Locum and Agency Working: Professional Risks and Good Practice

This locum doctor and agency nurse course helps locum, bank and agency healthcare professionals practise safely when they move between settings. It is written for doctors, nurses, midwives, nursing associates, pharmacists, dental professionals, optometrists, allied health professionals, social workers and healthcare support workers across the UK, whether you work as a full-time locum or pick up the occasional bank shift. It is also useful for the managers who book, induct and support temporary staff.

The starting point is that no UK regulator has a lower standard for temporary staff. Patients rarely know whether the person treating them is permanent, bank or agency, and they are entitled to the same care from everyone. What differs is the situation: an unfamiliar building, unfamiliar IT, a local formulary you have not seen, a handover squeezed into five minutes, and no one to tell you how things turned out. Most of the risk comes from that system, not from the competence of the locum, and most of it can be reduced with preparation and a few firm habits.

The course is designed to take approximately 2 hours, including reading, reflection points, a written reflective account and a 15-question assessment. It is self-paced and you take it on our course portal; see the course catalogue for related titles. Healthcare Practise UK is an independent provider. We are not affiliated with any UK regulator or the NHS, and no regulator has reviewed this course.

The course applies each regulator's core standards to temporary work: the GMC's Good medical practice, the NMC Code, the HCPC Standards of conduct, performance and ethics, the GDC Standards for the dental team, the GPhC Standards for pharmacy professionals, the GOC Standards of practice, and the GOsC, GCC and Social Work England standards. The duties most often tested in locum work are working within competence, handover, records, raising concerns, honesty and fitness to work.

Criminal record checks are covered for all four nations: the DBS in England and Wales, Disclosure Scotland under the PVG scheme, and AccessNI. On tax and employment status, including the off-payroll (IR35) rules, the course explains the basic framework and recommends independent advice rather than relying on an agency's view.

• Module 1, the landscape: who works as a locum, why temporary working carries particular risks (a table of orientation, systems, local knowledge, communication, feedback and wellbeing risks), contracts and status, and why the same standards apply wherever you work.
• Module 2, before you start: pre-engagement checks and keeping your own document file, indemnity in each setting, registration, performers lists and revalidation connections, and a six-question test of whether a placement is within your competence.
• Module 3, arriving safely: why induction matters, a minimum induction checklist (people, emergencies, escalation, systems, medicines, pathways, workload, practicalities), access to systems and records, and structured handover.
• Module 4, clinical safety in unfamiliar settings: human factors and cognitive load, medicines in a new setting including responsible pharmacist duties, test results and follow-up, and record keeping when you will not be there tomorrow.
• Module 5, conduct and raising concerns: joining a temporary team well, speaking up as an outsider, incidents and complaints that surface after you leave, and honesty in bookings, timesheets and fitness to work.
• Module 6, sustaining a locum career: feedback and appraisal across many placements, learning without a home team, wellbeing and isolation, and what good looks like for agencies and hosts.

The worked examples are drawn from everyday locum life: a doctor who missed an early warning score because alerts only reached logged-in users, a GP offered the receptionist's smartcard, an agency nurse facing an unfamiliar infusion pump, and a "chest pain, discharged" note that left the next team guessing.

Indemnity. Every registrant must have an appropriate indemnity arrangement. NHS state schemes usually cover clinical negligence claims for NHS work, including agency staff, but they do not give personal advice or representation for a regulator's investigation, a complaint or an inquest, and they do not cover private work. A table sets out what usually applies in NHS hospitals, NHS general practice, community pharmacy and private clinics, and what to check in each.

Logins. Using a colleague's logged-in session or password is unsafe and a breach of information governance: actions are recorded under the wrong name and the audit trail is lost. The course explains why it can also breach the Computer Misuse Act 1990 and data protection law, and what to do instead.

Results. Before you leave any shift or placement, every test and referral you requested must have a named owner, and the patient must know how results will reach them. A short table shows who owns blood tests, referrals, imaging and safety-netting advice. Our patient safety incidents course goes further into reporting and learning when something does go wrong.

Each module has reflection points and "apply it" tasks, such as writing your own one-page induction checklist, listing the three highest-risk medicines processes in your usual settings, or starting a locum log with one learning point from every placement in the last year. At the end you write a reflective account on the risks of temporary working you recognise from your own experience, the steps you will add to your routine, and how you will gather feedback across placements.

The 15-question assessment is scenario based: a paediatric shift six years after your last one, a night shift with "no time for induction", overlapping bookings, an incident found after you left, a move from England to Wales as a GP locum. The pass mark is 12 (80%), and you receive a certificate of completion from Healthcare Practise UK. Passing supports your learning record; it does not by itself demonstrate competence.

For CPD, record the time you actually spend, which may be more or less than the two-hour estimate. Nurses, midwives and nursing associates should note that self-directed online learning done alone normally counts towards the NMC's individual CPD hours rather than its 20 participatory hours; if you work through it with colleagues and discuss it, it can become participatory. Doctors reflect on CPD at appraisal, and the GMC does not set fixed hours. Other regulators set their own rules, so check yours and any employer requirements. Keep the certificate and your reflection together.

For individual locums, the course doubles as a revalidation aid: it explains how to keep a locum log, ask hosts for end-of-placement feedback and include all locum work in your supporting information. Our revalidation portfolio course takes that further.

For staffing agencies, banks and host organisations, it offers a consistent baseline for everyone on the books. Agencies and practices can buy credits and assign the course through our team credits scheme and keep a record of who has completed it. It does not replace any agency's own mandatory training requirements, which the course notes vary between agencies and hosts.

This course is part of our career and wellbeing courses. Locums often pair it with:

• Burnout, Resilience and Wellbeing, for fatigue, isolation and sustainable workload;
• Raising Concerns, for speaking up and whistleblowing protections in more depth;
• Ethics and Professional Standards in Aesthetic and Cosmetic Practice, for locums who also prescribe in private clinics.

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