Locum Optometrist Guide 2022

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THE LOCUM BRIEFING Your essential guide to thriving as a locum optometrist today

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S W E N P AO m u Loc ook b g lo

Seven habits for safe practice

Navigating the cost of living

How to reduce your risk of professional conduct pitfalls

Budgeting basics and negotiation tips

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e all have items we pick up without a second thought when leaving the house – wallet, phone, keys.

For locum optometrists, the contents of a kit bag is honed over time, with trial and error establishing the perfect professional toolkit to face the challenges of each day.

Each briefcase, rucksack or handbag are the only four walls that remain the same as a locum moves between locations, practices and specialties.

In the same way that locums distil their work life possessions, this guide presents a streamlined

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summary of key areas of practice.

OT, in partnership with the AOP and Johnson & Johnson Vision (JJV), explores portfolio careers, habits for safe clinical practice and the effect of the rising cost of living on the locum workforce.

Optical coherence tomography experts share their guidance on how locums can use the latest imaging technology to its full potential, and JJV’s Sheetal Patel highlights how contact lenses provide tailored support at each life stage.

Welcome to the Locum Optometrist Guide – the newest addition to earn its place in your kit bag.

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All about OCT Experts share their tips for using the latest imaging technology

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The portfolio optometrist

Published by

Selina Powell

Think

OT editorial team

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From a researcher to a local optical committee chair, meet the locum optometrists embracing variety within their career

Illustrations throughout courtesy of Shutterstock

OT features editor

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Myopia matters A whistle-stop tour of the increasingly important field of myopia management

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THE LOCUM PANEL

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Seven habits for safe clinical practice The AOP’s Henry Leonard shares his guidance on actions locums can take to avoid professional conduct pitfalls

Bhargavi Zinzuwadia Leicester

James Brawn Swansea

Hassnain Safdar Leicester

Pete Sharma Maidenhead and Windsor

Rebecca Rushton

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Managing your money Tax tips, budgeting guidance and how to navigate the rising cost of living

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Southampton

Dr Stephanie Kearney Glasgow

Sam Phillips Durham

Shamina Asif Walsall

Sarah Bentley

A contact lens for each life stage Exploring how contact lenses can support patients of all ages

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Decoding domiciliary How locum optometrists can benefit from providing eye care in patients’ homes

Blackpool

Sheetal Patel, Johnson & Johnson Vision

“We appreciate that locums are a very important part of the eye care sector“

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OCT

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Experts share their tips on how locums can harness optical coherence tomography to provide excellent patient care

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“Always use the OCT results as guidance – never refer just based on OCT findings”

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ny eye care professional who has seen the look of wonder on a patient’s face when they are shown the depths of their retina for the first time understands the impact of optical coherence tomography (OCT).

The technology provides optometrists and other eye care providers with more information about their patients’ eyes than ever before.

But how can locum optometrists sift through this data to make the most appropriate decisions about patient care?

OT speaks with OCT experts about how optometrists can refine their use of the technology.

Always adapting OCT product manager for Haag-Streit UK, Jacqui Kenyon, highlighted that one of the most challenging aspects of OCT for locums is that they may be switching between different devices depending on the individual practice that they are in.

She emphasised the importance of practice staff providing guidance to locums on the equipment that is available.

“All OCT devices offer different software packages, so the locum needs support from

Laura Pigula the practice to ensure they are achieving good quality scans,” she said.

Topcon Healthcare clinical affairs specialist, Laura Pigula, also emphasised the importance of locums being able to capture high-quality scans when using OCT devices.

Confidence in patient positioning and instruction, as well as understanding the benefits of each type of scan for different patients, is key.

“Use a methodical approach to interpreting the scans,” she recommended.

Pigula highlighted the benefits of becoming familiar with the retinal layers and where specific pathologies are located within the retina.

Locum optometrists should consider OCT scans in the broader context of other clinical findings, such as patient history, visual acuity and visual fields.

“Always use the OCT results as guidance – never refer just based on OCT findings,” Pigula advised.

Prioritising learning Both Kenyon and Pigula recommend that locum optometrists keep their OCT knowledge up-to-date by making use of the diverse range of education platforms on offer.

Different OCT manufacturers provide practices that purchase their equipment with online platforms where optometrists can assess and improve their

and use it to its full potential,” Pigula highlighted.

skills – such as the Optovue Academy and Topcon Healthcare University.

Optometrists can gain insight on the latest developments and hands-on experience with OCT devices at optical conferences, such as 100% Optical, while the Ophthalmic Imaging Association also holds an annual conference for practitioners.

