Mental health services have faced sustained workforce pressure for years. High vacancy rates, significant sickness absence and growing demand have left many teams reliant on locum and agency staff, often reactively, and often at a cost that feels uncomfortable.
But is locum support as expensive as it looks? When you look at the full picture, the answer is more nuanced than most budget conversations suggest.
Starting with the permanent cost
A Band 6 mental health practitioner, whether a community psychiatric nurse, AMHP or psychological wellbeing practitioner, typically earns around £38,000. Add employer on-costs such as National Insurance and pension, approximately 23%, and the true employment cost is closer to £46,700.
That is before factoring in what the service actually receives in return.
Sickness absence in mental health is above the NHS average
NHS Digital data puts average NHS sickness absence at around 4 to 5%, roughly 10 days per employee per year. In mental health services, the picture is often worse. The emotional weight of the work, combined with systemic pressures, means absence rates frequently exceed the NHS-wide figure.
Factor in annual leave, typically 30 days, and bank holidays, and a permanent Band 6 in a mental health service may be delivering clinical work for fewer than 190 days a year. At £46,700 total employment cost, that is over £245 per productive day.
What locum actually costs
A locum Band 6 mental health practitioner typically costs £220 to £260 per day depending on specialism and geography. No sickness. No leave. Immediate availability when the gap exists.
The cost per day is comparable. The locum model also removes risk. If a locum is unwell, the service does not pay. There is no cover to arrange, no sickness process to manage, and less impact on team morale.
The strategic case
Most mental health services use locum reactively to plug an immediate gap. That tends to be the most expensive and least effective way to use agency support.
Services that plan locum use as part of their workforce model, covering predictable pressure points, protecting permanent staff from excessive caseloads, and maintaining continuity during long-term absence, consistently see better outcomes and more manageable costs.
The numbers, when laid out properly, make a stronger case for strategic locum use than most finance conversations allow for.
If this is something your service is thinking about, feel free to get in touch.