Getting a Job in the UK

Locum? Bank staff? Umbrella company? Limited company?
If you’ve never heard of any of these terms before, how on Earth are you supposed to pick your employment terms when you land a healthcare job in the UK?

In this article I’ll attempt to explain the different ways you can be employed, giving you a basic run down of each option and some of the pro’s and con’s of each.

But remember, I’m not a financial advisor and this article is purely for general information purposes. Everyone’s situation is different so you’ll need to seek some professional advice if you’re unsure about the path you’d like to take.


What is a Locum Worker?

A “locum” is essentially a temporary worker, usually filling in for someone else’s absence.

Hospitals or private practices might advertise for locum positions if they are short staffed, have a temporarily increased work load or are struggling to fill a long-term vacancy.

The most common locum arrangement is to be an “agency worker” (i.e. to find work through a recruitment agency), and be paid through an umbrella company. See my articles about Umbrella Companies and Recruitment Agencies for a more in depth explanation of these terms.


Major Pro’s:

  • Flexibility: work where you want, when you want. With so many vacancies all over the UK you can pick where you would like to explore at different times of the year (summer in the South perhaps?), the type of work you’d like to do (have a dabble in paeds, hands, community, outpatients…), how long you want to stay (4 weeks? 4 months?) and how many days of the week you feel like working (4 day weekends anyone??)
  • Good hourly rates: as a casual you are generally paid more per hour than permanent staff. Be sure to negotiate your wage whether it is PAYE or Umbrella rates (which I explain more in my Umbrella Companies article). You’re usually paid weekly too, rather than monthly.
  • Flexibility: no, it’s not a typo having this listed twice, it’s honestly a major perk. Not stoked with the position you’ve landed in? With just 1 weeks notice you can leave earlier than planned. Happy with where you’re at? You may be able to stay longer. Last minute holiday booked? Negotiate to go away for a week or 2 and come back – it’s all possible.


Major Con’s:

  • Workload: as your “end client” (i.e. the hospital or clinic that you work for) is paying so much for your services, they expect to get bang for their buck. Be prepared for a full diary in musculoskeletal outpatients!
  • Uncertainty: when and where will your next job be? What will your colleagues be like? Will your boss be cool? How about your accom? Be prepared, you may not end up in your perfect scenario every time.


What are Bank Staff?

Bank staff are essentially casual staff employed by the NHS, not through a recruitment agency. You would apply for one of these positions directly, and would not be an agency worker. Sometimes referred to as “zero hours contracts” you’re paid to work as and when there is work to be done – this could be full time for a couple of months, or a few days a week here and there.


Major Pro’s:

  • Some flexibility: while you don’t have the same location flexibility as a locum (you’re generally employed to work in a particular hospital or NHS trust), you will be offered “shifts” to work that you can accept or turn down depending on your availability.


Major Con’s:

  • No work no pay: if your employer tells you not to come in for the day/week, you won’t be paid for that time off.
  • Lower rates of pay than locum: the hourly rate is set and not negotiable.


What is a Limited Company?

In the past health professionals have been able to set up a business or “limited company”, establish themselves as the director and then search for locum work. They would then bill end-clients/hospitals/private practices for their services through their company, and pay out wages as dividends in a complicated corporate structure resulting in lower tax rates.

As of April 2022 the HMRC (UK tax office) is essentially closing the loop hole that allows health professionals to work under this structure. You might still heard the terms thrown around, but I personally wouldn’t recommend going down this route. It’s high risk. In the worst case scenario you’ll be investigated by the HMRC, closed down, fined, forced to repay a large tax bill with interest, and end up out of pocket anyway.


What about being a Permanent Employee?

Don’t forget that you could of course just get yourself a normal full-time or part-time permanent job.


Major Pro’s:

  • Stability: regular work and income, an instant social support network with all your colleagues, a base to call home – no need to worry about where your next pay cheque will come from!
  • Paid leave: Full time employees in the UK are entitled to 28 days annual leave every year – can’t beat being paid to be on holiday. (Locums employed through Umbrella Companies are also entitled to paid holiday leave, but it’s usually included in your weekly wage. Read more about that here).


Major Con’s:

  • Less flexibility: while some may move to the UK with the intention of establishing themselves more permanently, for those who wish to make the most of the easy availability of travel throughout Europe a full-time job may get in the way of opportunities to explore!
  • Monthly pay: is it just me or is this weird? Maybe being paid so infrequently is a sneaky pro in disguise, but I’ve always been use to weekly or fortnightly pay myself.


I hope this gives you a decent general idea about the options you have available in the UK. Overwhelmingly it seems most people tend to go with being a locum via the recruitment agency + umbrella company set up for a good balance of decent wages, easy financial management and lifestyle flexibility.

If you’ve got any more questions that I haven’t answered clearly here let me know – I’d be happy to try and help!


> Picking a recruitment agency

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