Creating low-stress optical practices

Our best-practice guide to create a healthy, low-stress optical practices

In the AOP’s 2017 health and wellbeing survey, we uncovered several factors that contribute to workplace stress for optometrists. These include working under time and commercial pressures, an increasingly complex workload, and a fear of litigation. Many optometrists also feel undervalued as health professionals, both within the workplace and outside it. While the issues raised were seen across a broad range of employers, they were most prevalent in the larger groups.

Employer input 

We have been working with several employers to create a best-practice guide, Creating healthy, low-stress optical practices, but would like to express our particular thanks to Boots Opticians, Specsavers and Vision Express for their collaboration and input. 

It is clear that we share the same goals - to ensure we create workplace environments in which optometrists can thrive.


This short guide summarises our conclusions from the research and from our collaborations with employers, highlighting the five key factors that contribute to a healthy workplace with the minimum levels of stress:

  1. The importance of the optometrist’s role is recognised
  2. Workloads and work patterns are well-managed
  3. A comfortable working environment with adequate rest breaks
  4. Fostering good team relationships
  5. Openness about change and the need to change

There is also some general advice for employees and employers.

A comfortable working environment with adequate rest breaks

There should be rest breaks scheduled throughout the day, including an adequate lunch break. On some occasions, appointments and other work may overrun into breaks but this should be the exception and not the rule.

The physical conditions in the consulting room should be well planned. The heating and ventilation should be at a comfortable level and all equipment should be positioned so that the optometrist/s can work without undue physical stresses and strains.

Fostering good team relationships

All staff should work together to promote a positive working environment. There should be a clear set of values about the right way to work together as a team. These include helping and supporting others, politeness and respect. Unacceptable behaviour should be dealt with quickly and firmly. Any individual who is having problems should feel that they are supported by the team.

Best practice

  • Harassment and bullying in any form is not tolerated
  • Emphasis is placed on the importance of mutual respect in the workplace. Colleagues understand that while fun at work is important, a level of
    professionalism should be maintained at all times
  • Optometrists are included in all staff meetings and there is an open discussion on what is working well and what is not working
  • For new employees, there is a mentor or a buddy they can turn to for support, who is not their direct manager
  • Reverse mentoring, where younger members of staff coach the older ones, can identify differences in attitudes between different generations in the workplace, which can be positive for all
  • Self-awareness training to understand how your actions can have an impact on others is introduced
  • There are confidential helplines or peer to peer support for individuals who are having problems. If not provided by the company then explaining where this support can be found elsewhere
  • Provide a range of opportunities for colleagues to give feedback on team relationships, which could include confidential surveys
  • Practices and staff should be encouraged to arrange and attend social events outside work, so staff get to know each other on a personal, as well as a professional, level

General advice for employees and employers

General advice for employees

Don’t be afraid to speak out

It is often the case that managers and colleagues are not aware of issues and are both
able and willing to help when they find out. Do not suffer in silence.

Be flexible

There are conflicting priorities in business, as there are in life generally. In optometry,
these often include the tension between your professional clinical responsibilities,
commercial targets and customer service. In addition, not everything goes to plan
all the time. Sometimes you must show flexibility to accommodate this and help the
team. This should be possible without compromising your professional standards.

Be assertive

If your concerns are not being addressed, escalate the issues to higher levels of management. If they are still not addressed, or if there is a genuine difference between your values and those of the company, you may need to look for a role in a
company that shares your values.

General advice for employers

Encourage an open and supportive workplace

Often the best suggestions for improving performance will come from your employees. However, they may not feel able to speak out if there is an atmosphere of
repression and defensiveness. Be open to all ideas.

Be firm on how people behave at work

The ideal is that the team works harmoniously together to achieve the goals and objectives of the business. Keep an eye on the team dynamic to spot any examples of bullying, obstruction or shirking responsibility. These should be challenged and discussed – either with the individuals concerned, or with the team in general.

Show that you care about people as people

All staff should feel valued, regardless of their role. After all, happy staff are motivated staff that are more likely to provide a positive contribution to the business. Your employees should know they are much more than just cogs in the machine.

Openness about change and the need to change

It is recognised that the prospect of any change can cause anxiety and stress. Any change to working practices should be explained to staff in advance, allowing them to discuss how they will be affected.

With potentially a lot of change about to affect the roles of optometrists, such as the impact of technology, companies should be open with staff about the potential impact and should be preparing them for the future.