“Continuous learning in both advances in imaging techniques and new ways to diagnose different pathologies is of benefit to ensure you make the most out of your machine

The benefits of OCT For Pete Sharma, a locum based in Maidenhead and Windsor, OCT machines offer an extra tool for diagnosis and management. “It helps us to monitor pathology and enables me to provide better referrals going forward,” he said.

CULTIVATING CONFIDENCE The AOP's Henry Leonard highlights the importance of locums receiving training in performing OCT scans The General Optical Council standards for individuals require practitioners to recognise, and work within, their limits of competence, taking into account their knowledge, skills and experience. Many optometrists have received little or no training in OCT and require further training before they are competent to use these machines and correctly interpret the scans they produce.

If a practice has asked you to interpret OCT scans, and you do not feel competent to do so, you should make this clear in advance.

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LOCUM LIFE: WORDS OF WISDOM

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Locum optometrists share a piece of advice that has served them well

“The best advice I have been given is to treat every patient as if they were my relative” Sam Phillips

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“Establish a good working relationship with the resident optometrists in the practice you are locuming in. As a locum independent prescribing optometrist, I don’t often get to see patients returning for follow-ups and patients would rather not be referred to the hospital when they can be managed ‘in house.’ Thankfully I have a great working relationship with the resident optometrist in the practice I locum most often in and they are happy to work with me when it comes to co-managing these patients” Dr Stephanie Kearney

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“The work will always be there. Join the locum groups, apps and agencies.

Be flexible” Pete Sharma “Don’t be afraid to say no. It is very easy to be agreeable, to work at a rate you aren’t happy with, and in working conditions you find uncomfortable. As a locum, you have no obligation to work for any practice, so don’t feel obliged to do so. It is your choice what work you do” James Brawn

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“I really believe that OCT empowers patients and increases loyalty” Rebecca Rushton

Locum optometrist, Rebecca Rushton, noted that OCT devices help clinicians to pick up pathology that might otherwise be missed. “Just today I found an epiretinal membrane and vitreomacular

traction, both of which were asymptomatic. It can be useful for confirming visual field defects or queries about optic nerve heads too,” she added.

OCT images are useful when explaining ocular health to patients and help to reinforce the idea that they have had a thorough eye examination.

“I really believe that OCT empowers patients and increases loyalty to the practice,” she said. When Rushton first started using OCT, she had a phone call with the supplier to learn about the technology. “They explained some features which I’d never have found on my own. A lot of optometrists seem nervous about using OCT but most of what you see is common sense.”

Pigula highlighted that taking OCT scans is a non-invasive and quick procedure that has the potential to provide a better understanding of potential pathology than fundus photography or Volk.

“It can assist with a referral as evidence and guidance, but it can also prevent a referral due to being able to clarify a non-urgent reason why a patient’s vision has deteriorated,” she explained. ●

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THE PORTFOLIO OPTOMETRIST OT talks with locum optometrists who have diversified their careers by working in a range of settings

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any optometrists enjoy the variety that a career as a

locum brings.

Rather than spending each day working within the same four walls, locum optometrists adapt to different consulting rooms and equipment as well as forming connections with a diverse range of patients and

optical staff. A 2018 survey by the AOP of more than 2000 optometrists revealed that more than one in four respondents (27%) worked as locums.

When asked why they chose this mode of practice, 88% highlighted the flexibility that locum working brings.

As well as having the freedom to choose when and where they work, locum

optometrists are able to take on multiple roles in different settings. OT spoke with locum optometrists about what they find rewarding about a diverse range of roles – from cataract consultations to research and optical leadership.

An extended role The 2021 General Optical Council registrant survey found that optometrists

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“COVID-19 has brought our strengths as an LOC to the forefront” Sarah Bentley She is involved in undergraduate and postgraduate teaching as well as research. Kearney also works as a locum in practice to keep her independent prescribing skills current.

She became involved in research when she spotted a PhD position being advertised after she finished her pre-

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registration year. “It was on the topic of myopia, which I already had an interest in, so I applied. At the time I didn’t really understand the value of a PhD, but I am glad I did it as I am now able to undertake research and work as a lecturer,” she said.

Kearney highlighted that she enjoyed the mental stimulation of having no two days the same.

“I engage with lots of different people every day including patients, industry, students and fellow colleagues. It keeps the job fresh and exciting with lots of different perspectives to consider,” she observed.

The ABC of LOCs Locum optometrist, Sarah Bentley, has been a member of the Lancashire & Morecambe Bay Local Optometric Committee (LOC) for more than 20 years.

