23 May 2026
Whilst locum optometry might have its positives – the flexibility to work and play when you like and diversity of practice settings being just two – there is no question that choosing this life can be isolating.
The reality of locum work can mean relying on yourself alone, without the consistency of colleagues that can be relied on day-in and day-out.
As May’s Mental Health Awareness month nears its end, OT asked three locum optometrists about the things that put the biggest strain on their mental health in a normal working day – and how the optical community can better support locums.
The patient vs the paperwork
Sanaa Mikhael, a locum optometrist in London, told OT that the pressures felt by those in her mode of practice are similar to those experienced by locums in other healthcare professions.
“The challenge is balancing high-quality patient care with staying on time, completing paperwork, and documenting exams properly,” she said.
She explained: “I aim to finish all referrals on the same day, even if I’m returning the next day. It can be stressful trying to see patients promptly while giving them enough time, especially when late arrivals cause delays and create a knock-on effect. This is worsened by urgent cases and the need to manage patient expectations if we run behind.”
Added to this is the existence of ghost clinics – where patients are squeezed into non-clinical timeslots to guard against lost revenue in the case of no-shows.
“The introduction of ‘ghost clinics’ has added further stress, which unless carefully managed could increase the likelihood of unsafe practices,” Mikhael shared.
Raf Islam, a locum optometrist who also works in domiciliary and as an optometric adviser with Swansea Bay University Health Board, noted that one of the aspects that locums often identify as being a positive – working across a variety of different settings – can also be one of his biggest causes of stress.
“One of the biggest challenges of being a locum is managing the day-to-day pressures alongside clinical responsibilities,” Islam said.
He explained: “This includes adapting to different practice systems, referral pathways, and operating procedures, while also ensuring all clinical tasks and referrals are completed properly.”
Islam added: “The constant need to adjust to different environments can add significant stress.”
Kam Sandhu, locum optometrist in Berkshire and Surrey, agrees that differing environments can be challenging as a locum.
“One of the main challenges is the need to continuously adjust to different practices, teams, and systems whilst being expected to hit the ground running,” Sandhu told OT.
She explained: “The uncertainty of entering an unfamiliar practice and needing to adjust right away can be quite daunting.
“Quite often you may find yourself running a single clinic, and sometimes being the only optometrist on site can make you feel isolated, particularly if you are uncertain about the team’s ability to support you during challenging clinic situations.”
There is more support needed for locum optometrists, Islam believes.
“Although there are locum communities, there are limited opportunities to meaningfully connect and discuss challenges with other locums,” he told OT, adding: “As a result, I do not feel there is strong support for overall wellbeing.”
An increase in wellbeing initiatives that are solely focused on locums and the specific issues that they face would help, Islam said.
“I believe professional bodies, regional groups, and local optical committees should play a greater role in supporting locums by identifying concerns and providing better wellbeing support,” he said.
He added: “I would like to see more locum support groups and locum continuing professional education events.”
Mikhael agrees that finding a community of other locums is important when trying to protect mental health.
“Locuming can feel quite isolating at times, so having a community for support is really valuable,” she told OT.
She added: “Being able to discuss difficult situations with other locums provides reassurance and hearing how others handle similar scenarios helps reinforce and strengthen my own approach.”
I’ve made a conscious effort to prioritise my wellbeing and remind myself that, while work can be demanding, there are far more important things in life than day-to-day stress
The value of focus and perspective
OT was interested in hearing how Mikhael and Islam go about protecting their mental health – both in the moment in a busy clinic, and in the longer term.
For Mikhael it is about keeping perspective, she explained – and one particular incident brought this home for her.
“During a particularly stressful day at work, I received the sudden news that a young friend had passed away, which really put things into perspective for me,” she shared.
“Since then, I’ve made a conscious effort to prioritise my wellbeing and remind myself that, while work can be demanding, there are far more important things in life than day-to-day stress. This includes working out, taking regular time off or holidays, and avoiding overworking to prevent burnout.”
For Islam, protecting his own wellbeing is about being clear about boundaries, and ensuring a focus on the job that is being done.
“It is important to always act in the patient’s best interest and focus on patient care rather than KPIs,” he said.
Islam noted: “Building good relationships with practices and staff can make a big difference, and locums should feel confident saying no to situations they are uncomfortable with, such as ghost clinics.
“In the long term, managing stress means avoiding taking on too much work, staying calm during quiet periods or cancellations, and keeping finances organised by setting aside tax payments as soon as you are paid.”
He added: “I feel stress is self-induced, and sometimes we can get ourselves into stressful situations.”
Sandu also notes boundaries as vital – alongside the incentive of having a holiday to look forward to.
“Within the clinic, it’s important to establish clear boundaries and take advantage of any free moments for some time to unwind, which helps minimise burnout,” she explained.
“I always try to ensure that I wrap up any unfinished tasks before I head out of the clinic, which lets me enjoy the rest of my day without work lingering on my mind.”
Sandhu added: “In the long run, I always like to plan a holiday, it gives me something exciting to anticipate and helps me momentarily escape the realm of optics. I always return feeling refreshed and recharged.”
Sandu also emphasised how helpful other locums can be when a colleague’s insight is needed.
“The locum community is often very supportive, as they understand the unique challenges that come with locum work,” she said.
Sandu added: “Having other locums to talk to, to exchange experiences, seek advice, find reassurance, or even just to vent after a difficult day, really helps reduce that feeling of isolation, and also helps remind you that you’re not navigating these challenges by yourself.”
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