Before your first locum shift, there is a learning curve that most people underestimate. Knowing what's coming makes the difference between a smooth start and an avoidable scramble. Here is what to expect - and how to prepare. Why locums join us explains the full range of benefits, but this guide focuses on what happens before and during your first week.

Before Your First Week Starts

Four things need to be in place before any reputable agency can place you.

HPCSA registration - your registration must reflect independent practice status. The Health Professions Act No. 56 of 1974 makes it a criminal offence to practise without registration, and HPCSA Ethical Rule 9 sets out the specific conditions under which locum appointments operate. Interns and community service practitioners cannot work as locums. If you are unsure of your current status, check the HPCSA iRegister portal before you do anything else. Annual fees for GPs are R3,349 for 2026/27, due by 1 April 2026 - non-payment leads to suspension from the register. See our full guide to HPCSA annual fees and renewals for a breakdown by profession.

Professional indemnity - SAMA and the Medical Protection Society both offer locum-appropriate cover. HPCSA Ethical Rule 9 explicitly requires adequate professional indemnity for the duration of every appointment. This is a registration requirement, not a nice-to-have.

Documents needed - have these ready before registering with any agency. For a full breakdown see our How To Register page:

Valid HPCSA registration certificate (independent practice)
Professional indemnity and malpractice insurance certificate
Certified ID copy
Qualification certificates
Updated CV with full work history
ATLS, ACLS, or PALS certificates if you are seeking Basic Life Support Training or emergency placements
SARS provisional tax registration confirmation

Tax registration - locum professionals working as independent contractors must register as provisional taxpayers with SARS. You pay income tax in two instalments - 31 August and end of February - based on estimated annual income. If your annual turnover exceeds R1 million, VAT registration becomes compulsory. A qualified accountant with healthcare contractor experience will cost you far less than an unexpected SARS penalty.

What Your Agency Does Before You Arrive

At A24 Locums, we verify every candidate's HPCSA registration, credentials, and references before confirming a placement. Under the Labour Relations Act, the agency and the client facility are jointly and severally liable if a vetting failure causes harm - which means thorough vetting is as much in your interest as it is in the facility's.

You will receive a written locum agreement before your first shift. HPCSA Ethical Rule 9 requires the contract to be in writing and limits locum appointments to a maximum of six months. SAMA provides a standard locum contract template covering professional indemnity obligations, duties, and termination terms. Read it carefully before signing.

Your First Day at the Facility

Most facilities run an orientation lasting between half a day and two full days. Arrive early. Use the time to understand the practice management software - Elixir, GoodX, and Practo are common across private practice in SA - meet the nursing staff and receptionists who will be your operational support, and clarify the after-hours and handover protocols.

Ask specific questions upfront: Who do you escalate a complex case to? What is the formulary, and where is it? What does the after-hours coverage model look like? Where are the emergency contacts?

Patient documentation standards matter more in a locum context than in permanent employment. Because you may be at a facility for a short period, legible, thorough notes protect both your patient and your professional standing should a medicolegal matter arise later.

Your First Week: What Usually Happens

Once you are on site and oriented, the first week typically follows a pattern that most new locums do not anticipate.

Booking frequency starts lower than expected. Facilities tend to call on locums they have placed before, particularly for urgent requirements. This changes quickly once you have completed a few successful shifts and your profile builds credibility. Check locum doctor and AHP jobs available regularly and keep your availability current on the Staffshift Healthcare App - facilities book reliable locums repeatedly, and visibility matters.

Systems and workflows take time. Every facility runs differently. Spend your first few shifts observing how the team communicates, where things are documented, and how handovers work before trying to change anything.

Rapport with nurses and admin staff is built quickly or not at all. The reception team and nursing staff determine how smoothly your day runs. Introduce yourself properly on day one.

Feedback comes informally. Facilities rarely give formal reviews to locums, but they do call preferred locums back. Your conduct, documentation, and punctuality are being assessed from the first hour.

The Three Mistakes New Locums Make

1. Accepting a shift without asking enough questions Always confirm hours, expected patient volume, practice management software, and after-hours expectations before accepting. Arriving unprepared costs you credibility with the facility and with your agency.

2. Leaving documentation until the end of the shift Good notes protect both patients and practitioners. In a locum context, where you may never return to that facility, incomplete documentation is a medicolegal risk with no easy remedy.

3. Failing to update availability Facilities book the locums they can reach and rely on. Keeping your availability current on the Staffshift Healthcare App is one of the simplest things you can do to increase placement opportunities in your first month.

Frequently Asked Questions

Can I work as a locum while doing community service? No. Community service practitioners do not hold independent practice registration and cannot legally work as locums.

Do I need to register with multiple agencies? You can register with more than one agency, but you cannot confirm the same shift through two agencies simultaneously. See our FAQs for more common questions answered.

How long can a locum appointment last? HPCSA Ethical Rule 9 limits locum appointments to a maximum of six months.

When does A24 Locums pay? We pay weekly. See our pay rates page for rates by specialty.

Do I need my own malpractice insurance? Yes. This is a HPCSA registration requirement for independent practitioners.

The locums who build the strongest profiles with us are the ones who arrive prepared, document thoroughly, and confirm shifts promptly. If you are ready to start, register with A24 Locums today and one of our team will be in touch within 24 hours.

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