“Being self-employed means looking after yourself”
Four locum optometrists tell OT how they protect themselves and their finances
18 November 2023
Flexibility, upskilling in different settings, the value of being your own boss: every time OT speaks to a locum optometrist, their reasons for choosing this path are clear.
“Financial planning isn’t just about pensions and retirement planning,” Harmy Bains, independent financial adviser at AOP affinity partner, Lloyd & Whyte, told OT.
He added: “If you’re newly qualified or in the early stages of your optometry career, getting advice on how to handle your income and assets can make the difference between potentially struggling or thriving. There are various aspects that can help you protect your income, your family, and your future when you review your finances.”
For newly-qualified or early career optometrists starting locuming, saving into a pension pot or considering income protection might not seem like a top priority. With busy days and the ongoing securing of shifts likely a locum optometrist’s most immediate concern, it might be easy to kick these longer-term needs down the garden path. But in reality, if not now... when?
Here, locums and experts explain why these administrative aspects of locum life are vital, whether you’re one month or one decade into your self-employment journey.
Starting out: setting up your businessWhen starting out as a locum, your first task is likely to be officially registering yourself as a business.
Like most people embarking on self-employment, Sritharan started out by Googling as much information as she could on the process.
She was then referred to a “very knowledgeable” accountant by a colleague, and was able to get straight answers on the questions that she had, including the difference between a limited company and a sole trader.
“They really took the time to explain everything, and that was really helpful,” Sritharan said.
Buckinghamshire-based locum optometrist, Kam Sandhu, who has been self-employed for seven years, emphasised the importance of finding an accountant who is familiar with locum optometry specifically.
“When I first started locuming, I had an accountant who had absolutely no idea what he was doing and made things more complicated,” Sandhu said. “I was then recommended an accountant by a close friend, and since then running the business has just been so much easier and I’ve not had to worry about that aspect.”
In Sihra’s case, this meant utilising the accountant who had already set up her optometrist husband’s locum business.
“My husband is an optometrist too, and he was a locum first,” she explained. “He already had the business, but the accountant had set it up. He had decided the best thing for us was to be a private limited company.
“We have a spreadsheet for the accountant, where we fill out all our days, including travel. They guide you in what you can do and what you can’t do.”
Sihra believes that the advice offered in terms of tax returns and corporation tax is invaluable.
All her shifts and expenses are logged in a spreadsheet and the accountant prepares the business accounts before they are submitted, she said.
“It’s one pressure off,” she said. “They guide you into what you need to pay.”
Hannah Colclough, who locums in Cheshire and Merseyside, offers an opposing view.
“With setting the business up, I did it all myself,” she said. “I went to an accountant and they said they could set it up for a fee, but I actually found that it was really easy.”
Colclough added that she found following the steps laid out on Gov.uk, including adding a business address, relatively simple.
She has a practical tip for those going through the process on their own: “If you don't want to use your home address, you can use a registered address,” she said. “You can go online and pay for a registered office, where all your mail goes – like a PO box. If people don’t want their home address on Companies House, they can pay a yearly fee for that as well.”
She added: “It was quite scary to begin with, setting everything up and not wanting to get anything wrong with the Government. But there’s not much you can get wrong. It’s pretty self-explanatory.”
Colclough told OT that setting up a business bank account, another administrative aspect of establishing a locum business, can be quite straightforward too. Her account is with Monzo, but she notes that other locums use and are happy with free accounts offered by online banks Revolut and Starling.
There do not need to be many complexities with a business bank account, she said: “You just need a basic account that you can pay yourself from, and then expenses like fuel can go through there as well.”
Sritharan emphasised that the business side of self-employment involves a learning curve. “At the end of the day, you still feel like you don't know it all, and I guess it just comes with experience,” she said. “Being just seven months in, I think I'll have a couple of surprises here and there down the road.
“But it's just knowing how to manage your finances, being able to ask questions, and finding someone who you can ask questions to, so you’re prepared as much as you can be.”
The importance of indemnity insuranceColclough emphasised that indemnity insurance is something that is vital for locums – so much so that every practice she has worked at has asked about it before her first shift.
“With the apps that you use to set up work, you have to have indemnity insurance,” she said. “Everywhere I’ve worked at has asked me for it.”
She continued: “The AOP one is great, because it’s for optometrists specifically – it’s not just medical malpractice. I knew from university and from colleagues that that was the one to go for. It’s very well priced.”
Every locum OT spoke to had indemnity insurance with AOP, in Sandhu’s case “since the second I qualified.”
“It’s always advisable to have your own private indemnity insurance, because no one else is going to protect you,” Kaur Sihra said, adding: “I've always had AOP, from the beginning. If you need them, they are there. At the back of your mind, you know you’ve got somebody on your side.”
