Locum pay rates have increased despite hourly rate cap

Authors: Abi Rimmer 

Publication date:  05 Jan 2017

Average hourly pay rates for locums employed by NHS trusts increased in 2016 despite the introduction of a locum pay cap, data show.

Liaison, a company that manages staff payment systems, gathered data on the locum pay and agency commission rates paid by 60 NHS trusts between July and September 2016.[1]

The company found that, combined, the average hourly pay and commission rates for locums increased by £0.91 compared with the first quarter of the year (April to June), increasing the average hourly pay for a locum to £70.26.

Average pay rates for locums had increased by 1.3% to £63.30 per hour, and commission fees paid to agencies increased by 1.5% to £6.96.

In November 2015 a cap on the hourly rate that NHS trusts could pay locums was introduced. But trusts can hire staff above the capped rate when there is a legitimate patient safety requirement.

Liaison found that 64% of hours worked by locums between July and September 2016 exceeded the cap. The company also found that the average core rate paid to locum consultants was £101.10—32% higher than the core cap, and that the average core rate for a specialty trainee year 3 was £66.53 per hour—86% above the £35.73 core cap.

The hourly pay rate of £45.58 for foundation year two (FY2) doctors was the most misaligned with the pay cap. NHS Improvements’ wage rate for core FY2 shifts in the first 12 weeks of engagement is £18.26 per hour. The highest rates paid for FY2s were over four times the set rate.

The projected annual cost to the NHS for the top 10 highest earning locums between July and September 2016 was £3.5m, Liaison said. It said that, if these locums’ pay rates were limited to pay cap, the annual saving to the NHS would be £854 000. The data also showed that two of the highest earning locums had been in their general medical locum posts for three years.

Commenting on the findings Jim Mackey, chief executive of NHS Improvement, said, “We all know that the NHS is under intense pressure from a relentless increase in demand. So we all need to do our bit to help it cope with the operational and financial challenges it faces.”

He added, “Providers have reduced the bill for agency staff by nearly £900 million since the controls were introduced, but we need to see more from locums. The rates of pay we’re seeing are not a good deal for the NHS and it’s unfair on the staff working alongside these temporary workers.”


  1. Taking the temperature update: 2016/17 Q2. 2017. [Link] .

Abi Rimmer BMJ Careers


Cite this as BMJ Careers ; doi: