The NHS is grappling with an alarming trend as junior doctors increasingly abandon permanent roles in favour of higher-paying locum work. The flexibility, financial rewards, and independence offered by locum positions are proving too enticing to resist for many young medics. Adding to the phenomenon is the rise of "medfluencers" on platforms like TikTok, who are sharing their experiences and encouraging others to consider the shift.
Medfluencers Highlight the Benefits of Locum Work
Junior doctors are using TikTok to promote locum work as a lucrative alternative to traditional NHS roles. Dr Lizkerry Odeh, a popular "medfluencer" with over 55,000 followers, shared that she earns up to three times more as a locum than she did in her NHS position. Similarly, Dr Monika Sharma, with nearly 4,000 followers, recently qualified as a GP and has transitioned to locum work to gain more control over her schedule.
In her TikTok videos, Dr Sharma explains the challenges of working NHS rotas for seven years, including night shifts and weekends. By becoming a locum GP, she now chooses her own shifts and holiday dates, enabling her to achieve a better work-life balance.
Dr Summer Kennedy, another medfluencer with nearly 1,800 followers, has highlighted the substantial pay disparity. "I can now fully appreciate why people love the locum lifestyle," she said in a recent post, pointing out that hospitals are often willing to pay premium rates to fill staffing gaps.
Significant Pay Disparities
Junior doctors in their first and second foundation years earn between £32,398 and £37,303 annually, working an average of 48 hours per week. This translates to hourly rates of £12.97 to £14.94. In stark contrast, locum doctors can earn between £25 and £60 per hour, depending on the urgency of the position and the location of the assignment, according to Indeed.
For context, £25 per hour equates to approximately $31, and £60 per hour is about $75. This financial incentive is driving many junior doctors to leave permanent NHS roles for the more lucrative locum opportunities.
NHS Staffing Shortages and the Post-Pandemic Crisis
The NHS has long faced staffing shortages, but the problem has worsened since the COVID-19 pandemic. According to The King's Fund, in September 2023, there were approximately 121,000 unfilled full-time equivalent positions within the NHS, representing an 8.4% vacancy rate. Social care fared even worse, with a 9.9% vacancy rate, or around 152,000 unfilled roles.
Retention is also a growing challenge. Between September 2022 and 2023, 10.7% of NHS staff, or approximately 154,000 individuals, left their roles. This issue has been compounded by a 12% decline in medical degree applications, with only 12,100 British 18-year-olds applying in 2023 compared to 13,850 in 2022.
The increasing reliance on locum doctors is both a symptom of and a temporary solution to these systemic staffing issues.
The Role and Responsibilities of Locum Doctors
Locum doctors take on temporary assignments to fill staffing gaps in hospitals and clinics. According to Indeed, their responsibilities include conducting physical exams, diagnosing illnesses, writing prescriptions, administering emergency care, and assisting in surgeries or childbirth.
To qualify as a locum doctor, individuals must complete medical degrees, gain professional experience, and register with the General Medical Council. They typically work through staffing agencies, which match them with short-term assignments.
Personal and Professional Benefits of Locum Work
Locum work offers numerous benefits that appeal to young doctors seeking flexibility and autonomy. By working in various healthcare facilities, locum doctors gain diverse experiences that broaden their medical expertise and develop transferable skills like adaptability and leadership.
Networking is another advantage, as working across different locations allows locum doctors to build valuable professional connections. These relationships can prove instrumental in advancing their careers, whether through establishing private practices or securing permanent positions.
Perhaps the most appealing aspect of locum work is the ability to customise one's schedule. Locum doctors have the freedom to choose assignments that align with their personal and professional priorities, making it an attractive alternative to traditional NHS roles.
Drawbacks of Locum Work
Despite its advantages, locum work comes with challenges. Dr Sharma has highlighted the lack of benefits associated with being self-employed, such as annual leave, sick pay, and maternity leave. Additionally, the constant adjustment to new teams, systems, and patient demographics can be disorienting for some doctors.
Job security is another concern. Unlike permanent NHS roles, locum positions offer no guarantees of consistent employment, which can make financial planning difficult.
The migration of junior doctors from permanent NHS roles to better-paying locum positions reflects a healthcare system under immense strain. While locum work offers financial and personal benefits, the growing reliance on temporary staff underscores deeper issues within the NHS, including inadequate pay, demanding schedules, and systemic staffing shortages.
As this trend continues to gain momentum, it raises important questions about how the NHS can adapt to retain its workforce and ensure sustainable, high-quality patient care in the years ahead.
