Finding their why

So, how do optometry practice owners ensure that their practice teams are achieving their full potential – whether that is successfully completing the Scheme for Registration, or upskilling in areas like stock taking or identifying frames that will be popular with patients? How key is mentorship in practice team growth? And – importantly – how are managers responding when practice harmony goes off kilter?

To find out, OT spoke to Vikram Desai, optometrist and owner of four MW Philipps Opticians branches in the West Midlands, and James Bontoft, optometrist and owner of James Bontoft Optometrist in Barnoldswick, Lancashire.

Effective mentorship and pre-reg supervision

OT is interested in how important it is to find time for pre-reg supervision, and more widely, for mentorship of longer-term staff.

Bontoft explained that having a pre-reg in practice (OT’s Pre-reg focus print contributor for 2024 – 2025, Habeeb Rahman) is a new experience for him.

Ensuring that a pre-reg fits in with the existing team and shares the ethos and goals of the practice is vital, Bontoft said.

“One of the aims of our practice, particularly as we are quite clinically focused, is to spend a lot of time with each individual patient,” he explained.

“We receive a lot of referrals from the pharmacy, from the GPs, from the hospital, and from urgent eye care. We place a heavy emphasis on making sure that aspect of our practice is as good as it can be.

“We need to make sure that, if we are taking on a trainee, they have the experience, knowledge and skills to be able to start working more and more independently towards that goal.”

That means ensuring that pre-regs are exposed to a range of skills, techniques and knowledge so that they have a wide base to draw upon, Bontoft said.

Discussing particular cases both before, during and after appointments means clarity on the scenario that has presented, he added.

“For pretty much every patient, we have a brief discussion afterwards as to how it went, what the difficulties were, and any problems that we came across,” Bontoft said.

“We certainly have an open door. Because we’re not testing every 15 minutes, it does mean that we hopefully have a bit of time to try and have that discussion.”

As a business with one practice, whose reputation is based largely on word of mouth, “finding the right trainee, who is aligned with similar values, is super important,” Bontoft shared.

He added that this is true for every member of the practice team – from the front of house staff to the locum optometrist who might be booked for an occasional shift.

With four practices, Vikram Desai has been able to engineer a situation where his largest practice, in Acocks Green, Birmingham, is the primary space used for both professional training for existing staff and as the base for pre-regs.

The practice, which Desai purchased after the COVID-19 pandemic, has three floors and a high patient footfall and can offer exposure to a large number of clinical services – something that can provide useful learnings for the group’s handful of pre-regs.

Desai’s approach with pre-regs is to supervise them initially to ensure they are proficient in sight testing and haven’t picked up any bad habits, before assigning them their own clinics and patients once he is satisfied with their competence, he explained.

An open-door approach means Desai is always on hand to answer questions and discuss patients once pre-regs are testing independently, he said.

He added: “Once they have had help with that first scenario, they’re able to deal with that for future scenarios. It just takes a bit of practice.”

How does Desai develop staff who are not on the same structured route that pre-regs are?

“When we have someone new, they initially start on reception, maybe for two days a week, and then we try and get them dispensing quite quickly, so they feel like they are developing their skill set rather than just answering the phone,” Desai explained.

He added: “When you start a new job, you want to learn all the different things about the job. If you start early, they are keen to learn everything.”

Trainee dispensers begin by shadowing colleagues, before starting to take on simple prescriptions themselves, Desai explained, adding that it usually takes between four and six months for the skill to fully develop so they can dispense independently.

“They generally find that they’re thrown into deep end, but also looked after, rather than being left to it,” Desai said, “because I think that’s when people really struggle.”

Shadowing allows the whole practice team to feel involved in staff development, he believes – it helps to “create that team bond, where everyone chips in and helps each other, because that will only make everyone else’s job easier.”

Identifying goals vs practical upskilling

Identifying the career goals of practice team members requires an individual approach for each member of staff, Bontoft said – although this is likely to be more straightforward with a pre-reg, whose goal is almost always successful completion of the Scheme for Registration.

Being a small team makes open conversations about career progression easier, Bontoft believes.

“It’s such a small practice. We’re like a little family here, and we all know each other really well,” he said.

