Who, or what is a locum?

Who, or what is a locum

Who, or what is a locum?


To be more precise, who is a locum? A locum, or locum tenens, is someone who temporarily fulfils the duties of another. This has historically been a pharmacist who covers a regular pharmacist owner or manager for days off or holidays, or for a fixed period of cover e.g. maternity leave, or to fill in whilst a new manager takes up a post.

Recent changes in healthcare and increased demands on services have led to locum roles being taken up by technicians, dispensers, Health Care Assistants within Pharmacy. Locums can also be doctors, optometrists, and other Health Care Professionals and in teaching, supply teachers. Just calling yourself a locum, however, does not mean you really are. It’s really about what you do and how you do it, not what you call yourself. Unfortunately, lack of understanding at this basic level has been the cause of much anguish and cost to the uninitiated.


Let’s start with the biggest stumbling block -His Majesty’s Revenue and Customs. (H.M.R.C.). King Charles doesn’t really have anything to do with them, they are a government agency. HMRC is a non-ministerial department who are the UK’s tax, payments, and customs authority, and have a vital purpose: they collect the money that pays for the UK’s public services.


To put this in plain English, HMRC’s job is to collect taxes for the government, who then decide how they will spend the money collected. So HMRC collect taxes, as much tax as they can, no suggestion of how fairly, reasonably, or equitably they do this (They might disagree). If they can tax someone or something, they will try. To avoid paying more tax than you feel is fair or reasonable, you must be able to demonstrate you are not trying to avoid or evade paying due tax.


Most locums are self-employed (more to follow), Recent developments have led to some forming a limited company e.g. I Locum Ltd and pay tax as Corporation Tax whilst taking drawings and dividends on profits. Good accountancy support* is usually essential to make this work well.

If you choose to go down the self-employed route, good accountancy advice* is equally important, since oversights can be costly and stressful.

  • For support and advice in either case, we can refer you to experienced and cost-effective accountants who have great understanding of this market. Work can be done completely remotely and securely. We do not make any commission on any referrals – it is purely a goodwill gesture on our part.


  • The relationship between the employer and locum is central to how your tax status gets defined. Fundamental to any locum agreement is that it is,


a contract FOR services, NOT, repeat NOT, a contract OF service.


In other words, the locum provides the services agreed with the organisation as they see fit but cannot have dictated to them how they will provide them. An employee is subject to the direction of the employer, sometimes called Master and Servant relationship.


A locum can supply a substitute to provide the services agreed, provided the substitute is of a quality acceptable to the organisation and provides the same services, but the organisation cannot dictate HOW the service will be provided.


A locum should NOT be involved in managing an organisation, hold keys for premises, be involved in management tasks outside of the services remit. Providing information to the organisation regarding outcomes, e.g. Pharmacy First consultations for the organisation to manage should be deemed acceptable, if the locum role is to carry out the consultation and feedback to the organisation.

Hiring and firing of staff is another area outside the remit of a locum.


Going back to HMRC, a person who is self-employed has,

  • protection of their health and safety
  • protection of their rights against discrimination(in some cases)
  • the rights and responsibilities set out by the terms of the contract they have with their client.


Self-employed workers are not paid through PAYE, and they do not have the rights and responsibilities of an employee.

A person is self-employed if they run their business for themselves and take responsibility for its success or failure.

  • they put in bids or give quotes to get work.
  • they’re not under direct supervision when working.
  • they submit invoices for the work they’ve done.
  • they’re responsible for paying their own National Insurance and tax.
  • they do not get holiday or sick pay when they’re not working.
  • they operate under a contract (sometimes known as a ‘contract for services’ or ‘consultancy agreement’) that uses terms like ‘self-employed’, ‘consultant’ or an ‘independent contractor’.


This means such locums are responsible for paying tax and national insurance contributions to HMRC from their earnings, via self-assessment.


Self-Assessment is a system HM Revenue and Customs (HMRC) uses to collect Income Tax.


The contract for services is the cornerstone of keeping on the right side of the tax system. All our bookings are made by including our client and locum terms and conditions, which identify the specific details of each booking, start and end dates of the agreement and other issues alluded or referred to in this post. If you do not invoke a similar process, you may fall foul of HMRC who can then investigate, as they have been doing for around two years in Lincolnshire and Humberside and other regions, to try to collect taxes. Even if you end up cleared of avoiding payment of taxes due, investigation can be long, demanding and distracting, expensive as well as stressful. Is it worth it when it can easily be mitigated?


Be aware that if you work the same pattern of regular days for the same client at the same location, H.M.R.C. may regard this as a series of regular employments, rather than locum work, especially if the arrangement is open-ended. They may take the view that both client and locum are trying to avoid paying legitimate tax and national insurance by circumventing employment law.


This is a complex subject, and we cannot cover all aspects of the matter in one short post. If you have specific queries not answered by this post, please contact us and we will do our best to support you. Our recommendation is to limit difficulties, stick to our Terms and Conditions relating to bookings.