How to become a locum psychiatrist in the UK
Guide to becoming a locum psychiatrist in the UK: GMC Specialist Register, Section 12 MHA approval, Approved Clinician status, indemnity, and the NHS vs independent hospital rate split.
A locum psychiatrist 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
GMC registration + Specialist Register entry
Full GMC registration with a licence to practise. For any Consultant locum role, you need entry on the Specialist Register in Psychiatry. Trust grade and SAS locum work is possible without Specialist Register entry but pays substantially less.
- 02
Obtain Section 12(2) MHA approval
Section 12 approval is what lets you detain under the Mental Health Act. Most Consultant locum work expects it. Apply to your regional Section 12 Panel and attend the approval course. Approval lasts 5 years in England under the Mental Health Act 1983 Approved Clinician Directions 2015 (some regions operate a shorter local cycle), then requires a renewal course. Lapsed Section 12 drops your day rate sharply and agency availability falls off a cliff.
- 03
Apply for Approved Clinician (AC) status
A separate approval from Section 12, covering the broader Approved Clinician role under the MHA. Requires a portfolio of MHA practice and panel approval. Most inpatient and crisis team Consultant locum work expects AC status.
- 04
Pick your market
Three distinct markets: NHS agency (capped framework, lower rates, volume work), independent hospitals (Priory, Cygnet, Elysium, Huntercombe – higher day rates, practising-privileges model), and medico-legal / tribunal report work (highest margin per hour but needs a referral network). Most senior locums mix all three.
- 05
Register with psych-specialist agencies + independent groups
Globe Locums, Athona, Cpl Healthcare, Medacs, and Daytime Healthcare all run psychiatry desks. Direct relationships with Priory and Cygnet bypass agency fees entirely and are how most experienced locums work. Apply to a couple of each.
- 06
Sort indemnity with MHA and medico-legal scope
CNST covers NHS clinical work. Independent hospital indemnity does NOT cover you for GMC or civil claims. Hold your own cover with MDU / MPS / MDDUS, extended for medico-legal reporting if you’re doing tribunal or expert work.
- 07
Keep a formal MHA practice log
Section 12 renewal requires evidence of ongoing MHA practice. Agencies will not produce this log for you. A simple spreadsheet of assessments, detentions, and tribunal attendances with dates and settings is the minimum. Miss this and renewal stalls.
Documents to have ready.
- 01GMC specialist register entry printout
- 02Section 12 approval letter with expiry date
- 03Approved Clinician approval letter
- 04CCT certificate
- 05Enhanced DBS (on the Update Service)
- 06Occupational health + immunisations
- 07Indemnity certificate (private + NHS scope)
- 08MHA practice log and appraisal summary
Sessional sends reminders 30 days before each expiry.
First-year pitfalls.
- !Letting Section 12 approval lapse. Renewal course waiting lists run to 3–6 months
- !Assuming an independent hospital’s insurance covers you for GMC or civil claims. It doesn’t
- !Accepting ward cover where you’re the only Section 12 approved clinician. Detention decisions land on you alone
- !Medico-legal report income structured as employment rather than self-employment, triggering HMRC queries
- !Burnout from mixing NHS crisis team shifts with inpatient independent hospital blocks; plan the rota
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.