Locums

Swings and roundabouts

The work/lifestyle benefits of being a locum are obvious, but with daily rates remaining static and work becoming harder to find, the lure of a salaried position, albeit working for less, is beginning to entice even the most independent minded
back to the full-time fold, as Rory Brogan discovers

At the tail end of last year the plight of the locum optometrist was aired both in letters to optician and on the chat-room of Monoptica, with reports of plummeting weekend rates and incentives on the number of examinations carried out or sales made. There have been reports of locums struggling to get days and having to chase work as never before and of others deciding that now is a good time for security and the steady income of the fully employed.

In recent years, the number of optometrists qualifying has grown considerably, without a similar rise in the number of eye examinations.

With the resulting over-supply of practitioners, especially concentrated in locations around the optical universities - such as Glasgow, Northern Ireland and London - locum rates and full-time salaries have certainly dropped.

The drop in employed salaries has also had an impact on the locum market, as companies realise that it can be cheaper to employ a newly qualified optometrist on £25,000 a year than paying for locum cover on a day rate for two to three days a week.

One respondent on Monoptica late last year agreed that with the multitude of newly qualified each year, the situation was clearly down to supply and demand: 'Expect locums to be earning £180 per day in 10 years time. However, they will have to work harder, do more tests and be more accountable to dispensing/conversion rates, etc.'

While the situation may not deteriorate to that particular level, general manager at the agency Healthline, Jayne Marriner, who organises regular locum business, agrees that rates are currently as low as £180 a day, with a bonus on how much work is done. Obviously, there are also seasonal demands such as the quiet period around Christmas that picks up again early in the year. 'There are more OOs in the marketplace and more flexible, younger practitioners who are happy to take the lower rate with the bonus. They are more business minded.'

She agrees that the situation has changed from the period when optometrists dictated the market, and the multiples now have more choice. 'I can remember getting £500 for a short-notice clinic at the weekend and have not had anything like that in the past 18 months. Now companies are more aware of looking at the number of patients and figuring out whether it is viable to spend £350 on a short-notice locum and doing without if they can.'

There is certainly no shortage of locums, with areas like Norwich and the south coast well provided for. However, location allowances are required for the harder to fill placements such as Aberdeen and Grimsby, for example.

Marriner adds that Scotland has always had lower rates, currently at £200 for week days and £250 on a Saturday, while central London would be £225 and £275. 'Somewhere like Skegness would never get away with that,' she adds.

'If a locum is good they will be asked back, but if not, there is now plenty of choice. The quality has definitely gone up.'

As an employer of locums, Julian Taylor, a dispensing optician in Hamilton, Scotland, has noticed some major changes. His locum bill has shrunk and the quality has gone up, partly, he suggests, because of training, as well as the fear of litigation. 'They work a lot harder for their money and deliver high quality as they know I could get someone else.'

He suggests that practitioners now seem more interested in spending time with patients and looking at pathology, compared to the bad old days when one locum at Taylor's practice tested every half hour and half of his patients had to be re-checked.