Over that time, the committee has grown in

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AOP Optometrists' Futures survey, 2018

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working in hospital and university settings had some of the highest levels of job satisfaction within the optical workforce.

On average, 57% of optometrists reported being satisfied with their role.

However, within universities this figure rose to 63% while in a hospital setting job satisfaction rose to 66%.

Locum optometrist, Hassnain Safdar, works part-time providing cataract consultations as a specialist optometrist for CHEC Leicester, which provides community-based ophthalmology services.

Safdar’s role involves reviewing biometry data, assessing patients for other potential causes of reduced visual acuity before discussing the risks and benefits of cataract surgery. Safdar then lists patients who have provided consent for the procedure for surgery.

“What I find most rewarding about the role is the ability to help in the decision-making process for what can be a life-changing operation,” he shared. As part of Safdar’s role, he performs YAG laser on patients who develop opacification following

cataract surgery. “Being able to restore a patient’s vision once again with YAG laser and enable them to carry on doing the things they love is highly satisfying,” he highlighted.

Safdar noted that his extended role has benefited other parts of his practice as a locum – giving him added confidence when discussing cataract surgery with patients.

The variety of roles that Safdar has undertaken helps him to continue learning and broaden his scope of practice.

“We are in challenging times with waiting lists longer than ever before, so to be able to add breadth to my clinical skills has been an incredible opportunity to help my personal growth and the local population I serve.”

Locum optometrist and AOP Councillor, Dr Stephanie Kearney, is part of the myopia management team at Glasgow Caledonian University.

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groups, while also connecting with optometrists from other practices.

“I find it rewarding to engage with my colleagues in the area and help them out with any issues,” Asif shared.

She highlighted that working as a locum and an LOC chair is a “two-way street.”

“I can see what problems are encountered in practice and bring this to LOC meetings to find a solution.

On the other hand, as an LOC chair, engaging with ophthalmologists enables me to become better with referrals and the management of patients, record keeping, and understanding GOS claims better,” she shared. membership while the geographical area it covers has also expanded. There are now four locality leads – with Bentley responsible for liaising with optical practices in Blackpool, Fylde and Wyre.

“It is rewarding because I can now put back in what the LOC has given me,” she said.

Bentley values the role as a way of keeping informed of the latest developments within the profession and across her local area. “When you are employed a lot of information is trickled down through the practices, but as a locum, you can miss out on that,” she shared.

“Being on the LOC keeps my knowledge up-to-date and I

can pass it on to other locums,” Bentley added.

She shared her view that there is more engagement now with LOCs than there has ever been. “COVID-19 has brought our strengths as an LOC to the forefront. The people on the committee are very proactive and that has helped massively,” Bentley said. She highlighted that it can be daunting to approach an LOC, but there are a wide variety of roles within committees for people with different skill sets.

“You realise that anyone can do it – it is not too onerous a task,” she noted.

Working as a locum in areas of socioeconomic

“I have always had an interest in the larger issues affecting our profession” James Brawn

deprivation has fuelled Bentley’s passion for her LOC work. She wants to ensure that new pathways are implemented consistently across the UK. “The LOC is trying to make eye care accessible for everyone,” Bentley highlighted.

During her pre-registration training, locum optometrist, Shamina Asif, was encouraged to attend Dudley LOC meetings by her supervisor. Following qualification, she continued to attend meetings and was elected on to the committee before becoming chair at the age of 27.

“I would say it was the quest for knowledge that motivated me to become involved with the LOC,” she explained to OT. She enjoys conveying the strengths of optometry to people outside the profession, such as GPs and clinical commissioning

Representing the profession Locum optometrist, James Brawn, represents Wales on the AOP Council.

“I have always had an interest in the larger issues affecting our profession,” Brawn shared with OT. “With issues such as COVID-19, the optometry apprenticeship and the Education Strategic Review affecting our profession, I felt that now more than ever, it was really important to have strong voices on the AOP Council.”

Brawn highlighted the rewarding nature of acting as a conduit between the AOP Council and optometrists in Wales.

“I can transfer information and opinions between these groups, which can help influence AOP policy, support, and desired topics for CPD,” he concluded. ●

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Why optometrists are turning their attention to myopia management

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ver the past five decades, just as technology and teaching methods have changed, the vision of school pupils has also shifted.

If you entered a UK classroom in the 1960s, there would be half as many children with myopia as there are today.

This was one of the most striking findings of the Northern Ireland Childhood Errors of Refraction study – the largest research project to date examining how children’s vision changes through childhood and adolescence in the UK and Ireland.

Professor Nathan Congdon, of Queen’s University Belfast, highlighted that the prevalence of myopia is growing rapidly and

is predicted to affect half of the world’s population by 2050.

People with high levels of myopia have a greater risk over their lifetime of experiencing retinal detachment, myopic degeneration, glaucoma and certain types of cataract.

“Ocular risks primarily have to do with having an eye that is too long for the refractive power

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LOCUM LIFE: WHY I CHOSE TO LOCUM “I decided to become a locum for the freedom to work when and where I want. I get to choose the scope of practice and work with practices that align with me” Sam Phillips “I was attracted by the flexibility to be my own boss and choose my own shifts and locations.

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of the lens and cornea,” Congdon explained. He shared that there is evidence suggesting that individuals who spend less time outdoors and a greater amount of time on near work are more likely to develop myopia.

This is particularly the case when excessive near work begins early in life – such as in the pre-school or primary years, Congdon added.

He encouraged locum optometrists to be aware of the latest evidence on management options that are proven to prevent or slow the progression of myopia.

“This will allow you to give the most reliable and effective advice,” Congdon emphasised.

I always like to learn and adapt – working with different teams and companies opened this up for me. Locum work also builds up many links for future roles” Pete Sharma “I started to pick up some ad hoc days whilst working on a PhD full time to keep my clinical skills up to scratch. Once finishing my studies, I enjoyed the flexibility as it meant that it was easier for me to take on part time roles” James Brawn

Current options include recommending increased outdoor time and using contact lenses or spectacles that avoid the defocus of light in the retinal periphery.

Researchers are also exploring the effectiveness of low-dose atropine eye drops, although this management option is not currently approved for use in the UK. Locum optometrist, Dr Stephanie Kearney, is part of the myopia management team at Glasgow Caledonian University.

She highlighted that what scientists know about myopia has “changed considerably” over the past decade.

“We have really only scratched the surface when it comes to myopia management,” Kearney shared.

“Working in the field of myopia management involves continually keeping myself up to date with current research, critically appraising the evidence and interpreting how the information can be used to inform our current practice in the UK,” she said. ●

Myopia CPD Glasgow Caledonian University is offering an online continuing professional development module on myopia management starting in September 2022. For more information, contact myopia@gcu.ac.uk

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SEVEN HABITS FOR SAFE CLINICAL PRACTICE

AOP head of clinical and regulatory, Henry Leonard, shares his thoughts on practical steps locums can take to avoid professional conduct pitfalls

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morning coffee at a favourite café, a podcast at lunch or an evening walk with the dog – habits can be a way of adding balance to daily life.

As a locum optometrist, developing a professional routine can help to minimise the risk of a professional conduct investigation.

From keeping thorough records to checking local referral pathways, the AOP’s Henry Leonard shares his practical tips for locums to ensure safe clinical practice.

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Get familiar If you haven’t worked in the practice before, make sure you have some time before your clinic starts to familiarise yourself with the practice and introduce yourself to the members of staff you’ll be working with.

Well-trained support staff can be invaluable in helping your clinic run smoothly, so ask them about the patient journey in the practice.

For example, will patients receive pre-screening before they see you?

Which members of staff can perform delegated tasks such as visual fields and contact lens

teaches? In the consulting room, check that you know how to operate key pieces of equipment, such as the slit-lamp and the letter chart.

If the practice uses computerised record keeping systems, make sure you can login successfully and familiarise yourself with the system.

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Keep a task list It’s not always possible to complete your management of the patient whilst they are with you in the consulting room, so it’s

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The AOP’s legal and regulatory team regularly assists locum practitioners subject to an investigation.

Allegations around missed pathology are common where practitioners have overlooked the results of supplementary tests, such as tonometry readings, retinal imaging and visual field plots. You are ultimately responsible for the care of each patient you see, so if you are requesting a further test, such as repeat visual fields, you should follow this up yourself; do not rely on support staff remembering to show the results to you.

Keeping a list of outstanding tasks makes it less likely you will overlook something.

In some cases, locums may have arranged a follow-up test, such as dilation, on another day, but without making it clear that the responsibility for managing the patient has been transferred to another

important to keep a list of any outstanding tasks. This may include writing referral letters, ordering contact lenses, or checking the results of follow-up tests, such as repeat visual fields, which have been delegated to other members of staff.

