Locuming In F3 & Beyond

— Scott Pearson @ ‘What To Do In Your F3’ Conference

Scott Pearson graduated from Manchester Medical School in 2013. He completed his foundation training in Oxford Deanery where he undertook locum work. He is currently taking a year out before applying to speciality training and is locuming full time in A&E and Psychiatry.

Why Locum

There are a number of reasons trainees will choose to take up locum positions. Some will use the greater flexibility it affords to work on their applications, taking time out for courses, conferences and exam revision. Others use it to gain experience in areas that weren’t covered by their foundation posts. Locuming can allow you the freedom in terms of time and money to try new things, travel and experience medicine in other countries.

Disadvantages

Those that are considering locuming full or part time should consider the implications of not having a contract. These may include a lack of financial security, no sick or holiday pay, no pension contribution, a shift in paradigm towards ‘service provision’, and little or no formal training.

New Contract Changes

From 1st April 2016 the final proposed price cap for locum doctors was implemented. This restricts F2 doctors to a maximum of £25 per hour or £30 for anti-social hours. For the purposes of agency price caps, core hours are defined as 7am to 7pm, Monday to Friday (excluding bank holidays). To date not all hospitals have imposed new rates yet, but doctors should be aware that this is what hospitals are working towards. It is worth contacting the hospital or agency that you work for to get more information. New contracts have not been imposed in Scotland and Wales. For more detailed information visit Government guidance.

Options for Locuming

Doctors will usually choose to work internally ‘via bank’, through an agency or by setting themselves up as a limited company.

The advantages of working via bank is that often work is offered internally first so it may be easier to pick up your prefered shifts. There is little administration so this is probably the simplest option (worth considering if you are only planning on locuming for a short amount of time). The disadvantages are that you are usually paid the following month.

It is also possible to work through a locum agency. There are many around and it is worth getting recommendations from colleagues which they have used and found good. If there is a specific hospital you would like to work at you may wish to contact them and find out which agency they use. Signing up will require a CRB, document and ID check and references from your previous job. The advantage is that they often have a range of opportunities and usually also pay weekly.

Setting up a limited company

Some doctors choose to set up a limited company, of which they are the sole shareholder, as this can be the most tax efficient option. This can be done online through Companies House. They offer detailed information on the process and important considerations. You will usually need an accountant for this process.

https://www.gov.uk/topic/company-registration-filing/starting-company

There are three ways of taking money out of a limited company: salary, dividends and expenses.

Salary

The company must take Income Tax and National Insurance contributions from your salary payments and pay these to HMRC, along with employers’ National Insurance contributions.

Dividends

A dividend is a payment a company can make to shareholders if it has made enough profit.

Expenses

As a company you can claim back your expenses on business related spending such as travel to and from work. The rules are specific regarding this and it is important to understand what does and does not apply.

Further information is available online at:

https://www.gov.uk/running-a-limited-company/taking-money-out-of-a-limited-company

Other Considerations

Setting up a limited company can be tax efficient, but also requires a reasonable amount of administration. Anecdotally doctors spend around an hour a week on these tasks. For those that do not want the responsibility of ensuring the proper running of the limited company this may not be the best option.

Intermediaries Legislation (known as IR35)

IR35 is the tax and National Insurance contributions legislation that may apply if you’re working for a client through an intermediary. This may be applicable to doctors and is worth discussing with your accountant.

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