NHS Locum Reimbursement vs Locum Insurance: What’s the Difference?

NHS primary care organisations are facing increasing levels of staff sickness absence, placing additional pressure on practices that are already working to meet growing patient demand.

Across its services, the NHS monitors sickness absence trends among its workforce, and the figures highlight the ongoing challenges faced by healthcare professionals. In March 2026, the overall sickness absence rate across NHS England was 5.0%, resulting in more than 633,800 full-time equivalent working days lost due to sickness absence. (1)

The most commonly reported reasons for absence were mental health related conditions, including anxiety, stress, depression and other psychiatric illnesses. These figures demonstrate the significant impact that workplace pressures continue to have on NHS staff.

It’s not just about workload

When key partners or employees take long-term leave, practices face more than just operational disruption. There is also the financial burden of hiring locum cover and redistributing workloads among existing staff.

As staff absences continue to rise, preparation has never been more important. Practice managers and GP partners should understand the support available to them when a key member of staff is unable to work for an extended period.

Doctor and young patient in office

NHS sickness and absence reimbursement

As a GP partner, practice manager or other decision-maker within your organisation, you may already be familiar with the NHS reimbursement schemes that help practices manage the cost of long-term absences.

Full details can be found in the Statement of Financial Entitlements (SFE), which outlines the eligibility criteria and reimbursement levels available to practices. (2)

To qualify for reimbursement, practices must meet specific requirements depending on the reason for absence.

Sickness absence

For sickness-related claims, the absent colleague must be unable to work for more than two weeks before reimbursement becomes available. The practice will also need evidence of incapacity, such as a valid fit note.

At the time of writing, reimbursement for sickness absence can be paid for up to 52 weeks. Practices receive the full weekly reimbursement amount for the first 26 weeks of absence, after which the amount is reduced by 50% for a further 26 weeks if the absence continues.

Parental leave

Parental leave reimbursement applies to maternity, paternity and adoption leave. To qualify, the individual must be entitled to leave under statutory provisions, their employment contract (for salaried GPs), or the terms of the partnership agreement.

Reimbursement payments can reach up to £2,238.03 per week (at the time of publication). The first two weeks of parental leave are reimbursed at a lower rate of £1,475.17 per week before increasing to the maximum weekly amount thereafter.

It may still not be enough

While reimbursement levels are reviewed periodically, they do not always reflect the true cost of hiring a locum or paying existing staff overtime to cover additional workload.

Furthermore, some types of absence may not qualify for reimbursement at all. For example, practices may not receive financial support where a colleague is absent due to bereavement or other circumstances that fall outside the eligibility criteria.

As a result, many NHS primary care organisations are now considering locum insurance as an additional layer of protection against the financial impact of long-term staff absences.

Locum Insurance

Locum insurance is typically provided by specialist healthcare insurers and is designed to complement NHS reimbursement arrangements by covering gaps where state support may be unavailable or insufficient.

Depending on factors such as the number of sessions required, the seniority of the absent employee and the location of the practice, the cost of locum cover can significantly exceed the amount available through NHS reimbursement.

A tailored locum insurance policy can be structured around your practice’s specific requirements and may allow claims for absences that would not ordinarily qualify for NHS reimbursement, including:

Bereavement
Jury service
Suspension
Accident and sickness
Parental leave

Many policies also allow practices to customise:

The weekly benefit amount
The deferred period before payments begin
The maximum benefit period

This flexibility enables practices to better align financial protection with the actual costs they may face when replacing a key member of staff.

Doctor in his office with laptop

NHS Reimbursement vs Locum Insurance at a glance

Measurables	NHS Reimbursement	Locum Insurance
Cost	State-backed (no additional cost)	Available for a premium
Cover	Accident & sickness Parental leave	Accident & sickness Parental leave Bereavement Jury service Suspension
Weekly benefit	Capped and subject to NHS limits	Customisable to match the real cost of locum or staff cover
Flexibility	Limited by NHS eligibility criteria	Tailored to practice requirements

Key takeaway

Your organisation’s approach to managing long-term absence should form an important part of its wider risk management strategy.

While NHS reimbursement schemes can provide valuable financial support, they may not fully cover the cost of replacing key staff members or account for all types of absence. For this reason, many primary care organisations are choosing to supplement NHS reimbursement with a tailored locum insurance policy.

By combining both solutions, practices can put themselves in a stronger financial position when unexpected absences occur and ensure continuity of service for patients.

Speak to a member of our team

Whether you’re looking to supplement NHS reimbursement arrangements or explore a tailored locum insurance policy, our specialist advisers can help.

With more than 20 years of experience supporting primary care organisations, MIAB provides expert guidance and tailored insurance solutions designed around the unique needs of your practice.

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References

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