Some practice management software includes tools to keep track of these reminders, but you may prefer to ask for a printout or photocopy of the clinic diary and annotate this

practitioner. The locum assumes that the second practitioner will manage the patient, but the second practitioner thinks they are simply gathering data to help the first practitioner decide how best to manage the patient. The AOP has published guidance on internal referrals which includes a template for making internal referrals that makes it clear that you are transferring responsibility for managing the patient to another practitioner.

Another common source of complaints relates to patients who have been referred inappropriately, either because an incorrect pathway was used, or because the referral urgency was inappropriate. Locums should try to familiarise themselves with local referral pathways, especially if they are working in an area that they are less familiar with.

as you go along. It’s important to avoid taking any patientidentifiable data out of the practice, so if you’re using your own system to keep track of outstanding tasks for the day, you should dispose of this in the confidential waste stream before you leave.

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Make internal referrals Sometimes a patient will need to return on a different day for a follow-up test such as

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repeat fields, or dilation. If you’re not sure you’ll be able to see the patient yourself for the followup, you should make an internal referral, to ensure responsibility for managing the patient has been transferred to another practitioner.

The AOP has published guidance on internal referrals which includes a template, and you can keep a log of internal referrals using the online AOP locum logbook (see the ‘AOP resources for locums’ section below).

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Check local referral pathways If you’re not familiar with the area, it’s a good idea to find out about referral pathways in advance. Many practices have a ‘locum folder’ which contains important information for locums who are new to the practice, and this may include information about local referral pathways.

Many areas also have optical committees which publish this kind of information on their website.

“Don’t be afraid to ask for help if you need it” Henry Leonard commissioned services which may require you to be accredited for.

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Keep good records If you’re not familiar with the practice record keeping system, it’s a good idea to review the records you’ve made at the end of the clinic, to check you’ve recorded the right information in the right places, and to ensure you’ve completed any outstanding tasks for each patient.

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Build a good rapport Practice owners are more likely to invite you back if you’ve made a good impression with their staff. Don’t be afraid to ask for help if you need it, and take time to thank members of the team who’ve gone out of their way to help. ●

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Ask what services you’ll be expected to offer Some practices may just want you to provide private and GOS sight testing, whilst others may expect you to fit contact lenses, dispense spectacles or supervise trainees. Ask whether the practice have contracts for any locally

AOP resources for locums  Internal referral template: www.aop.org.uk/internalreferrals  AOP locum logbook: www.aop.org.uk/locumlogbook  Managing risk in practice: www.aop.org.uk/managingrisk

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THE RISING COST OF LIVING Locums share their top tips for helping to balance the books – from negotiating a fair rate of pay to budgeting basics

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ising fuel and energy costs, a growing supermarket bill and predictions that inflation will approach a 40-year high of 9%.

Cost of living pressures are causing workers across all sectors to reassess how they prioritise their spending.

For locum optometrists, the price pinch comes following a tumultuous time in the workforce prompted by the COVID-19 pandemic.

The introduction of social distancing restrictions resulted in many locums watching their bookings dry up overnight. However, demand has bounced back during the recovery phase of the pandemic.

“It’s important wherever you decide to work to mention your skills” Hassnain Safdar

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“Being a locum is everchanging from a business perspective,” locum optometrist, Sam Phillips, shared with OT. “In just two short years I have had sudden declines in work, then overwhelming demand, and in my area rates that have skyrocketed due to short supply,” he added.

Phillips noted that rising fuel costs have made it less attractive to provide a geographically broad locum service.

Locum optometrist, Hassnain Safdar, shared that he always tries to stick to a one-hour limit on his commute time in order

to preserve a healthy work-life balance. “The rising cost of fuel is something I’ve had to accept as part of my work as a locum,” he said.

Safdar tends to avoid busy city routes to work, which bring his fuel economy down.

“The fuel shortage makes me slightly apprehensive, but I’ve factored in public transport if I can’t find any fuel,” he said.

As a locum optometrist who does not drive, Rebecca Rushton is expecting the cost of public transport to increase.

“It is frustrating. This will further encourage me to stay local and I think employers may have to consider paying travel fees for locums from out of town,” she shared.

Asked whether they had observed the effect of cost pressures on purchasing behaviour in practice, locum optometrists told OT that it was hard to judge if there had been a direct effect.

