If you locum, the appraisal requirements are broadly the same as for any other licensed doctor. The difference is that you may need to organise the appraisal yourself, keep track of work across several hospitals and collect evidence without a permanent department behind you. As a locum consultant and appraiser, these are the practical things I suggest getting right.
Who is responsible for organising my appraisal?
Start with the organisation where you do most of your shifts — usually your main NHS trust or staff bank, or the locum agency through which you work. For most doctors, their designated body is the organisation where they undertake most or all of their practice. However, the formal GMC connection rules decide the answer, not simply the raw number of shifts.
If you work for several trusts or agencies, it may not be immediately obvious. Speak to your main organisations; sometimes you need to contact a few, or even all of them, before you know who is responsible. Check your connection in GMC Online and use the GMC connection tool.
| Working arrangement | What often happens / what to ask |
|---|---|
| NHS staff bank | Banks often require a minimum number of shifts or a period of working with them before offering appraisal support. Even when they are your designated body, they may ask you to arrange and pay for a private appraisal. |
| Locum agency | Many agencies have their own appraisal arrangements or contracted providers; some allow you to choose your own independent appraiser. Ask what they accept. |
| Several hospitals / agencies | Contact the organisations providing most of your work first. You may need to speak to several to establish the correct designated-body connection. |
| Independent locum / no designated body | Check the GMC no-connection route early: private appraisal may be only one part of your revalidation obligations. |
| Moving into a substantive NHS role | Your new employer will normally take over future arrangements once connected, but is unlikely to organise an immediate catch-up appraisal for overdue locum years. Arrive with your appraisal history up to date. |
A simple route to follow
1 Start with the trust, bank or agency where you do most shifts.
2 If unclear, contact your other main employers / agencies.
3 Confirm your designated body in GMC Online and ask about the local appraisal arrangements.
4 If arranging a private appraisal, agree the appraiser and software with the relevant team before booking.
A responsible officer oversees revalidation and makes the recommendation to the GMC; an appropriately trained appraiser undertakes your actual appraisal.
My NHS bank or agency wants me to pay privately. Is that normal?
Yes. NHS staff banks often have minimum engagement periods or shift thresholds before they offer appraisal services, and the specific thresholds differ from trust to trust. A bank might oversee your revalidation but expect you to book an independent appraisal yourself.
Locum agencies also differ. Some include appraisal, some use a contracted private provider (sometimes at a relatively high price), and some let you choose your own appraiser. Before paying, ask: Can I choose my appraiser? Is there specific software I must use? Will my responsible officer accept the completed appraisal?
You cannot choose or remove a designated-body connection simply because another option is cheaper: follow the GMC connection rules. If you have no connection, there are extra GMC requirements beyond obtaining an appraisal.
How should I record a year of locum shifts?
You do not need to list every individual shift. But your scope-of-work summary should clearly show the hospitals, approximate dates, grade, specialty or specialties, the agency or NHS bank involved and roughly how many shifts you worked (or whether it was a full-time contract). This helps your appraiser understand the breadth and volume of your work.
| Dates | Hospital / specialty | Agency or bank | Grade / amount of work |
|---|---|---|---|
| Jan–Mar 2026 | Hospital A · acute medicine, geriatrics | Agency X | SHO · 2–3 ad hoc shifts/week |
| Apr–Jul 2026 | Hospital B · general medicine | NHS staff bank | Medical registrar · 8–10 shifts/month |
| Aug–Oct 2026 | Hospital C · emergency medicine | Agency Y | SHO · occasional weekend shifts |
| From August 2026 | Hospital D · frailty / community medicine | Direct fixed-term contract | Full-time clinical fellow |
Example: “Between January and October I undertook ad hoc SHO and medical registrar shifts at three NHS hospitals in acute medicine, geriatrics and emergency medicine through Agency X, Agency Y and an NHS staff bank. I also worked a full-time clinical fellowship from August.” Include teaching, leadership, private and other medical roles separately. Retain rotas or booking confirmations in case you need to reconstruct the year.
Collecting CPD as a locum
A useful working benchmark for many UK doctors is around 50 hours or points of CPD across the year. The GMC does not mandate a fixed number of CPD points; follow your relevant college or local framework and tailor learning to your whole scope of practice.
Mandatory training is not a substitute for a varied CPD portfolio. Check how your college or local framework counts it. For example, if your framework uses a 50-point target and permits 10 points of mandatory training, you would aim for around 40 points of broader learning. This is an example, not a universal GMC rule.
| CPD source | What to record |
|---|---|
| Case-based learning | An anonymised case, lessons learnt and how you will change practice |
| Grand rounds / teaching | Date, topic, learning and relevance to your roles |
| Guidelines and independent reading | Source, key points and application to clinical decisions |
| Online courses / conferences | Attendance evidence, reflection and learning |
| M&M / governance meetings | Themes, learning and improvement actions |
| Mandatory training | Keep certificates in their own section; count toward CPD only as permitted by your framework |
A mix of learning usually makes a much stronger portfolio than twenty hours of mandatory modules completed just before appraisal. Keep a short reflective note as you go: what did I learn, and does it change anything I do?
What about quality improvement if I am only somewhere for a few weeks?
You do not need to run an enormous departmental audit. Even a small audit that follows the audit cycle can be useful: identify a question, establish a standard, review a manageable sample, introduce or recommend a change and, where possible, re-audit. For example, review a small number of VTE assessment records against local guidance.
