When a GP is off sick or on leave, the first question is usually “how much will cover cost?”. The honest answer is that there is no single figure. The locum’s rate is agreed for each booking, and several other costs sit around it: paid time beyond the appointment list, pension contributions, travel and any agency or platform fee.
This guide lists each part of the cost so you can budget for the whole booking and compare offers fairly. It does not quote market rates. Use the free worksheet with the figures you are actually offered.
The cost is more than the session rate
Ask for every element in writing before you confirm a booking. A low hourly figure can cost more overall if admin time, expenses or fees are added later.
| Cost element | What to confirm before booking |
|---|---|
| Clinician fee | The agreed rate, whether it is hourly, per session or per day, and how many units are paid. |
| Time beyond appointments | Paid time for results, letters, visits, duty work and handover. |
| NHS pension contribution | Whether the locum will pension the work, which adds an employer contribution. |
| Expenses | Mileage, parking or travel between sites, if agreed. |
| Agency or platform fee | How it is charged, whether VAT is added and whether it applies to cancelled sessions. |
| Changes and cancellations | The notice period and any charge in the locum’s or agency’s terms. |
Worked example: the full cost of a GP session
This hypothetical example uses one eligible pensioned freelance GP session in England or Wales, a £400 session fee and £10 of agreed expenses. The figures illustrate the calculation; they are not a market rate, an advertised vacancy or a completed FindALocum booking.
VAT is not currently charged on our booking fee. It will be added once our VAT registration takes effect; the total above does not include that future VAT.
| Cost | Basis | Amount |
|---|---|---|
| GP session fee | One hypothetical session | £400.00 |
| Employer pension contribution | £400.00 × 90% × 14.38% | £51.77 |
| Agreed expenses | Illustrative amount | £10.00 |
| FindALocum booking fee | £19.99 for one locum day worked | £19.99 |
| Total practice cost | Before any VAT becomes chargeable on our booking fee | £481.76 |
Sources: NHS Pensions: GP Locum A form, 1 April 2026 to 31 March 2027
There is no national locum GP rate
Locum GP rates are agreed between the practice and the locum, or through an agency. They vary with the area, how much notice you give, the length of the session, the workload and the time of year. An advertised rate tells you about one offer and little about the wider market.
Compare like with like. A sessional rate and an hourly rate only compare once you know the hours. In a locum booking the word “session” has no fixed length, so write down the start and finish times and what the session includes. A clear cover brief also stops the workload growing after the rate is agreed.
Budget for the NHS pension employer contribution
A freelance locum GP can choose to pension NHS work through the NHS Pension Scheme. If they do, they send a Locum A form with their invoice. The practice checks and signs it, then pays the employer contribution to the locum on top of the agreed fee. The locum passes both their own and the employer contributions on to the scheme.
On the NHS Pensions Locum A form for 2026/27, the employer contribution and administration levy together come to 14.38%. It is worked out on the locum’s pensionable pay, which for freelance GP locums is 90% of the fee. Check the current year’s form before you budget, as rates can change.
Work cannot be pensioned more than 10 weeks after it ended, so sign and return forms promptly. This process applies to the NHS Pension Scheme in England and Wales. Scotland and Northern Ireland have their own schemes.
Sources: PCSE: pension contributions, Locum A and B · NHS Pensions: GP Locum A form, 1 April 2026 to 31 March 2027
Check how the locum is engaged
CQC notes that most GP locums are freelance. Some work through their own limited company, and some practices put regular locums on the payroll. The arrangement affects who deducts tax and National Insurance and what your practice has to pay.
Calling someone a locum does not settle their employment status for tax. HMRC’s guidance applies to the actual working arrangements. If you are unsure, ask your accountant before the booking starts.
Sources: CQC: GP mythbuster 50, GP locums · GOV.UK: check employment status for tax
Compare agency and platform fees on the same basis
Agencies and booking platforms charge in different ways. Some add a margin to the locum’s hourly rate. Some charge per booking or per day worked. Some charge a subscription, and some routes let practices advertise sessions free. Work out each one for the same booking before deciding which is cheaper.
FindALocum charges a flat booking fee for each locum day worked. Your practice agrees the rate with the locum and pays them directly, so our fee never changes the locum’s pay.
- Is the fee charged per hour, per session, per day or per booking?
- Is VAT added? If your practice cannot reclaim VAT, include it in the total.
- Is anything charged for a session that is cancelled or shortened?
- Is there a charge if you later employ the locum directly?
- Who pays the locum, and when?
Work out the full cost with the worksheet
Download the plain-text worksheet and fill it in from the written offer. It adds the clinician fee, any pension contribution, expenses and fees, then divides by the paid hours so you can compare two offers fairly.
Keep the completed worksheet with the booking record. If the dates or workload change, update it before you agree the new terms.
Use the free locum cost calculator →
Common questions
Is there a standard locum GP rate?
No. Rates are agreed for each booking and vary with the area, notice, session length and workload. Compare offers on the total cost of the same booking.
Do we have to pay the locum’s pension contribution?
If a freelance locum GP chooses to pension NHS work, the practice pays the employer contribution set for that year on top of the agreed fee. Ask at booking whether the locum intends to pension the work, so it is in your budget.
Is the lowest hourly rate always the cheapest booking?
Not necessarily. Compare the total for the whole booking: paid hours, admin time, pension contribution, expenses, fees, VAT and cancellation terms.
Official sources
Sources checked . Requirements can differ by country, employer and role; use the current guidance relevant to the work.
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