ROSTRA/Direct cover

London · Hospital shifts · One grade at a time

The trust pays £60 an hour.
The doctor is paid £40.

On a ten hour shift the agency keeps £200 for making an introduction. We charge a 12.5% fee and give the rest back to the two people who did the work.

Spread calculator · drag to change the shift
Through an agency
Trust spends £600
£400
£200
Doctor keeps 67% · agency keeps 33%
Direct, through Rostra
Trust spends £580
£516
£64
Doctor is paid £52/hr · Rostra keeps a 12.5% fee
Trust saves£20
Doctor gains+£116
Our fee£64

Why the gap does not close on its own

Hospitals cannot hire their way out of this

Training posts are capped nationally, not by the hospital that needs the doctor. A trust with a rota gap has no lever to pull on establishment headcount, and the doctors it already employs are held to a 48 hour average week. Trainees have protected teaching time and cannot cover senior decision making.

So the gap between a rigid establishment and a moving clinical need is permanent. Somebody fills it every night, and today that somebody is billed through an agency.

12,833

Specialty training posts available in 2025, against 92,000 applications. Hospitals cannot create more.

UK specialty recruitment, 2025
7,474

Vacant medical posts in England. Every one is a rota that still has to be covered tonight.

NHS vacancy statistics, England
72%

Of trainees name rota gaps as the single biggest thing damaging their training.

GMC national training survey

The money already being spent

£8.3bnNHS temporary staffing spend, 2024/25
£5.1bnUK temp healthcare agency market, growing 7.6% a year
£1.0bnUnfilled hospital posts alone, 18–22% of the agency market
$9.6bnUS locum tenens equivalent

Working demo · click through both sides

Post a gap at 2am. Have it covered before the handover.

The compliance file is checked and kept current before the shift is ever posted, so the match takes minutes rather than the two days an agency spends chasing paperwork.

rostra.uk/app
Post a gap
Your bank is checked first. Agency is never the default.

Demo data. Hospitals and doctors shown are fictional.

Four things we will not do

The boundaries are the product

A marketplace in clinical staffing fails on liability long before it fails on supply. These four limits are fixed, and we would rather lose a customer than move one.

Not clinical

We rate attendance, never competence. Turned up, on time, did not cancel, would rebook. Clinical judgement belongs to the GMC and to the responsible officer at the trust. Rating a named doctor on quality invites a defamation claim and a GDPR problem in the same afternoon.

Not automated

No agent decides who is safe to staff. Software verifies documents, tracks expiries and ranks availability. A named human at the trust signs off every booking before it is confirmed.

Not the employer

We broker, we do not front the payroll. The trust pays the doctor and we invoice a fee. Agencies pay locums in days and wait 30 to 60 for the trust, which is how they end up needing capital we would rather spend on density.

Not everywhere

One city, one grade. A registrar in London cannot cover a gap in Nottingham. Coverage without density gives you five pools, none of which can fill a shift.

We would be an employment business under the Conduct of Employment Agencies and Employment Businesses Regulations 2003. That is a solicitor's hour before shift one, not a footnote after shift fifty.

Right now we want ten conversations, not ten thousand signups

Tell us what a bad night on your rota costs

I run a rota

Twenty minutes on how your department actually books cover, what your agency spend looked like last quarter, and where the process breaks. We are asking to learn, not to pitch. If it goes well we would want one paid trial shift.

I pick up locum shifts

Tell us your grade and the hospitals you would travel to. We are building demand first, so we will not sign you up until there are shifts worth showing you.