Why prisons are one of the strongest locum GP markets in the UK, and what you need to work there.
If you're a locum GP wondering where demand is right now, the answer might surprise you. While GP surgeries across the UK continue to face funding pressures, increasingly turning to Advanced Nurse Practitioners (ANPs) and Physician Associates (PAs) to fill appointment slots, one sector continues to depend heavily on qualified GPs: the prison healthcare estate.
Here's what's driving that demand, what working in prison healthcare actually involves, and what you'll need to get started.
The shift in primary care: what's happening in GP surgeries right now?
Over the past several years, GP practices across England have faced a challenging combination of rising patient demand, constrained funding, and workforce shortages. In response, many have expanded their multidisciplinary teams, bringing in ANPs, PAs, clinical pharmacists, and other allied health professionals to manage a growing share of routine and same-day appointments.
The NHS Additional Roles Reimbursement Scheme (ARRS) has supported this shift by funding a broader range of clinical roles within primary care networks, which, for a period, made it less financially straightforward for some practices to prioritise hiring locum GPs for short-term gaps.
The result: while locum GP demand in traditional general practice remains, competition for sessions in some areas has increased, and GPs with a flexible approach to the type of setting they work in are finding stronger opportunities elsewhere.
Who is hiring locum GPs?
The short answer: prisons.
HM Prison and Probation Service (HMPPS) operates healthcare facilities across the prison estate in England and Wales, and the clinical needs of the prison population are significant. Prisoners often have complex, long-term, and unmanaged health conditions, including mental health needs, substance dependency, and chronic disease, that require qualified medical input at GP level.
Unlike GP surgeries, prison healthcare services cannot easily substitute a GP with a PA or ANP for the breadth and complexity of clinical work involved. This makes qualified locum GPs a consistent and ongoing requirement across the prison estate, and demand has remained resilient even as the wider primary care locum market has fluctuated.
Why prison healthcare continues to need GPs specifically:
The clinical complexity of the prison population typically requires a qualified medical practitioner
Mental health, substance misuse, and chronic disease management are prevalent and require GP-level oversight
Many prisons operate as standalone healthcare settings without a wider PCN or multidisciplinary team to draw on
Locum cover is regularly needed to fill gaps in substantive staffing across the estate
What Do You Need to Work as a Locum GP in a Prison?
Working in a prison healthcare setting is rewarding, but it does come with specific requirements, particularly around security vetting. Understanding these up front will save you time and help you plan your registration process.
1. Clinical Registration and Compliance
- Current registration with the General Medical Council (GMC)
- Up-to-date appraisal and revalidation
- Evidence of appropriate indemnity cover for prison healthcare settings
- An in-date enhanced DBS (Disclosure and Barring Service) check
2. HMPPS Security Vetting
This is the area that most GPs are least familiar with, and it's important to understand before applying. All staff working in prison settings, including locum clinicians, are subject to security vetting by HMPPS. The level of vetting required depends on the specific establishment.
Standard vetting for most prison roles: Enhanced Level 2 (EL2)
This is the baseline requirement for the majority of non-high-security prison settings. It includes identity checks, employment history verification, and a criminal records check covering both spent and unspent convictions.
Required for high security establishments: Counter Terrorism Check (CTC)
GPs working in high security prisons, such as Category A establishments, will also require a Counter Terrorism Check (CTC) in addition to Enhanced Level 2 vetting. This involves a more detailed background check and requires you to have been a UK resident for a minimum of three continuous years immediately prior to application.
It's worth noting that HMPPS vetting can take time to process, recent information from HMPPS indicates that demand for vetting has increased, and timescales have lengthened in some areas, though additional vetting capacity is being brought on stream. Planning ahead and starting the vetting process early is advisable.
What If You Don't Have Prison Vetting Yet?
If you're interested in working in prison healthcare but haven't yet gone through the HMPPS vetting process, or if you're unsure whether your existing clearance is sufficient for a particular establishment, that's completely normal. Most GPs entering the prison locum market for the first time are in the same position.
Our consultants at Eligo Medical can guide you through:
• Which prisons are currently hiring and the vetting level required for each role
• How to initiate the HMPPS vetting process and what documentation you'll need
• Where to obtain the relevant training or accreditation if gaps are identified
• Signposting to recognised providers who offer prison healthcare induction or relevant CPD, where applicable
We work with GPs at all stages of this process, whether you're fully vetted and ready to go, or just starting to explore prison healthcare as a locum option.
Is Prison Healthcare Right for You?
Prison healthcare isn't for everyone, but for the right GP it can be genuinely fulfilling — and practically speaking, it offers consistent locum demand, competitive rates, and the chance to work with a patient population that often has limited access to quality healthcare outside of custody.
It suits GPs who:
• Enjoy working with complex, multi-morbid patients
• Are comfortable working in a structured, secure environment
• Are looking for variety beyond the standard GP surgery setting
• Want consistent locum demand without the uncertainty of fluctuating surgery rotas
- Have an interest in substance misuse - the RCGP Certificate in the Management of Drug Misuse (Part 1 and/or Part 2) is a useful qualification to hold.
Want to Know Which Prisons Are Hiring in Your Area?
Our specialist medical consultants have live relationships with prison healthcare commissioners across the UK. Whether you're fully vetted or just exploring your options, we can tell you exactly what's available, what's required, and how to get started.