Locum lessons

For many locum optometrists it is the flexibility and work-life balance that attracts them to this mode of practice, as well as an interest in experiencing a range of working environments. However, treading the path of this mode of practice does not come without considerations. The absence of statutory sick pay and annual leave, means if a locum is not working, they are not getting paid. This can leave locums vulnerable at times – something that was demonstrated through the pandemic when demand for locums dropped as practices operated a closed-door policy, and, at times of strict lockdowns, emergency eye care only.

“The pandemic was the first time in 21 years of locuming where I had a period of not working,” locum optometrist, Anil Chander, told OT.

Chander was without work from March through to June 2020, an unanticipated consequence of the pandemic for Chander and many other locums.

“I was lucky to have savings to fall back on, especially as I didn’t qualify for any of the Government support schemes. This highlighted and essentially confirmed the importance of have a rainy-day fund, which I would recommend to all locums,” he shared.

“The pandemic was an incredibly challenging period for the industry, but in particular for locums, who were left in the unknown when the country went into lockdown,” acknowledged Hassnain Safdar.

When practices were initially advised to stop all routine sight testing, demand for locums drastically dropped, making Safdar consider what else he could do. “As a locum, I’m mindful there is no security in work,” he said, explaining: “A month or two into the pandemic, I began to consider alternatives and as such I decided to undertake the IP qualification, took on a part time role at a private hospital, and became a team leader for NHS Test and Trace.”

As a result, today Safdar works part-time at a hospital and locums at various practices across the East Midlands the remainder of his week.

As a locum of 13 years, optometrist, Prinal Patel, initially choose the path because she wanted to experience different areas of optometry. While the pandemic proved a difficult time, she recognises that as a locum, “you do have to ride the wave of when demand is high and low – you work more at high demand times, making up for the low demand times,” she said.

The pandemic taught Patel three things: “Always have a reserve fund financially that you can fall back on for rainy days; while you do have to work to the business’ needs, you also have to set your own standards and needs during unpredictable times, and it is always good to have a side hustle, especially being self-employed.”

If there are days free in my diary, I let my network know and email agencies to contact me should dates come available

Lets get organised, and honest

As a locum, you are ultimately self-employed, and as with any self-employed professional, there is an administrative side to the role – from booking shifts, planning your diary and managing cancellations, to sending and chasing invoicing, expenses and tax returns.

For Chander, who qualified as an optometrist in 2001 and became a locum in 2002 after encouragement from peers who had done the same, the most difficult part of his role as a locum is keeping on top of the financial administration that is associated with having a
business.

“Sending invoices in a timely manner, chasing invoices, keeping full records and preparing accounts can take a lot of time outside of your normal working day,” he said, suggesting, “getting good accounting software can significantly help with this and help keep you on top of it.”

Similarly, for Safdar, the hardest part of locuming is related to accounts and “getting your head around how to manage your finances effectively.”

“Hence, I use an accountant to manage that,” he shared.

Patel combats some of these challenges through organisation and forecasting. “Although the role of a locum offers flexibility with your time, days and also your career portfolio, you have to stay very disciplined with your work schedule,” she said, adding: “You need to ensure that you have set goals and created a forecast at the beginning of the year. This may include things like the numbers of days you work, the budgeting around sick days, tax payments, costs, and holidays.”

An important part of the role of a locum is diary management, planning to ensure that work is secured and booked in advance. And while the pandemic led these three locums to re-evaluate their processes in this area, it ultimately has not resulted in large amounts of change since demand levels for work have returned to normal.

“I was always booked up several months in advance prior to the pandemic and essentially that’s the same now,” Chander shared. “In the 20-odd years I’ve been a locum optometrist I’ve always had ample work, the pandemic was just a once in a generation event which you could not predict,” he added.

Sending invoices in a timely manner, chasing invoices, keeping full records and preparing accounts can take a lot of time outside of your normal working day

Pre-pandemic, Safdar too would usually book work two months in advance and this “hasn’t really changed” he said, admitting that his diary is a little easier to manage now he balanc-es locuming with part-time employment. “If there are days free in my diary, I let my network know and email agencies to contact me should dates come available,” he said.

Patel has tweaked her diary management in recent years, moving from booking six weeks in advance pre-pandemic to two to three months in advance now. She also sets and returns to monthly financial target, and books work accordingly. “For example,” she shares, “if in December, I work 15 days, I know I need to try and make up some more days in November and January.”

Furthermore, today she actively talks about her cancellation policy upon booking.

Cancellations, while frustrating, are an inevitable part of being a locum. So, how do this trio deal with them?

For Chander, if there is a reasonable explanation for the cancellation, he will accept it and either have a day off or rebook elsewhere. However, “if cancellations kept on happening with the same client over and over again then I would decline to rebook any further days with them,” he said, adding: “Odd cancellations are sometimes unavoidable and this can apply both ways. Sometimes as locums you may need to cancel too.”

And while Patel understands that cancellations may and do occur, she has taken steps to lessen the impact on her. “Upon booking I ensure I let practices know that if they require any cancellations of bookings that advance warning is needed. Anything within seven days, I only allow a practice to do this twice before I then have a meeting with the practice owner to let them know that if cancellations are not made within an appropriate time frame, I would decline future bookings.”