How to become a locum occupational therapist in the UK
Step-by-step guide to becoming a locum occupational therapist in the UK: HCPC registration, RCOT indemnity, case management vs NHS agency, and the paediatric SEN private market.
A locum occupational therapist covers clinical work on a session-by-session basis for the organisations that need them, as a self-employed professional rather than a salaried employee. This guide walks through everything you need to do to start, in order, and the common pitfalls that catch people in their first year.
Step by step.
7 steps- 01
HCPC registration + RCOT membership
HCPC registration as an Occupational Therapist is mandatory and the title is protected. RCOT membership is optional but expected for most private referrals and includes profession-specific indemnity. Ideally have 2 years post-qualification experience before going purely locum.
- 02
Pick a clinical specialism
Locum demand is specialism-specific: neuro rehab, paediatric SEN, hand therapy, mental health OT, community / older adult. Generalist OTs find less premium work than specialists. Neuro rehab and paediatric SEN are the highest-paying private niches.
- 03
Register with AHP agencies + NHSP
Globe Locums, Sanctuary Personnel, Your World Healthcare, Maxxima, and Service Care Solutions are the mainstream AHP agencies. NHSP covers bank work across most trusts. Register with two or three across framework and off-framework to see the full range of bookings.
- 04
Build into case management and medico-legal
Case management companies (Bush & Co, N-Able Services, HCML) pay £55–£95/hr for catastrophic injury OT work plus mileage and report fees. Tribunal and expert witness work is higher still but requires Bond Solon / CUBS expert training first. Schools work (paediatric EHCP assessments) overlaps – £600–£1,200 per full assessment report is typical.
- 05
Complete specialism-specific training
Bobath, Sensory Integration practitioner status for paeds, Functional Capacity Evaluation (FCE) training for medico-legal work. These certifications directly map to higher rates and steady referral flow.
- 06
Handle HCPC CPD audit risk
HCPC re-registers every 2 years and audits 2.5% of the profession each cycle. OTs get deregistered at every audit for poor CPD evidence. Write a short CPD profile as you go rather than scrambling at audit.
- 07
Set up income tracking for mixed status work
NHS agency is PAYE / umbrella. Case management and school contracts are genuinely self-employed. Mixed practice is common (2 days NHS bank + 2 days private). Keep receipts for equipment, travel between sites, and home-office apportionment – these are legitimate deductions most OTs underclaim.
Documents to have ready.
- 01HCPC registration certificate
- 02RCOT membership + indemnity certificate
- 03Enhanced DBS (Child + Adult Workforce as appropriate)
- 04Occupational health + immunisations
- 05CV with clinical specialism explicitly stated
- 06Specialism training certificates (Bobath, SI, FCE, etc.)
- 07Safeguarding Level 2 / 3, moving and handling certificates
- 08Driving licence + business-use insurance (for community and case management work)
- 09Two clinical references
Sessional sends reminders 30 days before each expiry.
First-year pitfalls.
- !Taking school commissioning work without realising payment terms are 60–90 days and budget holders change
- !Entering medico-legal expert work without Bond Solon / CUBS training. Reports get rejected by solicitors
- !Not carrying appropriate assessment kit. Trusts assume a locum brings nothing, private clients expect the opposite
- !Diluting focus across too many specialisms. Locum rates reward depth not breadth
- !HCPC CPD audit failures. The 2.5% audit is real and deregistration happens
Run your locum work like a business, from day one.
Sessional tracks every session, invoice, expense, and document, so you spend evenings with family, not spreadsheets. Free to start.
Related
Last reviewed April 2026. Rates and regulator details change. If something looks off, let us know.