Locum optometrist guide

Navigating the rising cost of living

Locums share their top tips for helping to balance the books – from negotiating a fair rate of pay to budgeting basics


Rising fuel and energy costs, a growing supermarket bill and predictions that inflation will approach a 40-year high of 9%.

Cost of living pressures are causing workers across all sectors to reassess how they prioritise their spending.

For locum optometrists, the price pinch comes following a tumultuous time in the workforce prompted by the COVID-19 pandemic.

The introduction of social distancing restrictions resulted in many locums watching their bookings dry up overnight. However, demand has bounced back during the recovery phase of the pandemic.

Sam Phillips
Sam Phillips
“Being a locum is ever-changing from a business perspective,” locum optometrist, Sam Phillips, shared with OT.

“In just two short years I have had sudden declines in work, then overwhelming demand and in my area rates that have skyrocketed due to short supply,” he added.

Phillips noted that rising fuel costs have made it less attractive to provide a geographically broad locum service.

Locum optometrist, Hassnain Safdar, shared that he always tries to stick to a one-hour limit on his commute time in order to preserve a healthy work-life balance.

“The rising cost of fuel is something I’ve had to accept as part of my work as a locum,” he said.

Hassnain Safdar
Hassnain Safdar
Safdar tends to avoid busy city routes to work, which bring his fuel economy down.

“The fuel shortage makes me slightly apprehensive, but I’ve factored in public transport if I can’t find any fuel,” he said.

As a locum optometrist who does not drive, Rebecca Rushton is expecting the cost of public transport to increase.

Rebecca Rushton
Rebecca Rushton
“It is frustrating. This will further encourage me to stay local and I think employers may have to consider paying travel fees for locums from out of town,” she shared.

Asked whether they had observed the effect of cost pressures on purchasing behaviour in practice, locum optometrists told OT that it was hard to judge if there had been a direct effect.

“I haven't noticed customers behaving any differently, though I've had several conversations about the increased cost of living, so it's definitely on people's minds,” Rushton shared.

If there is a practice that you really want to work with you may decide to make concessions from a financial point of view as you may benefit in other ways

Sam Phillips

Phillips noted that some patients may cut back on services or products that they perceive as a “luxury.”

“I’d like to think that effective recommendations would mean the customer sees the value in the quality eyewear and eye care that we provide,” he said.

Budgeting tips

Sharing her budgeting tips, Rushton encouraged locums to have between three and six months of living expenses in the bank to provide a buffer.

“That way it's no biggie if you're off sick for a couple of weeks or if someone doesn't pay an invoice on time,” she said.

She recommended putting a third to a quarter of each payment to one side for tax purposes.

Phillips recommended comparing different options for fuel and parking – especially if working in cities.

“Consider cycling or public transport if convenient and readily available,” he said.

Locums could consider favouring block bookings if working in locations further afield, Phillips shared.

For Safdar, planning his route in advance is key.

“Check if there’s traffic on your route or whether you can take another route to avoid being stuck in a jam. Waze is a good app, which helps to plan your journey in advance and gives you approximate traffic data based on historic reports,” he said.

He also recommended checking whether there is free street parking within walking distance of a practice.

“It may mean you have to walk a little more, but those extra steps don’t harm you,” Safdar said.

Locum optometrist, James Brawn, recommended maintaining a separate account for self-employment.

James Brawn
James Brawn
“It makes life a lot easier when it comes to paying your tax, National Insurance and professional fees,” he shared.

Brawn noted that having an accountant helps locums to budget for their self-assessment payments.

“They can also advise you on which of your expenses are tax deductible,” Brawn added.

Lastly, Brawn recommended regularly re-evaluating locum rates.

“Due to the effects of inflation, if you charge the same today as you did five years ago, you are now effectively charging less than you did in 2017, yet are more experienced and may also have undertaken additional qualifications,” he emphasised.

Negotiating a fair rate

Turning to negotiating rates for locum work, Brawn highlighted the importance of knowing what the rate is for locum work in a certain area.

“Early in my career, I discovered to my horror that I was charging £100 less than the other locums in a store, quite simply as I didn't know what other locums were charging,” he said.

Brawn is open about what he charges and his desired working conditions (such as testing times and lunch break duration) when discussing potential work.

“I find that stating these upfront allows negotiations to run more smoothly,” he said.

Phillips noted that keeping an eye on locum apps and recruitment services can provide an indication of available rates in certain areas.

“You can use this information to negotiate better rates with your new and existing practices,” he said.

Early in my career, I discovered to my horror that I was charging £100 less than the other locums in a store, quite simply as I didn't know what other locums were charging

James Brawn

He noted that the offered rate is only one of a range of considerations when deciding whether to work at a practice.

“If there is a practice that you really want to work with you may decide to make concessions from a financial point of view as you may benefit in other ways. For example, working in a practice with new or different equipment may help you develop clinically which in its own way is valuable,” he highlighted.

Safdar encouraged locums to highlight the ways that they can bring value to a practice when negotiating a rate.

“It’s important wherever you decide to work to mention your skills and qualities and what you can add to the practice that will benefit them,” he said.

Locum optometrist, Pete Sharm, emphasised that the rate has to reflect his level of experience.

“I tell the store what else I can offer, whether it is myopia control, OCT training or my current training in independent prescribing,” he shared.