Big adjustments: five ways locum optometry changed in 2020

Some locums worried about how they would cover their household bills as bookings and income disappeared, seemingly overnight, with the introduction of lockdown in March.

While Government support was introduced to ease the financial burden on self-employed workers, substantial blind spots, including an income threshold that excluded many locum optometrists, left many practitioners facing an uncertain future.

“This year has been a real challenge for me and professionally those first few months were the most depressing and anxious of my career,” former AOP Awards locum of the year, Kris Cottier, told OT.

However, the resumption of routine sight tests and a substantial appointment backlog has seen demand for locum workers rise again.

Locum optometrist Rebecca Rushton told OT that she is optimistic about the future of locum work, despite the hurdles that the workforce has faced this year.
“I think there’ll always be a need for locums, but we need to ensure we offer the very best to our employers and patients,” she highlighted.

Below OT chronicles key trends that shaped 2020 for the locum optometry workforce.

1. Beginning of lockdown sees locum work decline

The introduction of lockdown in March resulted in a dramatic reduction in the number of patients seen through optometry practices, with optometrists only permitted to provide emergency and essential eye care.

A large proportion of the employed optometry workforce was furloughed, while locums saw a steep drop in demand.

“I went from a normal five-day working week to sitting at home and worrying about where the funds were going to come from,” locum optometrist Abid Noor told OT.

Some locums sought work in other sectors or volunteered to help the NHS. In Wales, locum optometrists were among volunteers who delivered prescriptions through a partnership with Community Pharmacy Wales.

2. Government offers self-employed support

The launch of the Self-Employment Income Support Scheme provided relief to some locum optometrists by covering 80% of an individual’s profits up to a maximum of £2500 per month.

However, those with an annual trading profit of £50,000 or more were not eligible for any support.

Company directors who route their income through dividends, locum optometrists who recently switched to this mode of working and those whose locum profits account for less than half of their earnings also fell through the Government safety net.

The AOP repeatedly lobbied for more financial support for locum workers.

In April, along with other professional bodies representing a combined membership of 300,000, the AOP urged the Chancellor to provide relief to self-employed workers and small businesses that were struggling to access assistance through existing schemes.

3. Rates for locum work decline

Anecdotally locums were asked to work for lower rates following the outbreak of the pandemic, with employers attributing this to a drop off in demand and revenue across the optical sector.

The AOP called on employers to treat locums fairly as the sector returns to routine sight testing.

AOP councillor for the South West of England, Ed Bickerstaffe, highlighted that locum optometrists are a highly skilled and flexible workforce.

“We’re urging employers to make sure they treat their locum staff fairly and ensure that rates reflect the value of the work their locums do as the volume of activity grows,” he said.

Speaking to OT in October, locum optometrist Hassnain Safdar highlighted that the demand for locums was beginning to recover following the March lockdown.

“Locum work is back on the rise after a dip in the early stages of the pandemic,” he said.

Locum Andrea Mentlikowski shared with OT that having a flexible locum workforce enables practices to adjust to different levels of demand.

"I personally think that the future of locum work is secure," she shared.

4. PPE and infection control introduced

In order to keep patients and staff safe, personal protective equipment (PPE) and infection control procedures were introduced to UK optical practices following the outbreak of COVID-19.

Sight test appointment times became longer in order to accommodate the need to clean equipment between patients and follow updated processes.

Locum optometrist Kris Cottier told OT that it was a challenge adjusting to wearing PPE but that it has now become part of his routine.

“It is amazing how quickly I’ve adapted my examination techniques to allow for this. Indeed, I’m not sure I will ever go back to not wearing a face mask for a sight test,” he shared.

Fellow locum worker Andrea Mentlikowski highlighted that the silver lining of PPE is that it may help staff to stay physically healthier over the winter.

"It will be interesting to see whether all our precautions against COVID-19 may prevent us from catching colds and other infections," she observed.

5. Practices work to reduce appointment backlog

 

Following the resumption of routine sight tests, practices began working through a backlog of patients who missed non-urgent appointments following the March lockdown.

Eye Health UK estimated that five million routine sight test appointments were missed during lockdown.

The burden on secondary care also increased following the temporary suspension of elective surgeries, including cataract surgery.

The NHS Confederation estimated that the NHS wait list could reach 10 million patients across all specialties by the end of the year.

Locum optometrists who spoke to OT highlighted that the pandemic has added to the impetus to treat more eye conditions in the community.

“In the long-term, we will all need to upskill and at the very least be MECS-approved as I believe the hospital eye service will look to optometry to manage their stable patients,” Kris Cottier highlighted.

Aberdeen-based optometrist, Craig McCoy, highlighted that there is demand for locum services in the area that he covers.

“Most practices are actually struggling with the backlog of patients from lockdown so the owners are grateful for the rest or extra capacity,” he said.

The Locum Guide was produced in partnership with Johnson & Johnson Vision and the AOP