She added: “The AOP, I have no fault with them. If you have any questions, they will get back to you and they will guide you. I will not have anyone else. You’ve got somebody with you.”
“I’ve found that, as a locum, you feel a lot more pressure,” Colclough shared. “With a residency, you can follow your patients through. But as a locum, you don’t know how other people are going to manage them. That’s where indemnity insurance comes in: if anything slips through the net. Starting out as a locum, obviously, you’re on your own. It’s there if you need it.”
She added: “I know a colleague who has spoken to the AOP for advice. She had questions like, ‘if they haven't got equipment in practice, what do you do?’ If something has happened with a patient and you’re having to deal with it, it’s good that you can use them for advice.”
At the back of your mind, you know you’ve got somebody on your side
Protecting yourself with income protection and critical illness coverIncome protection and critical illness cover might seem less vital, but like any insurance this is only the case until it’s suddenly needed.
The percentage of salary that could be paid out via an income protection policy
He added that income protection via Lloyd & Whyte can pay up to 65% of a locum optometrist’s salary should the worst happen, and that it can be tailored to suit individuals.
In a similar vein, critical illness cover – designed to pay out if the holder finds themself with a serious, life changing condition that means they can no longer work – can mean a level of security that would not be there otherwise.
Sandhu explained the value of health insurance and income protection: “as a locum, we have no entitlements to statutory sick pay, so I have assurance that should I incur any health problems or accidents,” she said. “I will have quicker access to healthcare and treatments and, if needed, I will still have some form of income.”
In the case of Lloyd & Whyte, policy holders may be able to receive a lump sum on diagnosis of a listed condition, depending on the type of policy they have.
Those without critical illness cover or income protection can get a free quote from Lloyd & Whyte online.
Looking to the future with savings and pensions
“Being self-employed means looking after yourself,” Bains said. “Getting appropriate advice on how you manage your pension, where you invest, and the tax benefits of paying into a pension pot, is crucial in helping you plan for your future.”
Lloyd & Whyte notes that, when it comes to savings and investments, there is a risk of investments going down and no guarantee that your capital will be repaid or increase.
Finding a balance
OT is interested in hearing how locum optometrists balance their day-to-day work in practice with the demands of self-employment.
For Sihra, a key reason for becoming a locum was the flexibility that it gives her around her young family. Keeping Tuesdays and Thursdays free allows her to update her spreadsheets and stay on top of her admin, she explained.
“You have to be organised and have time management, as a locum,” she said. “That’s the key thing.”
Colclough takes time out once a month to ensure her receipts are up to date and book future shifts.
“I’ll check what has come into the bank account and make a note of that,” she said. “I keep on top of everything, so it’s not left to the last minute. The main one is keeping on top of your mileage.”
She added: “Don't use your personal calendar. I keep all my shifts on a separate planner. I use MyShiftPlanner, on the App Store.”
She also prefers booking shifts in advance to finding last-minute slots, even if the latter might pay better.
“I’m definitely not that person,” she said. “Shifts usually come out two or three months in advance, so keep on top of it, know where you want to work, and make sure you can work there. [That way] you’re not stressing about income, because you’ve got the shifts booked. Even if one cancels, you’re not stressed about the whole week being off.”
Sihra appreciates the community of locums that exists. “We've got locum groups on WhatsApp, so everyone helps each other, if you have a question or you need help,” she said. “We are like our own little family.”
Key advice on protecting yourself as a locum
Kam Sandhu: get indemnity insurance for peace of mind“Having indemnity insurance is essential in protecting yourself as a locum. Knowing that I have indemnity insurance that can provide clinical advice, peer advice and legal aid, and knowing that it’s there solely to protect me as an individual, definitely gives me peace of mind.
“Knowing that I have protection and support from my indemnity insurance means that all I have to worry about is going to work and looking after my patients.”
Resharon Kaur Sihra: finish the job straightaway“Do what is expected of you. When I go in, I check the diary first. You need to fill out the records as they should be filled: you can’t cut corners or say you’ll do it after the next patient. You have to make sure you do what you need to do at that current time.
“You should be geared up to finish that job and know that you’re giving the best service to that patient at that time.
“You need to give detailed management and advice, make sure you provide the leaflets, and document everything. Make sure you’ve explained everything clearly to the patient. You can’t assume they understand what you’re saying. You have to make sure it is clear in layman’s terms and that they know what to do.”
Hannah Colclough: follow-up on your patients’ outcomes“Do your job properly. Make sure all your notes are complete, and everything that needs doing is done on the day. If you need to repeat fields or tests, make sure you make a note of it. If you’re in that practice again, you can check to see if it has been done. If you’re not in the practice again, you can call the practice or ask them to email you the results.
“Have that note-taking, and record keeping on top of it. Same with referrals – make sure you write on the notes to confirm that your referrals have been sent.”
Take the next step
More information for optometrists is available here.