Locum work

Having done a fair few locum shifts over the past year, I just thought I would share some pros and cons of picking some of these up.

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Locum shifts are a means whereby your trust employ extra help for particular gaps in the rota, and this is typically advertised at higher rates than your typical contracted work as you are essentially compensated for coming in on your off time to work. These gaps are generally put out for internal doctors who normally work within the trust, but may also be advertised (typically at slightly higher rates) to external agencies. It is broadly divided into F1/SHO/Registrar/Consultant brackets, with an increasing hourly rate higher in the hierarchy. Although there are some instances where particular skillsets may be requested, for example if no registrars are available to take up the shift, SHOs who are CT2/ST2 can 'step-up' to fill the gap.

The pay

The obvious reason why most of us do locum shifts. You get an extra pay that is normally credited into the next month's paycheck (or the month after, depending if the shift was before or after the cut-off dates where they finalise payments). It is a nice supplement to your income say if you were considering getting a new car, paying for a membership exam or other life commitments. Although it can vary greatly from trust to trust, the rates range from reasonable to very lucrative.

Flexibility

The main draw to doing a locum F3 year and why everyone seems to be attracted to it. You get to pick and choose which shifts you want to do, when you want to do them. Despite the perceived lack of stability, similar to a 4-month foundation training rotation, you tend to be able to pick up extra shifts several months in advance and plan your schedule out. At the cost of doing this in advance however, you may be able to negotiate or even straight up be offered escalated rates if you come on short notice to fill in a last-minute rota gap. On top of this, I tend to pick locum shifts when I have something to do at hospital where I am not otherwise supposed to be in, e.g. when my clinical supervisor is only available for a meeting on my off day; so I can go off to have the meeting during my break.

Clinical experience

This is greatly variable depending which shifts you do. Locum work is advertised for a range of different shift types, ranging from simply doing discharge letters, to leading a post-take (as a registrar/consultant). One might argue that there is no truly 'pure service provision' job as you can learn something from any clinical work, you are definitely exposed to more clinically challenging tasks when doing clerking/ward cover shifts compared to say, discharge letter shifts. This is by no means putting down the role of doing discharges, but if your main goal is to rack up more experience, probably consider the shifts where you are actually seeing patients.

Top tips for locum shifts

• Avoid doing too many. Especially true for an F1 where you aren't even fully registered yet. If you do for whatever need the extra pay, make sure your portfolio and development is not compromised. Ensure you at least meet or go beyond the expectations for passing your ARCP at the end of the year.

• Keep track of your locums. If you do quite a few, keep track of the ones you do. The easiest way I find is to save all the timesheets I submit. You will need to declare all your extra shifts in your Form R at the ARCP.

• Know your rights. If they pay you to do a particular job, don't be obliged to go beyond the scope of your job. If you happen to be in a good mood at the time, by all means help out your exhausted colleagues. However, I've seen a fair share of locums who are just dragged off to cover extra gaps that popped up during the day e.g. people calling in sick, without the extra compensation. Decline politely, or ask for the appropriate amount of pay.

• Get paid as you are offered. Again, I've seen several cases of backpedalling in terms of the pay. This is particularly true for last minute escalated rates where the rota coordinator agrees to the higher rate, but subsequently vetoed by management/a consultant. Ensure they make it clear and save evidence of it, ideally put on a recognised platform e.g. NHSP connect with the rates written in black and white.

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Overall, I think locuming is a good option for doctors to make an extra bit of cash during their off time (especially during the pandemic where time off work is perhaps less valuable). Let me know about your experiences of locum work below!