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Patient having an eye test

As a locum you may often find yourself in unfamiliar surroundings at short notice.

Practice managers should give you time to familiarise yourself with the operation of any equipment and software you may be required to use and ensure that staff are on hand to assist with this familiarisation. They should explain whether the pre-testing takes places and what it entails and make Standard operating procedures (SOPs) available to you as well as information on local referral routes and protocols. They should not ask you to do anything you have not been trained to do, for example supervising a trainee if you have never received training in doing that.

Repeat tests and follow-up are particular challenges for both the practice and you. You may not be able to book repeat procedures to align with when you will be in the practice and so you will need to rely on others to conclude the patient’s sight test.

As we explain it is here that both practice and any personal professional systems need to be absolutely watertight. All follow-ups should be assigned to an optometrist who understands that they are taking on clinical responsibility for the sight test or, alternatively, an internal practice referral should be made, as explained in the Internal practice referrals section on this page. Arrangements for this should be agreed with you when you are engaged and confirmed again, where possible, before you leave the practice.

Advice

For deferred procedures, practices and optometrists should ensure that:

  • A failsafe system is in place for repeat tests and patient follow-up and that locums understand how this operates
  • All necessary tests (including repeat tests) are concluded and the results considered before the sight test is deemed concluded
  • An employed optometrist is assigned to undertake the role of follow-up and final decision-making for patients where a locum is not returning
  • Information is available for locums on unfamiliar equipment and local referral protocols

It may not be possible for you to verify that your requested referrals (internal or external) have been acted on. Questions could arise later as to whether you did the right thing for a patient. We recommend that locums protect themselves against future questions over their actions on behalf of any particular patient by keeping their own personal record of non-routine decisions. Our locum logbook was designed for this purpose.

While our advice for employers describes the practical ways that they can support you to practise safely, you have personal responsibility to do the right thing by patients. For example you should take care that you give patients the time that they need even if you are being given a bonus for seeing more patients. You should challenge requests to carry out too many tests each day if you think the result is that you can’t give patients the time they need. We know that locums worry that they won’t be asked to work again for employers if they challenge in this way. If you have concerns that you're being treated unfairly by a practice that has hired you, you can contact our legal and regulatory team at [email protected]. They will be able to advise, and may be able to help you to take up the issue with the business involved if you wish to do so.

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