“I’ve been in and out of study since I qualified”

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

At an independent, Parish and Green Eyecare in Pencoed, just outside Bridgend. It was a small independent, just me and my supervisor.

I’ve never been a resident. Parish and Green, where I completed my pre-reg, had an unusual arrangement, where as soon as you were qualified, it was time to fly the nest. In most places, you’d stick around to be a resident for a while, and build up your experience. But my supervisor had done the same with all her pre-regs before, and said, ‘once you qualify, you’re good to go.’ As soon as I qualified, I was locuming.

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

What the market rate was. As a self-employed individual, obviously you’ll say what your rate is for a day’s work. I had no idea. When I started locuming, I was asking the practices how much they would normally pay. Of course, that meant they didn’t tell me how much they paid, in real life.

I found out about six months afterwards that I was being paid £100 less per day than other locums, because I didn’t know what the going rate was. I was very much under-charging for the services I was providing.

The second thing I wish I’d known would have been some logistical practicalities in regard to maintaining a separate business bank account, for example, for locuming. I used to be paid my personal account, which was lovely, but then I'd have a bit of a shock when it came to paying my tax each year.

The person who helped me as a locum was&hellip

My pre-reg supervisor. I felt that the experience I had as a pre-reg meant that I was prepared to make the jump to be a locum. I’d seen lots of pathology, and I felt as though my supervisor had helped turn me into a competent and strong optometrist, which meant that I was able to cope and make that jump without having that support network from day one. I felt ready to stand on my own two feet.

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

Flexibility. I knew, once I qualified, that I wanted to go back and do a postgraduate degree at Cardiff, which I did. Being a resident would not have been compatible with pursuing that.

From there on out, I found that being a locum let me pursue different things without having to worry about getting time off or permission. I’ve been able to spend time as an assessor for the College of Optometrists, teaching at Cardiff University, and being a hospital optometrist, none of which are full time roles. It was much easier to take those roles on whilst locuming, because I could fit my locum days around them.

I’ve been in and out of study since I qualified. At the moment, I’m doing a medical degree. I’m retraining as a doctor, and I wouldn’t be able to do that without being able to locum, to support myself. It’s been the thing I can depend on to allow me to explore different areas of interest and develop myself as a professional.

It’s been the thing I can depend on to allow me to explore different areas of interest and develop myself as a professional

My first day of locuming... 

Didn’t go well. There were four optometrists testing, including myself, and a lot of no-shows. They were doing the rolling clinic, which meant that, as the residents were a bit quicker than I was, I ended up seeing about six patients on my first day. There were so many no-shows that there was no one left for me to see.  

The director got quite upset with me afterwards. It was a bit of a shock to the system, because there was no understanding. It made me realise that maybe not everyone at work would be as understanding as I’d found in my pre-reg.

My biggest locum challenge is…

Finding practices that I feel, from an ethical and a care standpoint, align with my own values. There are lots of practices out there who need locums. However, there’s a reason why many are looking for locums, and it’s maybe because some aren’t run excellently, or don’t treat their optometrists well. You learn very quickly, as a locum, that these practices exist.  

Practices can make life easier for locums by…  

Reaching out to ask if there’s anything that, as locum, I need, or that I need to know. It could just be simple things like passwords for computers, or whether there is there a dispensing optician I can hand over to.

These are simple things, which mean that on the first day, you know what you’re doing. There’s nothing worse than turning up to a practice to find that you can’t log into any of the computers, and no member of staff knows what the passwords are.

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

The amount of clinical knowledge that you need has increased. In Wales, by virtue of the new contract, we all deliver some form of enhanced services, which means that we probably take on more complex patients than traditionally we might have done.

In the past, the complex patients might have stuck with the residents, and the more straightforward ones would’ve been seen by the locums. Now, we are very much integrated and involved in these care schemes. When I first started, 10 years ago, that wasn’t the case.

My favourite thing about being a locum is…

Working in different places and meeting different people. One of my drivers towards locuming was that I didn’t like the idea of being in the same room, in the same practice, for the rest of my life. I liked the idea of having a bit of variety. I feel as though it has kept me fresh, especially when I was taking on more of a portfolio role.

It has also allowed me to gain more experiences. You go to some practices, in some communities, and you see a lot more pathology. It helps you become more of a rounded person and more of a rounded practitioner.

It helps you become more of a rounded person and more of a rounded practitioner

My advice for new locums is...

To be organised in regard to your bookings, your expenses, and your invoicing.

Number two would be to talk with other locums from your area, to understand things like the rates and what is acceptable practice. There were things that happened early in my career, where I was asked to do things as a locum that I shouldn't have agreed to do because I wasn’t a resident, and it wasn’t fair on me. If I’d had another locum to talk to, they would have probably said, ‘No, don’t do that. That’s a daft idea.’

My last word on locuming is...

As lovely as locuming can be, there are some downsides, inevitably. Locuming can be quite lonely. For example, when I was a locum in practices where it was a single optometrist testing, ie myself, I could go months without seeing another optometrist. You don’t get a chance to discuss things with colleagues.

The other one is that locuming is precarious. There have been a few occasions where there have been health issues with myself or family, where I’ve ended up not working for a while. Obviously, by the nature of being self-employed, there’s no sick pay. But that’s the thing with locuming – you can’t have it both ways.

That’s the more realistic side of it. But if the downsides outweighed the upsides, no one would locum.