What Does a Dental Locum Cost in the UK? (2026 Guide)

The cheapest way to cover a dental shift is rarely the option with the lowest sticker price - it is the one with the lowest true cost once markups, hidden fees and the cost of an unfilled chair are added in. A traditional agency that charges a low day rate but adds a 20-30% markup can cost more than a platform with a flat, visible fee. And a chair that stays empty because nobody turned up costs more than either.

This guide breaks down what a dental locum genuinely costs in the UK in 2026 across the three ways practices book cover - a marketplace platform, a traditional agency, and an in-house staff bank - and shows where the real money goes in each.

The three ways to book locum cover, and how each one charges

Most UK practices use one of three models. They are priced in completely different ways, which is exactly why comparing them on the headline number alone is misleading.

A traditional agency charges you a rate that bundles the locum's pay and the agency's margin into a single figure, and the margin is usually not broken out. You are quoted "£X an hour for a nurse" and the split between what the locum earns and what the agency keeps is invisible. On top of that margin, larger national agencies add VAT to the whole charge - and for most dental practices, that VAT cannot be reclaimed.

This is where the real money is, and it is the cost practices most often overlook. Cavity Dental Staff, one of the larger national agencies, charges around £35 per hour for a general dental nurse at the time of writing, then adds 20% VAT on top - taking it to roughly £42 per hour. Because most dental practices make VAT-exempt supplies, they cannot claim that VAT back. It is a real, unrecoverable cost. Over a single 7-8 hour shift, the VAT alone adds roughly £49-£56 to the bill for one nurse, before you have even compared the underlying rate.

There is a counterintuitive twist here: VAT only applies once an agency is large enough to cross the VAT registration threshold. A small local agent operating below the threshold often does not charge VAT at all. So the national agencies - the ones that look the most established and capable - can end up being the most expensive precisely because of their size, while a practice owner who cannot reclaim VAT carries the full weight of it.

A marketplace platform like Airlocum is structured differently, and the difference matters most on exactly this point. The locum sets their own hourly rate, and the platform adds a flat, published service fee on top - so you can see exactly what the locum earns and exactly what the platform charges. On Airlocum the service fee is £3 per hour (plus VAT) for nurses and receptionists, and 10% of the hourly rate (plus VAT) for hygienists, therapists and dentists. There is no joining fee, no subscription, and no markup hidden inside the locum's rate.

Crucially, the locum's pay itself is not subject to VAT, because the locum is a self-employed professional contracting directly with your practice. VAT applies only to Airlocum's small service fee - not to the whole charge. So where a national agency adds 20% VAT to the entire £35-plus hourly rate, Airlocum's VAT applies only to the £3 fee. For a practice that cannot reclaim VAT, that structural difference is often the single largest saving on the page.

An in-house staff bank has no per-shift fee at all, but it is not free. The cost is the admin time to build and maintain it, the risk of having nobody available when you actually need cover, and the management overhead of running your own pool. For a large group with a dedicated resourcing team this can work well; for a single practice it often means an empty chair on the day a bank member is unavailable.

A like-for-like comparison: covering one nurse shift

The clearest way to see the difference is to cost a single, typical booking the same way across all three models. Take a dental nurse for one 8-hour day - the most common short-notice booking in UK dentistry.

The headline to take from this is not "platform always cheapest." It is that the agency's cost is the one you cannot see - and the VAT on it is the one you cannot reclaim - while the platform's cost is fully visible and carries VAT only on a small fee, and the bank's cost shows up as risk rather than an invoice. For a practice that cannot recover VAT, the difference between paying 20% on a whole £35 agency rate and paying it on a £3 platform fee is usually the largest single saving available.

Why "no fee" is not the same as "no cost"

The in-house bank looks free on paper, and for the right practice it can be the cheapest option overall. But the cost has simply moved from an invoice to your time and your risk.

Building a bank means recruiting, vetting and compliance-checking locums yourself, keeping their GDC registration and DBS current, and maintaining the relationships so people actually pick up when you call. When a bank member is unavailable - on holiday, already booked, or simply not answering at 7am - you are back to an empty chair, which is the single most expensive outcome of all. A lost session of NHS activity or private appointments dwarfs any per-shift fee. This is why many practices run a bank and keep a platform as the backstop for the days the bank cannot cover.

The cost most practices forget: the unfilled chair

Whichever model you use, the largest hidden cost in dental staffing is not the fee - it is the revenue lost when a shift goes unfilled. A single unworked NHS session can mean missed Units of Dental Activity, and missed UDAs can mean returned funding at year end. Across the sector, £147 million in NHS dental funding was returned in 2022-23 against missed targets, much of it linked to staffing gaps.

Seen that way, the right question is not "which option has the lowest fee" but "which option is most likely to actually fill the chair." A slightly higher fee that reliably fills the shift is cheaper than a lower fee that leaves it empty. This is where the platform model's speed matters financially as well as operationally: a request that reaches every available locum at once is more likely to convert than a consultant working through a call list, or a bank of three people who may all be busy.

Where each model genuinely wins

No single model is right for every practice, and an honest comparison has to say so.

A traditional agency can still make sense if you value a single named consultant managing everything for you and you are not price-sensitive about the margin. The trade-off is cost transparency and speed.

A marketplace platform wins on transparency, speed and per-shift cost for most short-notice and routine cover, particularly in well-supplied areas. The trade-off is that you are managing the booking yourself through the app rather than handing it to a consultant - though for most practice managers that is faster, not slower. It is also honest to say that platform performance depends on local supply: in rural areas, Scotland and Northern Ireland the locum pool is thinner for everyone, and no platform should promise routine same-day cover where the supply is not there.

An in-house bank wins for large practices and groups with the admin capacity to run one, and with enough regular cover needs to keep the pool warm. The trade-off is the upfront and ongoing management cost, and the availability gap when bank members cannot cover.

How to work out your own true cost

Before choosing, cost each option the same way - and include the parts that do not appear on an invoice:

Get the all-in number. Ask any agency to break out the locum's pay from their margin. If they will not, that margin is your hidden cost. On a platform the split is shown by default.

Add the admin time. Count the hours spent booking, chasing, checking compliance and handling invoices. A bank carries the most of this; a platform the least.

Price the risk of an empty chair. Estimate the revenue from one lost session, then ask how likely each option is to leave that chair empty. This number usually dwarfs the fee

Compare on filled shifts, not quoted rates. A low rate that does not fill is not a saving. Ask what percentage of shifts each option actually fills, and how fast.

A practice manager who costs all three this way will usually find the gap between the headline rate and the true cost is far larger than expected - and that the cheapest sticker price is rarely the cheapest outcome.

The bottom line

Dental locum cost is decided by three things, not one: the visible fee, the hidden margin, and the cost of an unfilled chair. Agencies hide the margin, banks convert the fee into admin and risk, and platforms put the whole number in front of you before you book. For most practices needing routine or short-notice cover, a transparent flat-fee platform is both the cheapest and the lowest-risk option - provided the local supply is there to fill the shift.

The best way to know your own true cost is to set up your options before you need them. Registering with Airlocum is free, takes a few minutes, and costs nothing until a shift is actually filled - so you have a transparent, fast backstop ready for the next time a chair would otherwise sit empty.

About the author: Eugene Bojé (BChD, MBA, MSc) is a qualified dentist and the founder of Airlocum, the UK dental staffing marketplace. He founded Airlocum in 2019 to give practices a faster, more transparent alternative to traditional locum agencies.