“I haven’t noticed customers behaving any differently,

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SELF-EMPLOYED STRUGGLES National chair of the Federation of Small Businesses, Martin McTague, shares insight on the hurdles facing the self-employed workforce Self-employed people are facing huge challenges at the moment, not least the recent hike in National Insurance, which our research found would prompt over two in five self-employed people to raise their prices, worsening the inflationary spiral which has already wrought havoc on bottom lines and cash cushions. Fuel prices and energy bills continue to rise, hitting

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many self-employed people especially hard, while disappointing GDP figures from February underline the scale of the challenge facing the economy as a whole. Around one in 10 formerly self-employed people have left self-employment since the onset of the pandemic. Some have moved into salaried roles, but – as the latest employment figures show – many will have joined the half a million workingage people who are now counted as economically inactive. As a country, we need to find ways for as many as possible of this group to re-enter work, perhaps in more flexible roles, to utilise their skills in order to generate growth and fuel the UK’s economic recovery.

though I’ve had several conversations about the increased cost of living, so it’s definitely on people's minds,” Rushton shared.

Phillips noted that some patients may cut back on services or products that they perceive as a “luxury.”

“I’d like to think that effective recommendations would mean the customer sees the value in the quality eyewear and eye care that we provide,” he said.

Budgeting tips Sharing her budgeting tips, Rushton encouraged locums to have between three and six months of living expenses in the bank to provide a buffer.

“That way it’s no biggie if you’re off sick for a couple of weeks or if someone doesn’t pay an invoice on time,” she said.

She recommended putting a third to a quarter of each payment to one side for tax purposes.

Phillips recommended comparing different options for fuel and parking – especially if working in cities.

“Consider cycling or public transport if convenient and readily available,” he said.

Locums could consider favouring block bookings if working in locations further afield, Phillips shared.

For Safdar, planning his route in advance is key.

“Check if there’s traffic on your route or whether you can take another route to avoid being

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FIVE TAX TIPS David Davies, of TWD Accountants, an AOP member benefits affinity partner, shares his thoughts on the steps locums can take to protect their finances

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Have a separate bank account. All income and expenditure related to your self-employed work should go in and out of that account. You should not be using your personal bank account

should also have a separate credit card that you 2 You use only for your business purchases supporting records, either electronically or in hard 3 Keep copy, to support all the figures you use in your tax returns for a minimum of six years you are paid in cash, put it in your 4 Ifbusiness bank account. You should not retain the cash and spend it because then your bank account will not reflect your transactions correctly. This way you have a full electronic trail of your income and expenditure

an accountant. An accountant can 5 Use save you money and protect you from tax-related risks.

stuck in a jam. Waze is a good app, which helps to plan your journey in advance and gives you approximate traffic data based on historic reports,” he said.

He also recommended checking whether there is free street parking within walking distance of a practice.

“It may mean you have to walk a little more, but those extra steps don’t harm you,” Safdar said.

Locum optometrist, James Brawn, recommended maintaining a separate account for self-employment. “It makes life a lot easier when it comes

to paying your tax, National Insurance and professional fees,” he shared.

Brawn noted that having an accountant helps locums to budget for their selfassessment payments.

“They can also advise you on which of your expenses are tax deductible,” Brawn added.

Lastly, Brawn recommended regularly re-evaluating locum rates. “Due to the effects of inflation, if you charge the same today as you did five years ago, you are now effectively charging less than you did in 2017, yet are more experienced and may also have undertaken

“Early in my career, I discovered to my horror that I was charging £100 less than the other locums” James Brawn

equipment may help you develop clinically which in its own way is valuable,” he shared with OT. Negotiating Safdar encouraged locums a fair rate to highlight the ways that they Turning to negotiating rates can bring value to a practice for locum work, Brawn when negotiating a highlighted the rate. importance of AOP “It’s important knowing what the support wherever you rate is for locum Find out about decide to work work in a certain AOP member to mention your area. benefits, including skills and qualities “Early in financial services: www.aop.org.uk and what you can my career, I /benefits add to the practice discovered to that will benefit them,” my horror that I he said. was charging £100 less Locum optometrist, Pete than the other locums in a Sharma, emphasised that store, quite simply as I didn’t the rate has to reflect his level know what other locums were of experience. charging,” he said.

“I tell the store what else I Brawn is open about what can offer, whether it is myopia he charges and his desired control, OCT training or my working conditions (such as current training in independent testing times and lunch break prescribing,” he shared. ● duration) when discussing potential work.

“I find that stating these upfront allows negotiations to run more smoothly,” he said.

IR35 in a Phillips noted that keeping nutshell an eye on locum apps and Locums need to be recruitment services can aware of changes to provide an indication of IR35 rules that were available rates in certain areas. introduced in 2021.