Best practice

  • Training is provided for optometrists on all of the options available in their career, including clinical and business aspects
  • Training and development programmes are future-focused, looking at the qualifications and experience that optometrists will need over the next five to 10 years
  • A clear vision of the future of optometry is shared by leaders of the company on a regular basis
  • Optometrists are encouraged to look at the whole range of career opportunities and educated on how to achieve them
  • Optometrists are encouraged to build a portfolio of roles, including time for voluntary work or working in hospitals

The importance of the optometrist’s role is recognised

While for most optical businesses profits come from retail sales, the core duty of the business is to provide a high standard of eye care to patients. And, of course, the responsibility for providing eye care rests with the optometrist/s working in the practice.

It is, therefore, important that all staff and managers in the practice understand the professional responsibilities of the optometrist/s. The main role of an optometrist is to provide eye care and screening for underlying diseases, and it is important that this is clear to all members of the store/practice team so that they can support the optometrist/s in providing this service to the public.

Business key performance indicators (KPIs) should recognise this and not focus too heavily on sales and profit.

Best practice

  • All staff are educated on the roles and responsibilities of optometrists
  • All staff recognise the fundamental importance of the optometrist to their business. This could be achieved through a short presentation from the optometrist/s at staff meetings, or some form of work shadowing
  • Cases where crucial early detections of underlying disease were made as a result of a sight test are widely shared throughout the company
  • The role of the optometrist as the guardian of the nation’s eye health is now being actively promoted to the public by the profession, with an emphasis on the importance of regular sight tests for all people
  • Optometrists are represented at senior levels in the company. Ideally, every practice is led by an optometrist, or an optometrist is involved in the decision making
  • There is a lead clinician role that allows optometrists the opportunity to discuss clinical matters and any potential conflicts with someone who fully understands their issues
  • Optometrists are supported to build professional networks and learn from their peers, either face to face or online

Workloads and work patterns are well-managed

The caseload for the optometrist/s should take into consideration the types of patients that they will be seeing and also the level of delegated functions that are in place in the clinic. There is no single right answer for the time allowed per appointment or the number of cases per day.

Administration and record keeping are important aspects of optometrists’ roles and adequate time should be built into the schedule to allow for this.

All staff should be familiar with the equipment used in the practice and sufficient time should be allocated for adequate training to enable the safe and efficient use of practice equipment. This is of particular importance for locums and new staff.

Best practice

  • Wherever possible, the reception staff are aware that certain patients, such as older people, require more time in the consulting room and they adjust the length of appointment times accordingly
  • All optometrists should have regular, 10-minute (minimum) catch-up meetings on a fortnightly basis with their line manager, to discuss any issues. These should then be acted upon by the manager and discussed at the following meeting. These meetings can be arranged formally or kept more informal. The
    important point is that they are held regularly, the conversation is open and honest, and that any points raised are effectively followed up
  • Opportunities to free up optometrists’ time by delegating functions to suitably trained and accredited colleagues are actively considered
  • Ensure the patient journey is regularly re-evaluated to provide the optimal level
    of service and care
  • Team meetings that discuss how the delegated functions are working and ideas for improvement are considered

The guide is suitable for all optometrists and those who manage optometrists, to help address problems and open conversations with managers and colleagues.

Guide distribution

The guide has been sent to all UK AOP members in the April 2018 edition of Optometry Today, it will also be distributed through Boots Opticians, Specsavers and Vision Express directly to their employees. The guide is also available to download for members and non-members. 

If members would like to receive additional hard copies of the guide, please email your name, membership number, practice address and number of copies required to [email protected]. (Subject to availability.) 

Manager letter

As an accompaniment to the guide, we have developed a letter for optometrists to pass on to their managers or practice mangers, along with a copy of the guide, should they feel it will aid their conversations. 

Using the guide

The guide isn’t meant to be prescriptive or directed to a ‘type’ of organisation, we’ve worked with number of optical employers to pull together examples that could be rolled out into any practice.

We hope it is a helpful addition to a practice’s current processes and useful in starting conversations to help create stronger teams, and optical practices where stress levels are low and job satisfaction high.

100% Optical Pilot

The guide was piloted at 100% Optical 2018, with a corresponding CET session on Sunday 28 January. Feedback from the CET session has been worked into this second edition of the guide. A short video created at the end of the session can be accessed below.