Agency vs Bank Locuming – Which is better?

So, you want to work as a locum doctor. There are two ways of going about this – working with a Trust Bank or with a Locum Agency.

The work opportunities provided by an Agency and a Bank similar. The key differences from a doctor’s perspective are registration, pay, and accessibility. We’ve put together a list of burning questions, so that you can make the best decision for you.

For definitions of both Bank & Agency locums, including other SHO roles in the NHS, click here.

Both are valuable ways to increase your income and experience, as well as a necessary staffing solution for hospitals in the private and public sector.


Which pays more?


Banks/Agencies – although this is disputable.

In Banks, the staffing is not outsourced, there are fewer admin costs and no commission is taken out of your pay. But, depending on your level and where you are in the country, and if you’re picking up private or NHS shifts, an Agency may pay more.

Agencies have traditionally been able to pay doctors more as they are used as a last resort by the hospital, meaning they have negotiation power. This, in addition, means agency doctors cost trusts more money. The use of agency doctors is regulated by NHSI and overuse can lead to sanctions.

Until a couple of years ago, doctors would typically make more money through locum agencies. But due to the IR35 legislation in 2017, changing the rules around tax for locum shifts in the public sector, and the capping of NHS agency rates introduced in 2015, they are less lucrative than they once were.

In terms of how often you are paid, agencies tend to pay more frequently (usually weekly). However, the regularity of bank payment differs from trust to trust (some weekly, others monthly).

Agencies also offer a referral fee (on average £200-£500) per introduction. Depending on the agency, you can do up to 5-10 referrals.


Which is easier to get started?



Each require the same documentation.

      • CV
      • 2 References
      • GMC Certificate
      • Medical degree Certificate
      • Occupational Health (vaccinations)
      • BLS/ALS (Basic Life Support/Advance Life Support)
      • Compliance Training (e.g. protection of vulnerable adults)

However, the only difference is how long the process takes – agencies have a faster process.

The registration process with an Agency usually takes around 1 month, and Banks can take 2-3 months. Agencies are financially incentivised to ensure you are compliant as quickly as possible. Whereas with a Bank the process takes longer due to trust’s many other administrative duties.


Which is easier to leave?



You have a 7 day notice period as you are an employee of the agency, not an employee of a hospital or trust. However this applies the other way – if the trust or hospital don’t want you working they only have to give you 7 days notice before you leave. The lack of job security may not suit all. As an employee of a bank, a notice period of 1-3 months is generally required.


Which is better for international doctors?



As an international doctor, you are allowed to work for both Banks and Agencies, however, if you are a Non-EEA (non-EU) doctor on a tier-2 visa, you are restricted to working no more than 20 hours per week at a different hospital from the one you are employed at. This is because you would essentially be working for an employer that has not sponsored you. If you are working for a bank, this is not an issue.

However, there are currently no restrictions for EEA (EU) doctors working in Banks or Agencies.


Which is better for you CV and career progression?



If you work with a bank, you can build relationships with consultants, and hopefully obtain a good reference.

If you work through an agency, it is less likely you will build those relationships as you are more likely to be working sporadic shifts in a variety of hospitals and departments.


Which gives me more flexibility?



With no minimum hours requirement or commitment, agencies offer an enormous amount of flexibility. However as the bank is internal, shifts are offered to you on the bank first.

The bank you are signed up to may only allow you to work in one particular trust/hospital, however more recently hospitals are sharing their banks and if you are signed up to 1 bank you maybe able to work in multiple hospitals.

Agencies, on the other hand, provide access to a greater number of hospitals, as not tied to a particular hospital/trust.

Certain banks, depending on your contract, may block you from working on other hospital banks and agencies for a period of time.


Which provides greater job satisfaction?



From working in a bank, picking up extra shifts in your own hospital will increase your familiarity with the hospital and doctors in it, and perhaps allow you to build experience in a specialism you want to learn more about, in a familiar environment.

If you are working through an agency at a new hospital, it is unlikely you will receive any support. It is likely the shift is due to high patient demand, so expect a busy shift with no introduction.


In Summary


  • Money – Bank/Agency
  • Flexibility – Agency
  • Career progression/Job Satisfaction – Bank
  • Paperwork/Getting Started – Agency


Overall winner… 🤷

Or perhaps…


Messly Locum


  • We take the best of both
  • We give you access to multiple hospital/trust banks
  • Instant-pay
  • Get started in 1 month


Messly Locum is not an agency. Instead, we get you signed up to multiple Trusts Banks so you can work additional shifts. We do charge a fee for Trusts for the use of the platform, this is based entirely on use, not an hourly rate and is much lower than an agency commission.

Using Messly Locum makes it easier & quicker to fill shifts via the bank, improving the fill rates through the bank therefore reducing the need for Trusts to use agency, making their spend less overall.

Fed up with the current system in your hospital? Let us know here and we can see if we can help implement Messly Locum in your hospital/trust.

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