Locum work at the practice: the round, tools, contract, terms

Written by Rabah Slimani, State-registered nurse · 23 August 2026 · 3 min read

Reviewed on 23 August 2026 · Reviewed by Julie Martin

What a locum nurse should know before committing: the real volume of the round, available protocols, supplies, fee split, professional formalities and how handover works.

Key points

The round is described honestly: number of visits, hours, travel times, heavy patients identified.
Every patient's protocol is written and available from the first round.
The locum contract follows the professional body's model and is signed before, never after.
The fee split is stated in the first conversation, with no hidden negotiation.

Why we publish this

Most locum arrangements are settled by phone in a few minutes, on incomplete information. The locum discovers the real round on the first morning — sometimes with ten more visits than announced.

We prefer to publish the terms. It may cost us applications; above all it avoids mid-assignment breakdowns, which penalise patients first.

Diagram

What decides your visit time

A round is not a diary of appointments: it is an itinerary. The order of visits follows four constraints, in this order.

The care first
An injection tied to a meal, or a morning dressing, sets its own moment; the rest is built around it.
Geography
Nearby homes follow one another: that is what makes the number of visits possible without rushing.
The unexpected
A wound that has changed takes the time it takes; the following visits shift accordingly.
Your preference
It is recorded and honoured whenever the three constraints above allow it.

The round, without embellishment

Orders of magnitude for a typical week. Exact figures are shared before signing, file by file.

Characteristics of a typical round
Item	Reality	Practical consequence
Hours	Early morning, plus evening visits where prescribed	A split day, not a continuous one
Area	Échirolles and the south of the Grenoble conurbation	Short journeys, but heavy traffic at peak hours
Common care	Dressings, insulin, infusions, monitoring older adults	Varied technique, little routine
Weekends	Visits maintained for care prescribed seven days a week	Rotation agreed in the contract
Supplies	Provided by the practice for the shared bag	Nothing to buy to start

What we provide

A successful locum period is prepared before day one, not during it.

Each patient's written protocol, with alert criteria confirmed by the doctor
The mapped round, in geographic order, with observed travel times
Access details: codes, floors, home particulars, pets, trusted person
Direct contacts for prescribers and the pharmacies involved
An accompanied round before long assignments, when the calendar allows

The formalities, in order

None of these steps is optional, and none can be settled after the first round.

Council registration
Registration with the departmental council and an active RPPS number.
Locum authorisation
Issued by the departmental council, valid for the period concerned.
Locum contract
Drawn up on the council's model, signed by both parties and filed with the council.
Professional liability insurance
A valid certificate, provided before starting.
Billing means
A personal CPS card and software configured for the locum period.

Fee split and financial terms

The retrocession rate is stated in the first conversation and written into the contract. We do not operate volume-based rates: that turns a collaboration into a permanent negotiation.

Travel costs tied to the practice round are covered as written in the contract. The locum's own charges remain theirs, as self-employment implies.

What we expect

Adherence to written protocols, systematic handover notes after every visit, and an immediate call whenever a situation falls outside the agreed frame.

Relative punctuality: we do not demand the exact minute, we demand that the patient knows what to expect and is told when there is a delay.

A locum period is not a parenthesis in the practice's life: for the patient it is the same care, with a different face.

The first round: what is handed over, and when

A successful locum period is decided before the first visit. Here is what we always hand over, the day before at the latest.

The detailed round: order, time windows, real travel times.
The practice's written protocols, dated.
Access details: codes, key boxes, building or pet particularities.
Which patients to contact first in case of delay.
Contact details for the most frequently involved GPs.
What to do after a blood exposure incident.

What we expect, what we guarantee

We expect traceability identical to ours: every procedure written down, every anomaly reported the same day, no protocol changed without agreement. The patient should not feel the difference.

In return we guarantee a written contract compliant with professional rules, a fee share announced in advance, a realistic rather than flattering round, and genuine availability throughout the period.

When to call

Clinical deterioration, refusal of care, an absent patient, a blood exposure incident, missing supplies, doubt about a prescription: call. Nobody decides alone on a Sunday.

A locum who calls too often is a good locum; one who never calls is a worry.

A round described honestly

We state the number of visits, the real span of the day, the journeys, the floors without a lift and the homes that take time. A locum who discovers reality on the first morning runs late all week, and the patient pays for it.

We also say what is stable and what is not: scheduled care, care that may be added, and the situations where a call to the doctor is likely.

The tools, and the time they take

Practice software for records and billing, secure messaging for exchanges with doctors, the practice phone for incoming requests. Nothing exotic, and a hands-on introduction with us before the first day.

Recording happens at the bedside, not in the evening: that is a discipline as much as a tool, and it is what lets the next person — us, or another locum — pick up a file without reconstructing the week.

A care bag, keys and a round sheet on a car passenger seat, a residential street and mountains through the windscreen. — The order of visits is fixed before the first home.

Financial and administrative conditions

A written contract compliant with professional rules, a fee share announced before the first day, registration with the professional body verified, and valid professional liability insurance.

We do not work without those four elements, even for a single day. That is not a formality: it protects the locum as much as the patient.

Frequently asked questions on this page

Do I need previous locum experience to apply?

No, but the regulatory conditions — council registration, locum authorisation, the minimum experience required by regulation — must be met before day one.

Is a contract required even for two days?

Yes. A locum assignment without a written contract exposes both parties and does not comply with professional obligations.

How does the first round work?

Accompanied where the calendar allows, otherwise documented: written protocols, visit order, access details and contacts are handed to you beforehand.

Could this lead to a regular collaboration?

Yes. Several successful assignments can lead to an established collaboration, discussed openly rather than implied.

Is a locum contract mandatory?

Yes. Standing in for a private nurse takes place within a precise professional framework, with a written contract and authorisation. We work no other way, even for a single day.

Who answers the practice phone during a locum period?

The line remains the practice line and the locum answers it during the round. New requests are recorded and handled under the same rules as the rest of the year.

How far in advance are locum periods planned?

Holidays are known months ahead; unplanned cover is arranged as soon as we know. In both cases the round, the protocols and the access details are handed over before the first morning, never during it.

Do you need to know the practice software before starting?

No. We arrange a hands-on introduction before the first day, on real cases from the round. What matters is not mastery of the tool but the rigour of the record keeping, which is the same whatever the software.

What happens if a patient refuses to be seen by a locum?

It is their right, and it is recorded without argument. We inform the prescriber the same day, because a prescribed procedure that is not carried out is a clinical fact, not an organisational detail.

Terms explained

Fee retrocession: The share of fees a locum pays back to the practice being covered, set by the locum contract.
Nursing council (CDOI): The departmental nursing council: registers professionals, reviews contracts and enforces the code of ethics.
RPPS number: The shared directory of health professionals: a unique, permanent and verifiable identifier for each professional.
Care protocol: A written, dated description of how a specific patient's care must be delivered: products, supplies, frequency, alert criteria.
Handover notes: The written record of a visit: what was done, what was observed, what must be watched. The shared memory of the care episode.
SESAM-Vitale: The electronic claims system: the patient's Vitale card and the professional's CPS card jointly sign an invoice sent to the health fund with no paperwork.
CPS card: The health professional's personal electronic identity card, required to submit electronic claims and to access national digital health services.

Official sources

What we write is based on public references you can check for yourself.

French nursing councilLocum contract: model and obligationswww.ordre-infirmiers.fr
French nursing councilBecoming a locum nurse: framework and conditionswww.ordre-infirmiers.fr
French health insuranceSetting up in practice: agreement and formalitieswww.ameli.fr

This page is informational and replaces neither a medical consultation nor a prescription.