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Our top tips for filling your locum shifts

No working environment is more sensitive to a sudden change in staffing than the NHS; safe staffing is inextricable from patient safety. Ensuring the correct number and range of locum clinical specialisms are on call improves hospital efficiency and vastly reduces risk of avoidable harm.

That being said, an institution of nearly 1.5 million employees cannot depend on the availability of each and every one to function properly. Filling locum shifts quickly and effectively is key to preventing any breakdown in service quality.

Locum work has major benefits for those applying; the ability to work flexibly can be an asset for establishing work-life balance. Furthermore, working in different hospitals provides greater opportunities for doctors to enhance and showcase their skills (valuable for career progression) and cultivates independence from hospital politics.

However, hospitals and departments often struggle to attract sufficient locum workers and are under increasing pressure to do so cost-effectively. At Messly, we work with NHS Trusts to help manage these temporary workforce demands through a combination of technology and engagement. Here are some of our top tips and learnings for hospitals to help with filling locum shifts.


  1. Building a trusted bank of doctors

Locum doctors have received some pretty negative press of late with critics going so far as to accuse them of ‘holding the NHS to ransom’ by charging excessive rates for cover. With a reputation as poor as this, it’s absolutely vital that your locum deficit is filled by those you trust. Building a large and engaged bank of doctors is without a doubt the most critical part of last-minute staffing.

The best locum shifts are filled by those who have worked in your hospital before; pre-existing knowledge of hospital demographics, priorities and fellow staff is invaluable to succeeding as a locum. Relying on your own experience is far better than the endorsement of any agency, but this takes time to achieve. We suggest you begin building your own ‘black book’ of doctor rotations, documenting the rotations who did more than warm the bench.


  1. Post locum shifts with plenty of notice

Though sometimes impossible, advertising your shifts early is the best way of ensuring engagement with your staff bank and reducing dependence on agency-sourced cover. Our research shows that a minimum of 4 weeks-notice is best practice for reallocating shifts. Whilst sick-leave will always leave you in the lurch, there’s no excuse for long anticipated rota gaps to go unadvertised.


  1. Provide ways for your doctors to book shifts flexibly

Our research has shown that email is not an effective method for sending out locum shifts, for several reasons:

  • Only a very few of your doctors will be suitable for a shift at any one time; doctors are inundated with locum emails from old departments and agencies – an average of 2-3 each day. As such, doctors often either don’t read them, or worse, send them straight to spam. This means opportunities for locum work, including those they would have wanted to sign up for, are frequently missed.
  • There is no real-time availability on locum shifts. A locum doctor may be interested in a shift they saw in an email 3 weeks ago, but now has no idea whether this shift is still available and is unlikely to chase it up on their own time. With no user feedback, this in turn leaves rota coordinators in limbo as to how often to email updates on their shifts.


4. Keep your doctors engaged

Just as a doctor’s availability changes over time, so too does their commitment to locum work. This places undue burden on rota coordinators who continually have to find novel ways of incentivising locum workers. In a world of increasing rota gaps, professional staffing shouldn’t ever come down to calling in personal favours.

Doctors respond best to personal connection; ensuring communication is bidirectional, transparent and appreciative is core to sustaining locum interest. Sending bulk emails to your entire mailing list and failing to respond personally to issues and enquiries disenfranchises your staff and reduces your pool of willing locums.


  1. Get feedback from your doctors

A desire to be heard is part of the human condition. Knowing what doctors’ opinions are of working in your hospital allows you to better cater to their needs and responding to this feedback is the best way of ensuring your staff feel valued. Better still, understanding what makes a doctor’s life harder is a guaranteed way of reducing risks to patients.

The challenge here is in providing doctors with the opportunity, and incentive, to give this feedback.


  1. Know your hard-to-fill shifts

Some locum shifts are downright anti-social. A last-minute A&E night shift on a bank holiday is never going to get the same sort of response as a rota-gap day shift on a well-covered ITU, and doctors know this. Compensation is king here: developing a clear escalation policy for less popular shifts prevents last-minute calls to agencies and their ever-escalating prices.


The quality of a hospital’s staff determines the quality of care that hospital can provide.

Ensuring every shift is filled is no mean feat – however, by following the above recommendations you can ensure the call for locum work is answered by the right people.




Messly is creating the UK’s first online mess by allowing doctors to connect, engage and learn from one another. By leveraging this network, we allow hospitals to connect and regularly work with the same trusted doctors while introducing new doctors from nearby hospitals. On average, we return a minimum 4x ROI to the departments we work with. Want to talk to us about your department? Email us at

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