Locum contracts: what to agree before a shift

Short answer

Your rights as a locum depend on how you work. A self-employed locum who invoices a pharmacy or practice has few employment rights and relies on the booking terms. A locum supplied through an agency is usually an agency worker, with equal pay and conditions after 12 weeks in the same role.

Before a booking, agree the rate, hours, cancellation terms, duties and payment date in writing. If you work through your own limited company, the off-payroll working rules (IR35) may apply.

Key facts

Status: Decided by the real working arrangement as well as the contract label (Acas).
Agency workers: Worker rights from day one, and equal treatment with direct staff after 12 weeks in the same job (GOV.UK).
Off-payroll rules (IR35): Apply when you work through your own intermediary, usually a limited company. Public sector and medium or large private clients decide your status for tax.
Late invoices: Businesses can claim interest and debt recovery costs on late payment. Without an agreed date, payment is late 30 days after the client receives the invoice.

Three ways locums are engaged

Locum work in healthcare usually falls into one of three arrangements. Each carries a different set of rights.

Self-employed, direct with the client. Common for community pharmacy locums and many locum GPs. You invoice the pharmacy or practice. You have the protections in your agreement and in general contract law, plus health and safety and some discrimination protection.
Through an agency. Common for locum doctors in hospitals and agency nurses. GOV.UK says agency workers get worker rights from the first day, such as the minimum wage, paid holiday and rest breaks, plus access to shared facilities. After 12 weeks in the same job, you qualify for the same pay and conditions as someone employed directly.
Through your own limited company. You provide services through a company you control. The off-payroll working rules decide how tax and National Insurance apply.

The label in the paperwork does not settle your status. A tribunal looks at control, the obligation to accept and offer work, and the right to send a substitute. Our employment status guide covers the tests in detail.

Terms to confirm before a booking

Ask for these points in writing, by email or through the booking platform:

the rate, and whether the rate covers breaks, overtime and late closing
start and finish times, and the rule for a session running late
cancellation terms on both sides, including any payment if the client cancels at short notice
travel, parking and accommodation costs
invoice process and payment date
the role: responsible pharmacist, clinic list, ward cover or on-call
systems access, smartcard needs and login details
a named contact for clinical escalation on the day

Confirm your indemnity cover matches the work. Regulators such as the GPhC, GMC and NMC require registrants to have appropriate indemnity arrangements.

IR35 and tax status

The off-payroll working rules apply when you provide services through your own intermediary, usually a personal service company. GOV.UK says a public sector client, or a medium or large private sector client, decides your employment status for tax and should give you a status determination statement with reasons. For a small private client, your own company makes the decision. NHS trusts are public sector clients.

HMRC's Check employment status for tax (opens another website) tool gives HMRC's view of status for tax. HMRC says the tool covers tax only. Your employment rights depend on separate tests. Get advice from an accountant or tax adviser on IR35 questions, because this page gives only an outline.

Safe practice on an unfamiliar site

Commercial terms and clinical safety are separate questions. Ask for standard operating procedures, the controlled drugs process and the location of emergency equipment before you start. If staffing or systems make safe practice impossible, raise the concern with the named contact and keep a note. Our guides to locum pressure and raising concerns explain your options.

A locum pharmacist example

Say a self-employed locum pharmacist accepts a Saturday booking by text. The text gives the rate and hours and nothing else. The locum replies with three questions: the cancellation terms, the payment date and the name of the area manager on call. The pharmacy confirms 48 hours' notice for cancellation and payment within 30 days. The locum saves the exchange with the booking. When the shift is cancelled the evening before, the locum has written terms to point to.

Questions to ask an adviser

Am I self-employed, a worker or an agency worker in this arrangement?
Do the off-payroll rules apply, and who decides my status?
Can I recover pay for a late cancellation?
Can I claim interest on an unpaid invoice?
Does my indemnity cover the role on this booking?

Where to get advice

Acas helpline: call 0300 123 1100 for help with status and agency rights. See our Acas guide.
Your union or professional body: the PDA supports locum pharmacists, the BMA has advice for locum doctors and the RCN supports agency and bank nurses.
Citizens Advice: general help with unpaid work. See Citizens Advice for work problems.
An accountant or solicitor: an accountant for IR35 and tax, an employment solicitor for status disputes.

Common questions

Are locum pharmacists self-employed?

Many are, when they invoice pharmacies directly and control how they work. Status depends on the real arrangement, so a locum working fixed shifts under close control may have a different status.

Does IR35 apply to locums?

Only if you work through your own intermediary, such as a limited company. Public sector and medium or large private clients then decide your status for tax.

What rights do agency locums have?

Agency workers have worker rights from day one, including the minimum wage and paid holiday. After 12 weeks in the same job, they qualify for the same pay and conditions as directly employed staff.

Can I get paid if a locum shift is cancelled?

Only if your booking terms provide for a cancellation payment. Agree cancellation terms in writing before you accept the shift.