“You can use this information These changes may to negotiate better rates with your new and existing have tax implications for practices,” he said. locums. Use the Check He noted that the offered Employment Status for rate is only one of a range of Tax tool on the HMRC considerations when deciding website: whether to work at a practice. www.aop.org.uk/ot/IR35 “If there is a practice that For more information on you really want to work IR35 changes, contact with you may decide to David Davies of TWD make concessions from a Accountants on 07775 financial point of view as you may benefit in other ways.

920 927.

For example, working in a practice with new or different additional qualifications,” he emphasised.

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FOR EACH LIFE STAGE

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From children discovering a love of sport to teenagers studying for exams, OT discovers tailored contact lens solutions that can support patients through every life milestone

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mewling infant, a child creeping like a snail to school, a soldier full of strange oaths.

When Shakespeare described The Seven Ages of Man in 1623, contact lenses were only a dream in the mind of Leonardo da Vinci – who a century before had imagined a person wearing a water-filled glass hemisphere over the eye.

Fast-forward to 2022, and contact lenses are giving people the freedom to enjoy each life stage – without submerging their head in a goldfish bowl.

Children are able to take part in sports without worrying about broken spectacles, office workers can comfortably wear contact lenses thanks to advances in material technology, and multifocal contact lenses offer presbyopes another option for refractive correction.

“With the wide range of contact lenses now available across different materials, modalities and optical designs, contact lenses are capable of supporting multiple patient lifestyles,” professional education and development manager for Johnson & Johnson Vision, Sheetal Patel, shared with OT.

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Patel outlines how contact lenses can serve as a constant companion through each life milestone.

Children In childhood, Patel noted that practitioners often only consider the benefits of contact lenses for children who participate in sports or who may refuse to wear glasses because of self-consciousness.

This narrow focus may limit how many children can benefit from contact lenses.

“It can be easy to overlook the positive emotional impact that contact lens wear can have on self-perception

and confidence, even for a child who is typically happy to wear their glasses,” she said.

Giving children freedom from glasses – whether fulltime, on special occasions, when socialising or playing sport – can be “incredibly empowering,” Patel highlighted to OT. Daily contact lenses tend to be the best option for children as it removes the need to clean lenses and therefore keeps the risk to a minimum.

Locum, 9

“Contact lenses are capable of supporting multiple patient lifestyles” Sheetal Patel contact lenses can serve a valuable purpose. “Even with existing contact lens wearers it is important to regularly follow up with patients and ensure that the contact lenses they are wearing continue to meet their needs,” Patel emphasised.

As patients’ lives change over time, with different jobs and hobbies, practitioners have a role to play in keeping then informed about the latest contact lens innovations.

“They also allow for the flexible wearing pattern that many children want,” Patel shared with OT, adding that there has been an increase in digital device use among children.

“It is important to consider contact lens materials that will retain moisture consistently throughout the contact lens wear time and therefore maximise comfort.”

Young adults As patients move from childhood to adulthood, their lifestyles change, which results in evolving requirements for contact lenses. Patel noted that practitioners should consider

the potential contact lens risks among young adults who wear contact lenses – such as university students accidentally napping or sleeping in their contact lenses.

“We must ensure we discuss the risks of this behaviour during history and symptoms and prescribe an appropriate material where necessary,” she said. As young adults enter the world of work, practitioners should consider how to best support changing lifestyle factors, including increased digital device use.

Other life events – such as getting married, travel and outdoor adventures – may present opportunities where

Presbyopes Patel highlighted that as patients become presbyopic, eye care practitioners can offer multifocal correction options.

“Providing this correction

option, rather than monovision, allows us to provide patients with the best possible vision, with binocularity maintained and intermediate visual needs met,” she said.

Taking a holistic view of ocular changes within this age group is important, Patel added. Reduced tear break up time and an increased prevalence of meibomian gland dysfunction means that the contact lens material needs to provide the required moisture during contact lens wear.

“Additionally, it is important to ensure that vision is optimised, and a contact lens takes into account the changes that occur in pupil size not just due to age but also due to the refractive error,” Patel shared.

Eye care professionals have a role in not only offering multifocal contact lens options to existing contact lens wearers, but providing this choice to emmetropes who have become presbyopic and wish to remain spectacle-free into the future. ●

Contact lens resources for locums The Johnson & Johnson Vision (JJV) website has a significant amount of information to support contact lens knowledge and practice. As well as online CPD available on the website, information about all Acuvue products and access to fitting calculators for the multifocal and toric contact lens products is available (www.jnjvisioncare.co.uk).

In 2022, JJV will continue to deliver a number of educational events tailored for locums in partnership with the AOP as well as deliver a targeted communication plan for locums to allow them to stay up to date with the latest contact lens information and education (www.aop.org.uk/events).