There are other ways to provide meaningful quality-improvement evidence too. You could document case-based reviews or discussions: three anonymised case-based discussions from three shifts at three different hospitals may offer valuable evidence of reflective review and potential improvement. They should demonstrate what was evaluated and learned, rather than merely recounting cases.
A manageable mini-audit
IDENTIFY a problem → REVIEW a small sample → IMPROVE / propose a change → REFLECT and remeasure if possible
Quality improvement is considered across the revalidation cycle, so you do not necessarily need to produce a new major audit every appraisal year. Be open about limits where follow-up could not be completed.
How do I collect patient and colleague feedback as a locum?
Being a locum is not an exemption. Formal patient and colleague feedback is normally needed at least once per revalidation cycle, and it must be relevant to your scope of practice. A longer placement is ideal because colleagues know you better and feedback may be more informative; if you only work ad hoc shifts, you still need to make a reasonable plan to collect it in those settings.
| Situation | Practical approach |
|---|---|
| Repeat shifts or longer placement | Arrange the formal exercise while colleagues and staff know you and can support patient distribution. |
| Ad hoc shifts at many hospitals | Plan ahead and use an independent feedback provider; collect across relevant settings if needed. |
| Colleague feedback | Include a range of professional roles and people who can comment meaningfully on your work. |
| Patient feedback | Use an appropriate structured, independently administered process with anonymised reporting; agree alternatives with your RO if necessary. |
The GMC publishes patient and colleague questionnaire resources, and software providers can administer feedback for you. Importantly, you should not personally collect or collate patient responses. If feedback is difficult, record the attempts and discuss the appropriate approach with your responsible officer — do not simply omit it.
I have changed agencies, appraisers or software — does that matter?
Not in itself. You might use one appraiser one year and another the next, move between agencies and switch appraisal platforms — for example, to Improval. That is fine provided you keep engaging with appraisal and retain the completed records.
Keep your own appraisal folder
2024–25 — signed appraisal report and PDP
2025–26 — signed appraisal report and PDP
2026–27 — signed appraisal report and PDP
Patient and colleague feedback reports
Supporting CPD, QI and governance evidence
Download each signed report, your PDP and relevant supporting information. When you move designated body, your new responsible officer may ask for your previous appraisal history.
I have missed an appraisal. Is this a problem?
A gap is not automatically a disaster, but it is worth dealing with promptly. Annual appraisal remains the expectation. Sometimes a locum has a 14-month gap followed by an eight-month gap; discuss any irregularity or missed appraisal with your responsible officer.
You may hear that three appraisals within five years shows minimal engagement. That is sometimes used informally, but it is not a formal GMC minimum, and five appraisals are not absolutely required in every five-year cycle. Approved missed appraisals do not always have to be made up.
| Situation | What to do |
|---|---|
| One appraisal slightly late | Explain the timing and agree the next date. |
| One missed appraisal | Discuss the reason and arrange a current appraisal. |
| Several gaps | Get back up to date, reconstruct relevant evidence and discuss the position with your RO. |
| Revalidation is approaching | Speak early to your RO; deferral may be appropriate if further time or evidence is needed. |
My advice is to fix the roof while it’s sunny. Whatever the reason for the gap, the best next step is to get your appraisal record back on track. Extra CPD helps show engagement but does not retroactively replace a missed appraisal.
What if I have only done a handful of locum shifts?
You can still have an appraisal after a relatively small amount of clinical work. In my own appraisal practice, around two weeks’ worth of recent clinical shifts during an appraisal year can provide a useful basis for discussion, depending on the nature of the work and supporting evidence. This is an example from my practice, not a GMC minimum; the appropriate evidence depends on your scope of work and circumstances.
What about complaints or significant events from a previous hospital?
Relevant complaints, incidents and significant events from previous placements still matter. Declare them where required, engage with any investigation or governance review and reflect on lessons learnt. A complaint itself does not automatically prevent a successful appraisal.
If you cannot get the information from a previous trust, record whom you contacted, when and what you asked for. That shows you took sensible steps rather than ignoring the matter.
I am moving from locuming into a substantive NHS job. What happens?
Try to enter your new job with your appraisal record up to date. Your new NHS employer will usually ask about your appraisal history and place you on its future appraisal schedule once the designated-body connection is established. It is unlikely to organise a catch-up appraisal immediately just because your locum appraisal was already overdue.
So if your appraisal is due before you start, my recommendation is to complete it while still locuming. If that cannot be done, agree a documented plan with the new appraisal team — but do not assume that changing jobs wipes the slate clean.
Your locum appraisal checklist
I have checked GMC Online and asked my main trust / bank / agency about my designated body.
I know who is arranging or paying for my appraisal, and any appraiser approval requirements.
I have summarised hospitals, dates, specialties, grades, agencies / banks and approximate shifts.
I have included relevant CPD beyond mandatory training.
I have evidence of quality improvement, case review or other reflective evaluation.
I have planned formal patient and colleague feedback for this revalidation cycle.
I have declared relevant complaints and significant events and requested outstanding records.
I have saved signed previous appraisals and PDPs.
I have arranged my current appraisal and addressed any gap before changing jobs.
Final thoughts
Locuming gives you flexibility, but appraisal is something you need to take ownership of. Keep your placements and learning organised, plan feedback well before revalidation and stay reasonably up to date. If you are behind, start putting things right now — fix the roof while it’s sunny.
I’m Dr Andrew Harborne, a locum consultant and independent medical appraiser. If you are unsure about your situation, need an independent appraisal or just want to ask a question, you can book through Medical Appraisal Hub or message me directly on WhatsApp.