Locum Work


This guidance aims to give clarity for trainees and trainers about undertaking additional work, including private and locum work and other employment whilst employed in a hospital/GP training programme.

  • Trainees are reminded that all additional work that requires a licence to practise as a doctor must be declared on the annual Form R.
  • This applies to all additional work, even if it is undertaking an additional period of duty (over and above contracted hours) in the usual place of work, and activity where the activity describes the trainee as a doctor, including cosmetic procedures and medical support at sports events.
  • Trainees may undertake locum or other work outside of their employed training programme provided the following conditions are met.
    • The work undertaken complies with the European Working Time Directive/Working Time Regulations (now referred to as EWTD) and the requirements stipulated in their employment contract and the terms and conditions of their employment.
    • At least 5.6 weeks (28 days, including bank holidays for those working an average 5 day week) leave in the leave year is uninterrupted by locum work.
    • If opting out of the EWTD trainees must still adhere to the requirements stipulated in their employment contract and the terms and conditions of their employment.
    • The work is not undertaken during periods of leave of absence for study or sickness.
    • The work is not above the trainee’s level of competency.

*It is the personal and professional responsibility of all trainees to ensure that these obligations are met.

In addition:

  • The work must be approved by the clinical/educational supervisor in the host organisation including GP Practice, if in primary care, and the Training Programme Director or Head of School if in secondary care. However, it is acknowledged that a trainee may be asked to do locum work at very short notice and sometimes this may not always be possible.
  • Trainees training less than full time should explore increasing their regular hours before undertaking locum activity.
  • Trainees must comply with the HEE NW Less Than Full Time and Out of Programme policy and requirements where applicable.
  • Trainees must work in an approved practice setting until first revalidation.

Any work undertaken may provide additional experience but is not approved as relevant experience within the hospital/GP specialty training programme.

Because of the capacity issues within Trusts, trainees in all specialties are often asked to provide “internal locum cover” to ensure the continuity of service and reduce the risk to patient safety. Provided the employer can be assured that the criterion has been met, this practice could continue.

  • It is the responsibility of the trainee undertaking locum work, and the local Trust commissioning it, to check with their medical defence organisation to ensure that they are appropriately medically indemnified.
  • Both the GP and hospital schools recommend that trainees do not undertake excessive cover because the curricula are challenging.
  • The work plan and programme should be targeted to allow reflection on learning and experience in the context of the training programme; preparing for the required licensing assessments; completion of the portfolio and satisfactory progress in workplace-based assessments (WPBA).
  • Significant amounts of time spent on additional or locum work may detract from the main programme.