December 3, 2021 | Student | Optometry | Pre-reg

Experienced Optometrist Jason Searle shares the pros and cons he has found for working as a locum or employed optometrist.

As a Newly Qualified Optometrist should you locum or be employed?

Many years after qualifying, I have held many roles as an optometrist; some employed and others as a self-employed locum. With locum-life appealing to many newly qualified optometrists, this article looks at the pros and cons of both sides and factors you MUST consider before making your next career move.


Locum vs employed – Flexibility

The ability to choose when and where you work is one of the main draws of locum work. Don’t want to work a Saturday because you want to see a football match, then you don’t have to book it. Have a family commitment on any given day? Keep that day free in your diary. However, this flexibility comes on both sides as if a practice wants to cancel a clinic (due to a new hire or a non-viable clinic) you may not get booked or cancelled. This may mean finding another place to locum – or even taking a financial hit of a day of not earning! Always keep this in mind!

Depending on contracts, you may also be required to pay a cancellation fee if you need to cancel a clinic at short notice (or may even be in receipt of a fee if you get cancelled). Make sure you read any locum contract before signing.

Working as employed generally contracts you to set hours and days, but you have the security of payment, even if your clinic is empty!


Locum vs employed optometrist salary

The income of a locum is generally higher than that of employed and again, this is another reason why people tend to get drawn to it. Keep in mind that the money receive will not have any deductibles (tax, National Insurance, pension, student loan repayments…). You will therefore have to budget for the payment of this each year, whilst taking the time to complete a self-assessment for HMRC. Although, you can pay an accountant to do this for you, but keep in mind their fees can amount to a day or two of locuming! You also do not get paid holiday or sick-pay – so any time off will hit your income.

Employment means you should be under Pay as You Earn, where your employer calculates and pays deductibles on your behalf, meaning your take home pay is for you to spend as you wish. Employed workers may also be able to receive bonuses and benefits, which if used effectively, can make your pay package competitive with locum roles overall (even if you do end up seeing less money enter your bank account each month!).


Employee Rights

As a locum (or any other self-employed worker), you do not have any employee rights. This means that you are not entitled to sick pay, holiday, maternity pay or any other rights that an employee may have. If you are ill or wish to take a holiday, you will not receive any income and can harm your cash flow. It is therefore advisable to take out relevant insurance to ensure you are financially covered should an accident put you out of work. It is also worth making sure you take out your own pension as you do not have an employer to contribute for you.

On the flip side, if you are employed, these are there to protect you!


Continuing Education and Training

As optometrists, we are all responsible for our own professional development and making sure we reach the correct number of appropriate CET points (or soon to be CPD) to meet the GOC requirements. Many employers offer training events and conferences for their employees and this offer may not extend to locums. Therefore, as a locum, you may need to make additional arrangements and pay for external training events.

The NHS also offer each ophthalmic performer a CET grant, but this can only be claimed via an NHS contractor. Some contractors may not be willing to claim for self-employed optometrists and if they do, they may claim a fee for doing so. Easy access to this grant and having access to regular training often makes an employed role more attractive.


Expectations – Employed vs self-employed

Many practices expect the most work out of their locums to justify the locum fee. This means that on some days you may have a full clinic, whereas the other resident optometrists in the practice may have a much quieter diary. Testing times may be reduced for locums and your first appointments in a new location may be hampered by having to provide an eye examination whilst figuring out the patient management system, the record cards as well as knowing how to operate the new sight chart and slit lamp.  If you are employed and have the same testing room, equipment, team and records each day, you can focus more on the patient in front of you verses wondering what cupboard the tropicamide is hidden away in! Therefore, locum work may be challenging for newly qualified optometrists who should be focusing their efforts on practising safely.



Locums are often a transient member of the team and often have little opportunity to socialise with other members of the practice team. This can lead to a lonely work existence. Working as an employed member of staff means you can strengthen your professional relationship that will make work a more sociable experience. As in any team-based workplace, some teams can be a joy to work with and others much less so. A benefit of being a locum means that if you struggle to fit into a team then you know that the time you will be working with them is temporary and you do not have to book work with them in the future.


Risks involved

Locum work draws the biggest risk when comparing working modalities. Transient encounters with patients that may require follow up or responding to patient queries following a contract with a practice it can be difficult to ensure that the patient gets the best follow up care. If this doesn’t occur, then complaints may follow. Being a resident optometrist in an employed role can mean you can ensure your patient has the correct follow up and can receive the best care. This may suit the more cautious of optometrists and those who are new to the profession.

On top of professional risk, being self-employed carries financial risk from many avenues – loss of income through non-booking/quiet times, worries from HMRC when ensuring you keep full records of your business encounters, trying to work out if you are open to IR35 and may be deemed employed or self-employed in the eyes of HMRC as well as missing out on sick-pay, holiday, and staff bonuses.


In conclusion, there are pros and cons to both sides of the employed vs self-employed argument, with many more that have not been covered in this post. For those who are newly qualified, I would suggest that an employed role is the best one to start with as an employer will take care of the extra duties that you must cover yourself if you become self-employed, leaving you the time and energy to focus on becoming the best optometrist you can be.

Prospect Health have a range of optometrist jobs and dispensing optician jobs. You can browse all of our opportunities over on our optometrist job pages where you can find roles with both independent and multiple employers.


December 3, 2021 | Student | Optometry | Pre-reg