Locum Optometrists In The UK: Rolling vs. Fixed Clinics—Which Model Actually Wins?

As a highly specialized professional, you are part of the 1% of the UK population with your specific skill set. Your expertise is undeniable, yet many in the profession find themselves questioning if staying in a traditional employed role is worth the mounting stress.

The issue often isn't the clinical work itself, but a system designed for volume rather than value. When it comes to the structure of your day, most practitioners are forced to choose between two models: the Fixed Clinic or the Rolling Clinic.

The Illusion of the Fixed Clinic

On the surface, the fixed 25-minute or 30-minute slot offers the promise of stability. You know exactly when you start, when you finish, and what your paycheck will look like at the end of the month.

However, this predictability often comes at a high price. Under an employer’s banner, a fixed schedule is rarely just about testing eyes. You are frequently expected to balance clinical duties with administrative tasks, sales targets, and key performance indicators. While the "fixed" nature removes some scheduling anxiety, you often sacrifice the autonomy required to maintain a truly patient-focused pace.

The Tyranny of the Rolling Clinic

Few things amplify professional burnout like the rolling clinic. Favored by several large optical chains, this model is built on maximizing profit through pure volume. While management may argue it helps offset delays, the reality for the practitioner is far more punishing.

1. Internal Conflict

Rolling clinics can inadvertently pit colleagues against one another. If one optometrist takes an extended break or falls behind, the burden shifts to the rest of the team. Your finishing time and the integrity of your lunch break become entirely unpredictable variables.

2. The Ghost Clinic Trap

Perhaps the most frustrating aspect of this model is the "maxi diary" or "ghost clinic." This involves managers booking additional patients over and above your agreed capacity—sometimes an entire extra clinic’s worth. Because we are ethical professionals, we often feel pressured to see these patients out of a fear of GOC malpractice concerns. This is a form of professional manipulation that prioritizes the bottom line over practitioner well-being.

The rolling clinic reinforces a toxic narrative in the industry: that being "fast and salesy" is more valuable than being "thorough and clinical."

Is There a Better Way?

Transitioning to locum work was the turning point in my own career. While a locum cannot change the fundamental culture of a practice, they possess the power of choice. If a practice's model does not align with your clinical standards or personal well-being, you are not obligated to return.

By moving away from a single employer, you gain the perspective needed to decide how you actually want to practice optometry. You learn to navigate the politics of rolling clinics and the efficiency demands of fixed clinics on your own terms, rather than out of a sense of forced obligation.

If you are feeling the weight of the "maxi diary" or the stress of a rigid fixed schedule, it may be time to reconsider your professional environment. I have helped many optometrists transition from traditional employment to the freedom of locuming through the resources on my website, and I invite you to explore those options.

The question remains for the profession: between the predictability of the fixed clinic and the pressure of the rolling clinic, which is the lesser of two evils?