Overview and key points
After years of static reimbursement limits, the 2025/26 GP contract introduces a long-awaited uplift to locum sickness absence reimbursement, effective from 1 April 2025 under the new Statement of Financial Entitlements (SFE). The weekly reimbursement cap rises to £2,151.96, aligning more closely with today’s locum market.
However, unlike the 6% uplift in 2024, this increase cannot be claimed retrospectively for absences before April 2025.
The 2025 uplift is a win – with caveats
What’s changed in 2025/26?
- GP locum sickness absence reimbursement has been raised to £2,151.96/week, payable from week three onward
- Parental leave reimbursement is now an updated tiered structure
- Reimbursement is effective from 1 April 2025
- Absences before this date remain under 2024 rates and will not be applied retrospectively
Whilst this is certainly a step in the right direction for GP managers, the new GP locum reimbursement reduces, but does not eliminate, the gap between reimbursement and actual costs.
Real-world locum costs: the ongoing gap
Based on current UK market rates:
- Average locum rates range from £83.72 to £85.59 per hour
- The standard GP works 8 sessions/week = 32 hours
- The estimated weekly cost of locum GP cover ranges from £2,679 to £2,739
- The NHS reimbursement still leaves a shortfall of £500+ weekly per absent GP
What the SFE reimbursement covers — and what it doesn’t
| Absence Type | NHS Reimbursement | Notes |
| Sickness (certified) | From week 3 | Stress/burnout must be medically certified |
| Mental health absence | Possible | Depends on GP certification and length |
| Parental leave | Tiered rates | Must follow defined SFE structure |
| Suspension | Yes | Requires commissioner approval; capped |
| Compassionate leave | Not covered | Practices must self-fund or insure |
| Accidents/injury | If certified | Treated as sickness if medically validated |
Evidence required
- Medical certificate
- NHS England reimbursement forms
- Compliance with eligibility (absence length, type)
Why locum insurance still matters
The table below is a comparison of the NHS reimbursement and the insurance-backed proposition. It shows that while the NHS reimbursement is a valuable addition to a practice toolkit, the role of insurance provides enhanced protection/risk mitigation, is contract based and not flexible at the discretion of the NHS.
| Feature | NHS Reimbursement | Locum Insurance |
| Activation point | Week 3 of absence | Tailored excess |
| Scope | Defined leave types | Any medical leave incl. mental health |
| Coverage limit | Fixed cap (£2,151.96) | Matches actual locum cost (e.g. £2,700) |
| Processing | NHS forms + evidence | Contract-based, payments are covered by FCA regulation and do not require receipts |
| Policy certainty | Subject to NHS changes | Fixed and customisable |
Key takeaways for GP managers
- Zero reimbursement in first 2 weeks of absence
- Mental health cover is possible, but not guaranteed without certification
- NHS funding still lags behind true locum cost
- Reimbursement doesn’t solve availability issues
What’s the smart strategy to adopt for 2025/26? Adapt and combine
Many practices now:
- Choose rounded cover via insurance
- Increase policy limits to reflect actual costs
- Flex their excess periods and policies to suit their needs
- Have contract certainty, backed by regulation
- Cover non-SFE reimbursable absences
- Use payouts to offset team or admin stress
Final thought
The uplift in 2025 is a positive step, but it’s not sufficient. Insurance remains your key tool to close the gap and protect your team and your practice financially and operationally.
Let’s talk it through together
Our team is here to support you with the right advice and enable you to make informed decisions. Please contact us if you’d like to talk through any of these changes.
*Data according to Messly https://www.messly.com/locum-rates/hourly-locum-pay-rates-for-general-practice-gps-in-2023
** NHS Statement of Financial Entitlement addendum 2025 https://assets.publishing.service.gov.uk/media/6819e41ea8cdfb0ccdb8e096/gms-statement-of-financial-entitlements-amendment-2-directions-2025.pdf
FAQs
Why is locum insurance valuable cover for GP Managers?
- Fills the gap left by NHS reimbursement (which starts late and is capped)
- Covers more types of leave, including those not reimbursed by the NHS (e.g., compassionate leave)
- Provides financial certainty during unpredictable absences
- Helps maintain service levels without straining the practice budget and the team
What’s our recommended strategy for 2025/26?
- Combine NHS reimbursement with tailored locum insurance.
- Adjust policy limits to reflect actual costs.
- Use insurance to cover non-reimbursable absences.
- Reduce stress on admin teams by ensuring financial certainty.
What does the locum insurance protect?
Locum insurance protects GP practices financially when a regular GP is absent, and a locum (temporary doctor) needs to be hired. It typically covers:
| Feature | Locum insurance |
| Trigger point | Starts from day 1 or after a chosen excess period (e.g., 1 week) |
| Types of absence covered | Most medical absences including: • Sickness • Mental health • Accidents/injury • Compassionate leave • Parental leave |
| Coverage amount | Matches actual locum costs (e.g., £2,700/week or more) |
| Flexibility | Customisable policies: choose excess period, coverage limits, and duration |
| Certainty | Contract-based payouts, regulated by the FCA (Financial Conduct Authority) |
| No Receipts Required | Payments are based on contract terms, not reimbursement forms |
| Admin Relief | Reduces financial stress and admin burden during GP absences |
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