Locum Passport, Locuming, Opinion piece

Where to locum: NHS vs Private


In this blog, we will highlight the key differences for locums working in the public and the private sector in the following areas; Working conditions, Type of patients, Shift hours and Pay.

While most of us locums usually complete bookings with NHS authorities/authorised service providers, the UK has seen a growing demand for locums in the private healthcare sector. Private healthcare expenditure more than doubled between 1997 and 2013 to over £25.3Billion which means that the workforce has also had to grow to meet this new demand. 

Working Conditions

It’s fair to say that the NHS has come under scrutiny for the working conditions of its staff in recent years, especially for A&E staff and those in high turnover wards. These conditions are to some extent governed by the other areas that we will cover in this blog but in this section, we will focus on the environment you’ll be working in. 

Private healthcare providers will generally have better quality, availability and access to equipment and resources than in the public healthcare system. It’s not surprising, the NHS serves a population of 64.3 million while just 11.4% of the population have some form of private healthcare policy.

Hello, double-edged sword. While it may sound like a great place to work, if you’re interested in cutting-edge healthcare advancements and working with doctors leading the cutting edge in bringing them to the public, the NHS is the place to be. 

Locuming is a great way to gain experience in both sectors and find areas of interest. You don't have to remain a locum forever, you may find yourself moving from a locum to a permanent worker in a place where you’ve enjoyed working. 

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Types of patients

Most private healthcare providers will have specialist centres/areas for different types of patient (surgical, medical, procedure) whereas (as you probably already know) it's a bit different in the NHS. You can focus in on serving patients in the speciality you want in certain private institutions while you can get a really good foundation in most areas working in the NHS.

The 11.4% of the population that do have private healthcare will likely share similar demographics while working within the NHS will expose you to new challenges of working with snapshots of the general population. For instance, dealing with non-english speaking patients and acute medical patients of all ages is much more likely in the NHS.

Shift hours

Shifts hours are largely the same, with most healthcare providers (both public and private) needing locums during the usual 9-5, Monday to Friday. Of course, there are always bound to be opportunities for different hours and days. NHS often having good access to bank staff to cover more obscure dates and times.


Perhaps the most obvious difference in this list is pay. Unlike completing a booking in the NHS, pay rates at private healthcare institutions are not capped. Since 2015, when the pay caps were introduced, Private healthcare providers have often been able to offer more lucrative rates, often as much as £10-12/hour more! However, both pay rates in the Private and Public sectors has been increasing since 2015.
IR35 affects us all in some way, so I won't talk about it too much in this post. If you want to find out more about how IR35 may affect you, read our blog here.

So there it is, our main differences between the Private and Public sector. What other differences have you seen when working? Leave your comments below!

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