This guidance provides SAS doctors and those acting as locum SAS doctors with the information  you  need to know about locum roles and contracts, as well as what happens if you choose to return to a substantive post. 

Locum contracts

Locum contracts are appointed by Trusts to cover leave for an absent doctor or to temporarily cover a vacancy in an established post.

A locum doctor can be appointed to provide cover for: 

• annual leave
• study leave
• sick leave
• maternity or adoption leave
• other types of leave

Locum doctors should only be made to cover a substantive post. For example, SAS doctors are usually appointed on a locum contract to cover for a senior clinician post (i.e. another SAS doctor or consultant). 

Even if covering for a vacant role, locums have no automatic entitlement to be appointed to the substantive post when it is filled.

SAS doctors in locum posts (for both SAS or consultants equivalents)  are distinct from SAS doctors temporarily acting up as consultants, covering absences without adopting a new contract. Read our guidance on this type of acting up.

Locums in secondary care are typically employed internally or through a locum bank. 

Length of appointment

The length of appointment of a locum contract can vary from a few weeks to several months, but locums should be appointed for a maximum initial period of six months. Any extension beyond that should be subject to a satisfactory review by the employer and in consultation with the relevant colleague. Contracts can then be extended by a further six months, meaning locum contracts should be a maximum of 12 months in total).

The use of long-term locums should be avoided, and appointments of more than 12 months should be subject to the formal Advisory Appointments Committee process. The Department of Health and Social Care (DHSC) have agreed that employers must not use locum appointments as long-term solutions to staffing problems.  

If you are appointed on a locum contract for longer than a year you should contact the BMA for further advice, as you could be missing out on career progression and career development opportunities. 

Those on locally employed contracts can use the BMA’s contract checking service, where one of our experts will personally review your contract to ensure you’re getting correct entitlements. 

We also have more general guidance on what to expect when providing a locum service and considerations when negotiating pay.

Doctors should also refer to the NHS Code of Practice on appointing locums  to check what employers may request from you, and to ensure you are working to sufficient  employment standards upon your appointment e.g. employment references and health declarations.

Locum consultants

Terms and conditions 

Locum consultants are SAS doctors that are appointed to cover consultant roles. 
Locum consultants do not need to be on the specialist register. Those without specialist registration should have equal terms and conditions as other locum consultants with specialist registration. 

All SAS doctors employed as locum consultants should receive a separate consultant contract, distinct from their SAS one. 

The consultant contracts for each respective nation outline the employment conditions for local consultants.

The employment conditions for locum consultants are outlined in the consultant contract for each nation e.g. Schedule 22 of the consultants terms and conditions of service (2003) in England. Best practice conditions advised by NHS employers and some of the contractual provisions that locum consultants in England, NI and Wales can expect to have include:  

•   Job Planning: 
  
  A job plan for a locum should be agreed by the time a locum consultant takes their post. The locum consultant and clinical manager should carry out an initial review of the agreed job plan after three months in post as set out in NHS Employer guidance. This review should be in line with Schedule 3 of the consultant 2003 terms  and conditions of service. Objectives should be agreed as part of the job planning process and locums should have the same access to resources e.g. for administrative support and continuing professional development. Provision for a locum consultant to take study leave can also be agreed as part of the job planning process. If you are still in a locum post after six months, you will be contractually subject to the job planning process as per Schedule 22, paragraph 7.
  
  
• Expenses:
  
  Where a locum consultant travels between their home (or temporary accommodation) and principal place of work, expenses shall be payable in respect of any distance by which the journey exceed 10 miles as per Schedule 21, paragraph 14  in the consultants 2003 terms and conditions.  
• Annual Leave:
  
  NHS Employers have advised that locum consultants should receive annual leave on the same basis as substantive consultants. Annual leave should be accumulated during the tenure of a locum contract, on a pro-rata basis and agreed in advance.   

In Scotland, provisions of Section 11 of the consultant terms and conditions (2004) will apply instead. These include:

-    Job Planning:

Locum consultants in Scotland are appointed to a post on the basis of agreeing to fulfil the existing job plan for that post and the job plan should be open to review in line with provisions of Section 3 of the terms and conditions 2004.

-    Expenses:

Where a locum consultant travels between their practice premises or place of residence (whichever is nearer) and their principal place of work, expenses will be payable in respect of any distance by which the journey exceed 10 miles each way unless mileage allowance for any journey required for emergency cover is more favourable (as set out in Section 8, paragraph 8.2.3-8.2.8 of the terms and conditions ). 

-    Annual Leave:

Locum consultants are entitled to annual leave at the rate of six weeks per 12 months continuous locum service. They will also be entitled to any public holidays falling within the period of the contract.

