Choosing between a permanent associate dentist and a locum dentist is one of the most important workforce decisions a UK dental practice can make. In a market shaped by the ongoing dentist shortage UK-wide and increasing NHS pressures, the right staffing model can determine your practice’s financial stability, patient continuity, and long-term growth.
This guide explains the key differences between permanent and locum dentists in the UK, including cost, compliance, continuity, and strategic considerations. so you can decide what’s right for your practice.
Understanding the Difference in the UK Context
In the UK, most “permanent” dentists in general practice are self-employed associate dentists working under long-term agreements. Locum dentists, by contrast, work on short-term contracts to provide temporary cover.
All practising dentists must hold valid registration with the
General Dental Council, regardless of contract type.
In NHS-focused practices, additional requirements may apply under the
National Health Service, such as performer number status in England and Wales.
Permanent Associate Dentists
Advantages
Permanent associates provide stability. They build long-term relationships with patients, understand practice systems, and contribute to team culture. Continuity of care is particularly important in NHS settings, where patient lists and contract delivery depend on consistent clinical provision.
Financially, permanent associates are often more predictable. While percentage splits apply, daily rates are not inflated by short-term urgency, as can happen with locums.
Permanent associates also allow for structured career progression, development of special interests, and long-term practice growth.
Disadvantages
Recruitment can take longer, especially in regions affected by the NHS dentist shortage UK services are experiencing. If the role is not attractive or UDA targets are unrealistic, vacancies may remain open for months.
There is also greater onboarding investment required to integrate a permanent associate effectively.
Locum Dentists
Advantages
Locum dentists offer flexibility. They are ideal for:
- Covering maternity or sickness leave
- Bridging gaps during recruitment
- Managing temporary workload spikes
- Preventing cancellation of NHS clinics
Locums can start quickly, particularly if already GDC-registered and regionally available. This reduces immediate service disruption.
Disadvantages
Locum rates are typically higher than permanent associate percentages when calculated over time. Agency fees may also apply.
Continuity of care can suffer if locums rotate frequently. Patients may prefer consistent clinicians, particularly in NHS settings.
Long-term reliance on locums can also increase operational instability and reduce team cohesion.
Cost Implications: Permanent vs Locum
From a UK financial perspective, locums often carry higher short-term costs. Daily or sessional rates may exceed the effective percentage paid to associates over time. In addition, administrative coordination and onboarding for multiple short-term clinicians increases indirect costs.
Permanent associates, while requiring longer recruitment lead times, usually provide stronger long-term financial predictability. Reduced turnover also lowers hidden recruitment expenses.
In practices already affected by the dentist shortage UK-wide, frequent locum use may signal underlying structural recruitment challenges.
NHS vs Private Considerations
In NHS-focused practices, continuity is especially important for UDA contract delivery and patient access. Permanent associates typically provide more reliable NHS service coverage.
In private practices, flexibility may be easier to manage financially, but patient relationships still matter. High-end private dentistry often relies on consistent clinician branding and reputation.
Mixed practices must balance both realities carefully.
When Is a Locum the Right Choice?
A locum dentist is often appropriate when:
- A permanent associate is on leave
- You are mid-recruitment for a long-term role
- Unexpected resignation creates a temporary gap
- Seasonal demand increases workload
Locums are best used strategically rather than as a permanent staffing model.
When Is a Permanent Associate the Better Option?
Permanent associates are usually preferable when:
- You need long-term NHS contract stability
- You want to build patient loyalty
- You aim to expand services sustainably
- You are investing in digital or specialist development
Practices focused on growth and continuity benefit from stable clinical teams.
Recruitment Strategy in a Competitive UK Market
Given current workforce pressures, the most resilient practices combine:
- Strong retention strategies
- Ethical international recruitment planning
- Structured onboarding
- Selective and strategic locum use
All recruitment decisions must remain compliant with standards set by the General Dental Council and relevant NHS requirements.
Final Thoughts
In today’s competitive UK dental market, there is no one-size-fits-all answer. Locum dentists provide flexibility and short-term protection against service disruption. Permanent associate dentists provide stability, continuity, and long-term growth potential.
The right decision depends on your practice’s financial model, NHS commitment level, regional workforce availability, and long-term strategic goals.
For most UK practices, locums should be a tactical solution, while permanent recruitment remains the strategic priority.
