“I wish I had locumed earlier”

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

For a large multiple practice in Berkshire. I was senior optometrist and was on the directorship programme, with the hope of being able to purchase the store, because the current partner was planning on retiring.

I sat the assessment to be able to purchase the store, and then I found out I was pregnant. I went through the process and did the business plan, but by the time I went on maternity leave and was making decisions about what to do afterwards, I realised that having a large practice whilst having a toddler was probably not the best option.

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

How much work is needed in remote locations. I wish I had locumed earlier, because I would have been able to go to different areas of the country. That is probably one of my regrets. Prior to having the little one, I think I would have really enjoyed going to all four corners of the country: going down to the coast, or the Isle of Wight – but I wasn't exposed to the demand of optometry outside of Berkshire.

The people who helped me as a locum were…

Firstly, Harvinder Sembi, who owns Specsavers in Bracknell. We met through the Berkshire Local Optical Committee, and he is the person who gave me my first locum gig.

I was really nervous about going back into the testing room and into that clinical but also retail environment. I was scared about not being able to achieve the same sort of KPIs that I had done before, because I had had such a big gap in testing. Harvinder gave me my first locum day, but also made me feel comfortable about the fact that he wasn’t expecting out of reach numbers or conversions. He really helped me get the ball rolling. He’s the first person that I am appreciative and thankful to.

The second is Mo Chaudhry, who owns Locumkit. He’s actually dual-qualified: he is a chartered accountant and an optometrist. He has been my lifeline throughout this entire process, since leaving residency. He has been able to speak to me about the business aspect: the finances, and how to operate as a locum.

Because he is an optometrist himself, he understands it from a high level. I’ve learned more about business, economics and the industry just through being able to mull over numbers with him than I had throughout my previous roles. If it wasn’t for Harvinder and Mo, I would not feel as confident about locuming as I do now.

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

I had had a little one, and there is obviously the flexibility aspect. But really, I didn’t return to residency because I felt I’d exhausted that progression route. I didn’t feel like there was anything else left for me to do, other than own a practice. I’d done all the previous roles from a retail perspective; I’d done the senior leadership and management roles as a senior optometrist. I’d supervised pre-regs; I’d done recruitment.

For me, going back wouldn’t have pushed me out of my comfort zone. It would have been very comfortable to go back, but in terms of pushing my career and my progression, I didn’t feel like I was being offered anything new.

Initially, locuming was more of a research project, to see what different practices were like, and how they operated. I’ve been lucky that, over the course of the two years, lots of different opportunities have been thrown at me, and I’ve been in a position to take them. I have also had the time to take them, which I wouldn’t have if I was in a full-time residency role.

“I do love seeing newly qualified locums – it’s lovely to see them take ownership of their careers, and have so much enthusiast enthusiasm”

On my first day of locuming...

I was terrified of the optical coherence tomography (OCT) machine. I was used to the Nidek, and this was an older OCT. I looked at and thought, ‘I’m really scared about having to use that.’

After a few patients, I got used to it. The scans are generally the same. But I remember looking at that first set of results for that first patient, and thinking, ‘I really don’t want to miss anything.’

My biggest locum challenge is…

Finding a level playing field with other clinicians – particularly with things like cycloplegic and dilation appointments, when another clinician has started that process and the patient has to come back for a follow-up.

As optometrists, we spend a lot of time doing continuing professional development (CPD) and higher certificates. A lot of those assessments involve being given either an incomplete record, or a record written by someone else. Often, you’re asked what is missing, what further tests you would do, and how you would manage that patient. The skills you need in order to complete that type of CPD are the same skills that you would need if you’re given a record from another optometrist and you’re asked to do a follow-up test.

As long as I have the previous record, I’ll never complain about it, because I think the skills are required. But I’ve noticed that there is a disparity in thought on that – there are some optometrists who don’t agree with doing those follow-up appointments for colleagues. My biggest challenge right now is trying to get to a point where we all feel comfortable, and are on the same level.

As a locum, I’ve adapted my days by…

Prepping a little bit the night before, depending on where I’m working. If I know that they have a piece of equipment that I have not used before, I’ll look up how to use that equipment or watch some videos that will help me with training. There’s more organisation required. But once you get used to doing it a few times, it’s pretty simple.

I do wake up much earlier as a locum than I did as a resident. It’s a case of planning my journey there, planning my parking, and that sort of thing – the logistics.

Practices can make life easier for locums by…

Emailing a pack out before the clinic day, including things like usernames, passwords, emergency contacts, referral routes, how internal referrals work, and the process if you have to follow up a patient.

They need to provide that pack, but most importantly, locums need to have it prior to the clinic day. Sometimes, practices have given it to me on the day. I don’t have the time during a busy clinic to flick through it and find the information I need. I would prefer it to be sent via email a week before, so I can pre-prep for the day. Anything you can do around the clinic day is helpful.

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

The amount of newly-qualified optometrists who I’m now bumping into. I do love seeing newly-qualified locums – it’s lovely to see them take ownership of their careers, and have so much enthusiasm about it. However, I think it’s quite risky to do it within the first year of qualifying. The ones who I end up working with, I try to be extra friendly, to let them know that we can work together and I can help support them with any questions they have. Personally, if I was doing that within my first year, alone in clinic, I would find that terrifying.

My favourite thing about being a locum is…

Because I now work in a hospital setting during the week, being able to offer my knowledge to lots of different people in lots of different locations, and then include them in my solution and management plan, which will differ depending on what location I’m in. That is now becoming the most enjoyable part of my day.

My advice for new locums is...

If you’re getting to a point in your career where you think that you’re not being pushed to try new things, locuming is a good option before making decisions about taking up other roles. Take that opportunity to do your research.

Also, get a good accountant. That is invaluable.