Top FAQs About Starting Locum Optometry in the UK

I've helped hundreds of optometrists become more knowledgeable about locum optometry. ThroughThe Optom Coach, I personally help optometrists transition from employed to locum work confidently, removing the confusion and delay that often happens when trying to go solo.

Let's dive deep and address the root of these common FAQs about starting locum optometry in the UK.

💼 1. How do I register as self-employed and set up properly with HMRC?

Most are terrified of doing it wrong, getting fined, or making a legal mistake. This is best left to either an accountant to guide you or an experienced locum. It is possible to register yourself as a sole trader; however, if you want to choose the more tax-efficient route of a Limited Company, this requires an accountant's expertise.

🧾 2. Do I need an accountant—and how much should I be paying them?

Optometrists understandably don’t want to overpay, but they don’t want to screw up taxes either. Through my network, I've seen rates for a Limited Company around £675 a year and for sole traders around £350. These are seriously competitive rates, and a good accountant will easily save you more than what they charge. While such rates are hard to find online, they give you a rough benchmark to aim for.

💰 3. How much do locums actually earn—and is it stable?

You may have heard “£350/day” but don’t know the real average. The biggest factor? Supply and demand. High population areas often mean lower rates. The lowest I've personally seen is £250 a day, but on the coasts and in South Wales, you can easily make £400 a day, and at the maximum, push £500+.

The average sits around £350, which is an excellent daily rate—equalling roughly £75,000 a year if you work 5 days a week. When you factor in the tax benefits over employed counterparts, the pay rise is very real.

📆 4. How do I find and book shifts—without constantly chasing agencies?

The logistics overwhelm many. We generally book shifts through apps, sometimes via texting managers directly, and occasionally via email. However, with so many platforms out there, registering is not as simple as it seems. Having a roadmap atwww.theoptomcoach.comcan help you cut out the fluff and get registered efficiently.

🏢 5. What’s it like working in different optical chains (Specsavers, VE, etc)?

New settings equal anxiety. Prospective locums worry about test room layouts, equipment, systems, and expectations. Truthfully, they all work differently. Some use touch screens, others paper records. Some have modern equipment; others use Perkins tonometers and no autorefractors.

🧠 6. What if I get stuck or don’t know what to do during a clinic?

This is the #1 fear—it’s not money, it’s confidence. You fear messing up and looking unprofessional. What I’ve found is that you just need a reliable contact or mentor to help you during those initial tough times. After that, it's just pure experience until the unfamiliar becomes familiar.

🔁 7. What’s the best way to refer, document, and cover myself legally?

We want to feel bulletproof with GOS18s, letters, and HES notes. Always use the referral method your practice uses.

• Paper: Referral pads.
• Electronic: Editable PDFs of GOS18 forms or integrated systems.

In your clinical notes, always record your findings, the reason for referral, and the urgency. Avoid non-approved abbreviations. Treat every patient with the urgency you would a family member; don't sit on suspicious visual fields or discs, as failing to refer could lead to a clinical negligence case.

📍 8. How do I work in Wales or Scotland—is it different from England?

This is a big unknown for England-trained optometrists who don't know about Health Board (HB) structures or local GOS variants. Reach out to local locums or check ROC/LOC websites for guidance on practicing across borders.

💼 9. Do I need a separate business bank account, email, or insurance?

The short answer is yes. You must have your own professional indemnity insurance. While you technically don't "need" a separate bank account or email, not having them will cause significant administrative headaches long-term. Set them up right at the start.

🛍️ 10. What gear do I actually need to carry with me as a locum?

At an absolute minimum, you should carry:

• Ophthalmoscope & Retinoscope
• Volk Lens
• Trial Frame
• X-cyl/Spherical flippers

I recommend over-preparing: carry hygiene items, spare Tropicamide, and anaesthetics. It is better to have it and not need it than vice-versa.

🤝 11. Do I have to use agencies—or can I go direct?

You don't have to use agencies, and going direct can be beneficial. However, modern booking apps have made the process so streamlined that you miss out on significant work by ignoring them. The best strategy is a mix of both.

🧭 12. How do I stay organised with invoices, taxes, and CPD?

Admin fatigue is real. Most booking applications now automate the invoicing side, and your accountant handles the taxes. However, you are on your own regarding your diary and CPD points. Forging a system early on is the only way to avoid "winging it" and failing.

⚠️ 13. What are the red flags to avoid in shifts or stores?

Locums often fear being taken advantage of in chaotic environments. Generally, high-volume, "salesy" stores can be difficult, as can poorly equipped stores with unsupportive staff. Word of mouth is currently your best tool for vetting locations.

🧠 14. What if I’m not fast enough?

If you can hold a 25-minute clinic in a store with pre-testing and electronic systems, you are fast enough. In stores with paper records and manual equipment, 35 minutes is generally acceptable. This is usually a mental barrier rather than a skill barrier for those who have passed their OSCEs.

🔒 15. “Am I really good enough to do this on my own?”

If you have passed your OSCEs, you are a legally qualified eye expert. If you aren't over-referring, causing excessive rechecks, and you can stick to your timings, you are ready. You've survived A-levels, university, and the Pre-reg year—you have the evidence to back up your capability.

If you want support in the early days until you find your feet, that’s exactly what I provide. I help you set up, start working, and become a confident locum.