumDeck Help FAQs and videos

Historical context | NASGP & BMA guidance for negotiating and setting your GP locum rates

In the past the BMA published a range of ‘suggested fees’ for locums, but in 1999 the Office of Fair Trading (OFT) advised that publication of locum rates was anti-competitive in the context of the Competition Act 1998. As a result, the BMA's "Fee Guidance Schedule (FGS) 12, Fees for GP Non-principals" was withdrawn, and guidance issued to BMA staff that no advice could be given to their members on locum rates.

The BMA's publication of a locum rates, or even a minimum or maximum level of fees, was considered anti-competitive by the OFT, and those who participated in ‘price fixing’ could be fined up to 10% of their UK turnover for up to three years.

The BMA’s policy was to maintain full compliance with the advice provided by the OFT in 1999, and so worked with the NASGP to provide a helpful checklist in spreadsheet form to allow GP locums to calculate their own rates, and was subject to careful legal scrutiny by the BMA’s lawyers to ensure compliance with competition law, and other accountancy related advice has been subject to careful scrutiny by specialist medical accountants.

This guidance has been produced to support all parties involved in negotiating for GP locum services.

Please note that these notes must not be considered as providing any guide to the level of fees that may be set by GP locums. Competition Law is complex and anyone with a Competition Law enquiry must seek appropriate legal advice.

And don't forget that it is not just your rate that you are negotiating; your contractual terms are an integral part of your agreement, and you need to ensure that they are also acceptable to both parties.

The BMA and NASGP are not liable for any loss or damage, howsoever arising, which is occasioned to anyone acting, omitting to act or refraining from acting in reliance upon the contents of this advice.