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DECODING DOMICILIARY OT explores what is involved in working as a domiciliary optometrist – and hears about the rewards of providing eye care at home

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ach year, around 3.5% of all NHSfunded sight tests are performed where the patient lives.

Although traditionally the unsung heroes of optics – with many unaware that domiciliary optometry exists – an ageing population has heightened the demand for domiciliary services and increased awareness of the important role domiciliary optometrists play.

Locum domiciliary optometrist, Amandeep Nandra, began her career with Specsavers as an optical assistant before

qualifying as an optometrist in 2016. Nandra started working within domiciliary care as a way of seeking more variety within her career.

“It feels great helping people who are unable to attend appointments on the High Street,” she explained.

“Having new glasses or receiving a referral for cataract surgery can have a huge impact on their lives. It gives them

CLIENT

LOCUM LIFE: SHARING PRACTICAL TIPS “This may seem a bit old fashioned, but I carry a diary with me. I record all of my expenses, where I have worked and at what rate, and important information like computer passwords and referral numbers for local hospitals. Another practical tip I have is to carry around internal referral forms,

information leaflets, a few fluorets, and a few minims of Tropicamide/Phenylephrine in my briefcase. It can be really frustrating as a locum to not have these things to hand, so carrying a few in your bag is really useful” James Brawn “Keep on top of your accounts weekly or monthly. Don’t leave it as a mammoth task to do at the end of the year” Rebecca Rushton

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the confidence to do things they may have been struggling with previously, such as using a mobile phone,” Nandra shared with OT. She noted that domiciliary optometry can help to address the distress and isolation that can result from vision problems.

“Patients can benefit from a free NHSfunded eye test, a great selection of glasses to choose from and high standards of care – all from the comfort of their own home,” she said.

Over time, the proportion of domiciliary

sight tests performed in care homes has decreased, while the percentage performed in the homes of individuals has increased.

In 2002, there was an even split between the two settings, while in 2020, two thirds of domiciliary sight tests were performed in individual homes.

Nandra highlighted that she uses the latest technology while working as a domiciliary optometrist for Specsavers Home Visits, enabling her to provide the same quality of eye care as a patient would receive in-store.

“We use many of the same instruments, but specifically designed for use in the home,” Nandra shared.

Optometrists working for Specsavers Home Visits receive training on how to support the needs of patients with memory loss through the Alzheimer’s Society’s Dementia Friends initiative. ●

“Turn up 20 minutes before clinics, so you can talk to the staff and understand store dynamics. This will help ensure you are ready for the day. Remember to work as a team member and that each store works differently. Be open to learning store processes and be willing to be flexible based on store needs and dynamics” Bhargavi Zinzuwadia

e

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The AOP Locum logbook Record keeping made easy

Our new online locum logbook is designed to assist locum members to keep a record of the work they’re responsible for.

Supported by Jonhson & Johson Vision the online logbook is a more secure and environmentallyfriendly method of record keeping.

Make your day easier

www.aop.org.uk/locumlogbook

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EXCEPTIONAL VISUAL PERFORMANCE ACROSS OUR MULTIFOCAL PORTFOLIO

*1

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NEW

With PUPIL OPTIMISED DESIGN for crisp, clear reliable vision.1

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100% of parameters optimised by age and refraction.**,1 Now available in both daily disposable and reusable modalities.

Visit jnjvisioncare.co.uk/acuvue-multifocal-portfolio or speak to your ACUVUE® Account Manager to find out more about the ACUVUE® multifocal range. *Compared to prior JJV multifocal design; technology optimised for both the parameters of refractive error and add power for a multitude of viewing distances and light levels. **Compared to competitor’s designs; technology optimised for both the parameters of refractive error and add power. For more information email : info@vision-care.co.uk.

1. JJV Data on File 2021. ACUVUE® PUPIL OPTIMISED DESIGN TECHNOLOGY: JJVC Contact Lenses, Design Features, and Associated Benefits.

All ACUVUE® contact lenses have Class 1 or Class 2 UV-blocking to help provide protection against transmission of harmful UV radiation to the cornea and into the eye. UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. UV transmission measured with -1.00 lens.

For more information on proper wear, care and safety, please consult the Instructions for Use or visit our J&J website www.jnjvisioncare.co.uk/important-safety-information © Johnson & Johnson Medical Ltd 2022. ACUVUE®, ACUVUE® OASYS, ACUVUE® MOIST and LACREON® are registered trademarks of Johnson & Johnson. PP2022MLT4463

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