Determining basic salary as a locum consultant

Pay provisions for locum consultants are set out in Schedule 22 of the consultants terms and conditions (2003). These provisions are largely mirrored in Northern Ireland, Scotland and Wales but you should refer to the nation-specific consultant terms and conditions that will apply.  
SAS doctors on locum consultant contracts shall be renumerated at the equivalent rate to the first point on the consultant salary scale. 

Any pay progression provision and approved non-NHS consultant level experience will additionally be recognised when determining your basic salary. For example: 

• If a SAS doctor’s basic salary at their previous regular employment (including any discretionary points) is higher or equal to the rate at which they would have been paid for taking up the locum consultant appointment,  then their starting salary in the new locum consultant appointment shall be fixed at the threshold in the scale next above  their previous rate.
•  Where a locum consultant’s training has been lengthened due to being in a flexible training scheme or because of undergoing dual qualification required for the locum post, the employer will credit additional seniority to ensure that you reach the pay threshold you would otherwise have attained if on a full time or single qualification basis. For example, a locum consultant’s training that has been extended by two years shall count as the equivalent of two years’ consultant level experience if you would not have otherwise been able to reach that pay threshold.
• Where a locum consultant is covered by the job planning process and is approaching completion of 12 months locum service  (whether continuous or cumulative), they will receive pay progression in the same way as substantive consultants. This is subject to meeting the criteria set out in Schedule 15 of the 2003 consultant terms and conditions. Whether you meet these criteria will be assessed by their current employer and based on that years’ service. If your previous 12 months of service was with more than one NHS/HSC employing organisation, the current employer will ensure they receive assurance that you met the criteria in your other service. 

Locum SAS doctors

Terms and conditions

Locum SAS doctors cover SAS-level roles (e.g. specialty doctors or specialists) for a temporary period of time. For example, this may include Specialty doctors fulfilling locum role as specialists. 

Locum SAS doctors must have full registration within the GMC and must have worked for a minimum of four years in full time postgraduate training, at least two years of which have been in the relevant specialty, to cover a specialty doctor role. 

For doctors appointed to cover the post of a SAS doctor role, it is best practice for all provisions of the 2021 terms and conditions for specialists and specialty doctors (and the equivalent 2021 SAS contracts for Northern Ireland and Wales) to apply to locum appointments as a minimum.

For example: 

• Annual Leave:
  
  Doctors working as SAS locums should be entitled to five weeks and 2 days annual leave (or six weeks for SAS doctors who meet the criteria detailed in Schedule 15, paragraph 2 of the terms and conditions) and six weeks annual leave respectively per 12 months of continuous locum service*. Leave should be taken during the occupancy of the post wherever possible. If this is not possible, leave may be carried to the next appointment or the doctor may receive payment in lieu for the leave which has not been taken. Locum SAS doctors should be entitled to any public or statutory holidays falling within the period of their contract. 
• Job Planning and Inductions:
  
  In all locum posts doctors should be provided with an induction which is appropriate to the post and the length of the appointment. For doctors working in longer term locum posts, a job plan should have been agreed by the time the doctor takes up the post. Objectives should be agreed as part of the job planning process and locums should have the equal access to facilities, training and development and support as other SAS doctors to deliver commitments in the agreed job plan.
• Expenses:
  
  All locum SAS doctors should also be subject to the model provisions for expenses set out in Schedule 18 of the 2021 SAS terms and conditions. Where you travel between your home or temporary accommodation and principal place of work, you shall receive expenses payable in respect of any distance by which the journey exceeds 10 miles each way. Schedule 16 of the Scotland 2022 terms and conditions also entitles locums to this.

*service as a locum in the employment of one or more NHS organisations uninterrupted by the tenure of a substantive appointment or by more than two weeks during which the practitioner was not employed in the NHS.

Determining basic salary, pay and progression as a locum SAS doctor

Locums are able to negotiate their rates to recognise previous pay progression and experience. As a guide, locums can refer to the SAS doctor salaries as set out by the NHS employers pay circular. 

In Scotland, locum SAS doctors appointed to a fixed term contracts of three months or more have contractual provisions to be paid at the same rates as those employed on a permanent basis. Locum doctors on a fixed term contract of less than three months shall however be paid at the rate equivalent to scale point 6 of the pay scale, as per Schedule 10 of Scotland 2022 terms and conditions. 

Locums may however wish to negotiate higher rates to compensate for the short-term nature of these locum contracts. 

If you are employed under the 2021 specialty doctor or specialist contract, you may also decide to undertake extra-contractual remunerated clinical work. In this case, you have the option to offer such additional hours or work to the service of the NHS via an NHS staff bank of your choosing. Rates of pay are determined by NHS staff banks or can be negotiated.