“As a locum, I see completely different patient demographics”

Before I became a locum, I was working...

As a mobile optometrist for Dollond & Aitchison Opticians, when they existed.

When I started as a locum, I wish I had known…

How organising your finances and the perks of being employed were completely different to being self-employed – for example, having to factor in no paid holiday leave or sick pay, no paid paternity leave, no employer pension contributions, no professional fees covered, and no longer having educational support and provisions from your employer.

Being aware of those periods where work can get quiet and it’s harder to find bookings [is important]. Also, understanding how self-employed taxation works, including making your own tax payments, and having to ensure that they are made by the due dates.

I made the decision to become a locum because...

Of the flexibility that it brings. Doing charity trips was one thing I always wanted to do. In the early days, before I had kids and when I was newly married, I was doing three trips a year with Vision Aid Overseas (now Vision Action). It gave me that flexibility to take time off when I wanted to, and to organise my own trips.

My first day of locuming...  

Was slightly different. Because I had worked for Dollond & Aitchison as a mobile optometrist, I had a very good relationship with them already. Because I was a mobile optometrist, I went into doing the same work that I was doing before, working for them in the same practices, but as a locum. There weren’t any big challenges. I was doing what I was doing before, but on a self-employed, as opposed to an employed, basis. 

My biggest locum challenge is… 

The uncertainty. Your shifts can get cancelled at any time. If anything changes, you’re always the first to be cancelled. 

Also, I think the locum market is going to change quite a bit. I think I’ve benefited from the good years of it, and it’s not always going to be as easy in terms of rates and availability of work. 

Practices can make life easier for locums by… 

At the beginning of the day, if someone’s new, introducing them to the staff, and letting them know how the system works and what the referral pathways are. Referral pathways are a big.

One of my biggest bugbears as a locum is... 

Where other locums and even resident opticians leave you with their tests to take over. You should take responsibility for what you do, and have the confidence to do that fully, and not just pass it on. 

One change I’ve seen whilst working as a locum is… 

In the past six to 12 months, I’ve noticed that people are booking their locum shifts much further in advance. A couple of years ago, you might only have booked two or three months in advance. I’m hearing, now, of people booking a year in advance, which was unheard of.  

It’s mainly due to the locum booking apps. A lot of the companies have chosen to use apps, and people are booking very far ahead. If your days do get cancelled, it becomes a lot more difficult to rebook those days, because they’ve already been taken. That’s quite a big challenge. 

My favourite thing about being a locum is…  

I like the variety. I get bored staying in one place. As a locum, I see completely different patient demographics. The practices that I cover are from one end of the spectrum to the other, from the budget end, to the high-end. 

My advice for new locums is...  

Upskill: become an independent prescriber, and do the various specialties, because you're going to have to differentiate yourself to get that work. 

To broaden your horizons, and I would encourage anyone to do the charity trips. They are very rewarding. When we’re working, it can become monotonous, and then you go away, you’re refreshed; you do something good. You come back, and mentally you feel a lot better. You’re not caught up in that rat-race so much, all the time. 

To broaden your horizons, and I would encourage anyone to do the charity trips. They are very rewarding

My last word on locuming is... 

I think the market will change. I think a lot of it is to do with supply and demand. Now that a lot of companies are trying to introduce remote testing, it will be interesting to see how that takes off.  

Another thing is whether the locums who have got additional qualifications and skillsets will be paid and rewarded for them. Students are going to come out of some universities with additional qualifications as part of their degrees. Also, the big question is how artificial intelligence is going to affect our jobs. 

I also think there are going to be more optometrists taking on more of the ophthalmologist role. The population is getting older, and the number of ophthalmologists is not increasing. I think optometrists are going to have to take some of those roles, for example outpatient appointments, off the doctors, because they going to have to concentrate on surgery and the more complicated aspects of care.