“There’s no reason not to always be upskilling”

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

As a pre-reg, firstly at a Specsavers, and then at Vision Express. I felt I was well-placed to jump into locuming afterwards, because I knew I could work at both places. That was 80% of my work sorted, without needing to worry about other companies so much initially.

It was a bit awkward, transferring halfway through my pre-reg, but once I had qualified and started locuming, it was nice to have had that experience from the two companies. It made it easier.

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

The importance of continuing my optometry learning. Everyone spoke to me about further training, telling me I was young, that I was already in study mode, and that I should use that momentum do to all my training now to be set up for the next 20 years. But in my mind, I felt like I had done all my training, and that I needed a break.  

Now, I’m almost back-pedalling. I need to be in a place where I have more structure, but I’ve fallen behind slightly because I haven’t done certain things. I’m doing my minor eye conditions service (MECS) training, but I’ve fallen out of practice with studying. What I would have been able to fly through in a couple nights when I was in student mode, it’s now taking me a week to go over. Having that youth on your side when you first qualify, and being able to apply further training and set yourself up for the future, was something that I didn’t understand when I first started locuming. 

I realised this… 

Very recently. It has taken me seven years to reach this understanding. When you’re employed, I think a lot of the guidance you receive comes from your employer, or from more senior optometrists – the team around you. It is about drawing from other people’s experience. But when you’re solo, as a locum, you only have your own understanding, and your own input, in every decision that you make.  

I really appreciate agency, but it has taken me seven years to understand that, and it would have been there earlier if I’d kept up with the support I’d had and respected other people’s input at an earlier stage. 

The person who helped me as a locum was… 

My fellow locum optometrist, Amina Bi, who mentored me in domiciliary work. Her background was domiciliary, long before mine was. I’ve known her two years, so when I went into domiciliary, it was nice to have someone who was a locum domiciliary optometrist on hand. With locuming, you don’t get much support. With domiciliary being just an entirely new sector to me, I bowed to her experience. She was definitely more experienced than me. 

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

I’ve always really valued agency and independence. It was a reflection of my personality, at the time. I was younger, and I just wanted to live my life, work, clock out when I needed to, and go on holidays. I didn’t want to be answerable to anyone – I really valued my own decision making. I also wanted as much flexibility in my free time as possible. 

That’s an aspect of my life that has really slowed down. Now, I crave structure in both my work and in my social life. I think it’s an age thing. When you’re younger, you want that flexibility, because you want to do that impromptu trip to Paris over the weekend. You want to drop everything and go to Thailand for a couple weeks. Now, I can’t just go on holiday. I need to get ready; I need to make sure that the kids are ok, and that no one needs me for anything in the house.  

I’m about to take on a part-time residency, alongside regular locum days, which will be better for me. I can focus on my further training outside of that as well. 

On my first day of locuming... 

I had qualified a month before, without a driver’s licence. I took a month to learn to drive, passed my test, and then had my first locum day, which was in Southport.  

I was travelling from Blackburn. I was like, ‘I’ll be totally fine, I’ll just stick to local roads, I don’t need the motorway.’ I went on Google Maps, tapped a couple of the routes, and set off. Immediately, the car directed me onto the motorway, and I freaked out. I had to just go with it. It was really anxiety-inducing. I made it there in one piece, but I was definitely hogging the inside lane.  

Whenever something catches you off guard, it’s more stressful. I had to do the same on the way back, and that was fine, because I’d processed my trauma by then. 

My biggest locum challenge is… 

How competitive the market is right now, within the locum community.  

I entered the locum workforce at a time when people were already saying it was saturated in my area. But I had gone away for university, gone away for my pre-reg, and I felt very comfortable travelling, being out on the road, and living away. I managed to secure a few clients who paid reasonably well, and I was quite happy in my own little world, avoiding the main multiples, once I got set up. Places like Scrivens and Bayfields were always really good to me, as were the independents I worked for. I always found ways to make things work for me, despite how difficult the market was at the time.  

It’s even more saturated now. I was speaking to a recruitment agency a few days ago, a lady who I have been working with for seven years, and we realised that I hadn’t booked a day with her in two years. She told me that the north west, for locums, is so saturated, and the newer locums have been taking rates that are so low, that it is affecting rates on a national level. Once the rates drop here, we’re traveling further out, so everyone is affected. 

As a locum, I’ve adapted my days by… 

I set off early, to avoid the busy traffic. You get to enjoy more daylight, that way. As a locum, you don’t see much daylight, because of the way that testing rooms are set up in most practices. Mornings are really important to me. Even on my days off, I’m up quite early. 

Practices can make life easier for locums by… 

Understanding that not every locum is going to understand the protocols and procedures that you have in practice. In a practice that has multiple residents, you’ve already got differences within those residents, in terms of how they do things, and that’s with them still following the stores protocols and guidance. When you’ve got locums who are not affiliated with the company itself, and used to doing things their own way, it’s important to give them room for flexibility. Expecting them to understand how things work in the shop very quickly can be a bit unreasonable. 

Referrals are a big aspect – a sheet with information on pathways for referral, where to go for routine and urgent referrals and where to call in an emergency, and a locum handbook, would be nice.  

Also, introducing them to someone on the team who they can speak to if they need anything during the day. Sometimes you get optical assistants or clinic managers who are really knowledgeable about the testing room. It doesn’t need to be an optometrist. 

My favourite thing about being a locum is…  

Despite the fact that I respect and appreciate people’s input a bit more now that I’m older, I still ultimately value my own agency. That’s part of who I am. I do love taking care of everything, wrapping up, and then not having to think about it, and not having to come back to it. Being done with a task, and being able to go away and live my life.  

I do still appreciate the flexibility, too. I gravitate towards regular days and some sense of a structure, but I really like being able to prioritise my personal life. I can say, ‘That’s fine, I can take care of that. Let me clear my schedule, and I’ll do that.’ My priorities in life are personal. I'll always prioritise family life and helping people around me as much as possible. As a locum, I can do that quite easily. 

My priorities in life are personal. I'll always prioritise family life and helping people around me as much as possible

My advice for new locums is...  

Be mindful of your training and your skillset, and what the lifetime value of that is, and whether you ought to upskill and protect yourselves from changes in the sector that might happen 10 years from now.  

There’s no reason not to always be upskilling. There are always little things that you can be doing. That’s why there’s such an emphasis on CPD. Not only do you learn things via CPD, but there are always hints on where the sector is going. You can get ahead by paying attention, noticing where things are heading and paying attention to the additional skills that you could get. 

As a locum, you’re never switched off. Office hours are pretty much 24/7. It’s not a simple case of working nine to five, three days a week, making all the money that you need, and not needing to do any work outside of that. You might work three days a week, but you’re always looking out for the next email, for the notification that says there’s a shift in your area; you’re getting phone calls the night before, sometimes very late, from a desperate store director.  

When I started my domiciliary locum work, I got a second phone. I’m now trying to use my business line, trying to separate things to make locuming feel like a healthier career choice.  

Also, remember that you are a locum. With you not being employed, your hours, your testing time, your rate of pay – that’s all to be negotiated, not simply accepted. 

My last word on locuming is... 

I think people need to ask themselves why they want to be a locum. I don’t think people really consider why it might be useful to them. People have an obsession with being self-employed, but in reality, you do lose a lot of benefits.  

Also, unless you’re going to be doing something with the other free time that you have, why do you need to locum? Some people locum seven days a week. I knew someone who had worked for nearly a month straight, and he wasn’t working at especially good rates. If he had been more selective about his shifts, he could’ve probably done that in four or five days, for the same amount of money. Why would you do that to yourself? Burnout is very real.