Bontoft explained that his dispensing optician has a desire to train as an optometrist in the future and is currently upskilling in audiology, stock taking and wax removals, whilst a newly hired front of house team member is learning about frame choices and “really trying to progress her role.”

At the same time, he acknowledged that some staff members might be nearing the end of their careers, and therefore have less of a desire to train in new areas – and that this should be taken into account too.

“When there are only a few of us in practice, it’s a very personal relationship we have with each other,” Bontoft said. “I know their aims and goals. I try and be the best employer I can be and help them with whatever they want to do.”

Desai emphasised the importance of not formalising the upskilling process for new staff members, who might work at different paces. A structured plan for development is likely to be overwhelming for certain people, and he agrees that a more individual approach is needed.

New practice team members start by being shown the computer system and shadowing someone who has worked at the practice for at least a year, which allows them to “feel like they’ve got some value straight away,” Desai explained.

“That allows them to gain confidence,” he said. “Also, by shadowing that person and watching them dispense, they know where they need to be in terms of skill set and the sort of job that they are going to be doing on a day-to-day basis.”

This also allows them to identify the aspects of the job that they find most interesting, Desai believes.

“That allows them to create their own goals and identify where they want to be,” he said.

He added: “Some of them, we find, are quite ambitious. They want to work as an optical assistant, but they want to also get a qualification.

“We work closely with a company that provides training for optical assistants to become qualified optical assistants. We’ve got five on the programme at the moment, and four who have already qualified and passed.”

Having an external training programme means optical assistants feel that the qualification they gain is valued and can give them the confidence to move on to a dispensing optician career in the future if they wish, Desai said.

“They know that that is a goal they can achieve,” he added.

Balancing work and personal life

Optical assistants taking their qualifications have paid days that they can utilise for study, either from the practice or at home, Desai explained, adding that they are also encouraged to study whilst at work if there are quiet periods.

Using study days to work from practice means they can call on the expertise of pre-regs or other team members if they have questions, he said.

“I think they feel like they’ve got a lot of different avenues that they can use to help them get through it,” Desai added.

Although the practice is open for five and a half days a week, Bontoft says, all of his front of house staff work part-time.

“We don’t have one member of staff doing all five and a half days – it’s split between the three of them,” he said, adding that start and finish times are also flexible depending on parental or grandparental responsibilities.

This commitment to flexibility as default means that work-life balance is retained and the risk of burnout is decreased, Bontoft believes.

“We’re always very flexible. Some start late or finish early, and we can fix things at the drop of a hat, really,” he said. “It’s all give and take.”

If the good vibes go wrong

OT is interested in hearing how practice owners manage on days when the practice is not as calm or as organised as they would like.

“The least harmonious times are when everything comes together at once: every person comes out wanting a pair of glasses, and on top of that we have minor eye conditions, CUES, and emergencies pouring in,” Bontoft said.

“There are days where it all just comes to a head,” he acknowledged – where multiple dispenses are required and patients are waiting for emergency appointments at the same time.

One solution Bontoft has put in place is to be stricter on appointments, through the use of a dispensing diary – and a requirement that patients book an appointment for certain things, rather than just dropping in.

“Even with that dispensing optician diary, invariably, we still have times where it’s absolute mayhem and everyone wants attention at once,” Bontoft admitted.

“We just have to accept that sometimes it’s a bit bonkers – we just have to grin and bear it and work through. There’s no way we can avoid it.”

In terms of conflict resolution, talking things through and making changes where required is vital, Bontoft said – something that he believes an independent practice, without multiple levels of management, is in a good position to do.

“We can be flexible and nimble enough to change something that isn’t working, to something that works better for all of us,” he said.

Desai shares a miscommunication between branches that he and his practice manager found themselves tackling head-on earlier this year.

The solution was to run staff meetings with ideas for constructive improvement at both sites where there had been an issue, allowing team members to be brought in on the solution, Desai explained.

“They took it on board, made the changes, and realised that it also helps them, because it makes it a more efficient workplace. It’s always about learning,” he said.

Following up afterwards with a night of bowling and drinks allowed colleagues who hadn’t spoken for a while to catch up in person, Desai shared.

“It just felt like it brought the harmony back,” he added. “Sometimes it's not so much about what's being said, it's more like people losing touch with each other.

“We knew that we just needed everyone to get in touch with each other again. Organising a social night definitely did help.”