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The return to lockdown: practices share their thoughts

As the new lockdown takes effect in England, OT  hears from practices about remaining open for eye care, the business impact, and the challenges for the High Street

frames on display
Pexels/Karolina Grabowska
The High Street will empty once again from Thursday 5 November as England enters a four-week period of national restrictions.

While non-essential shops will be closed, optical practices will be able to remain open and provide eye care based on prioritised needs.

With practices already operating with increased infection control and social distancing processes, many expect to continue as they have been since re-opening for routine care.

While recognising the ability for optical practices to provide a vital primary care service, helping meet patients’ needs and also supporting hospitals in managing waiting lists, practitioners have also expressed concerns around the impact of the lockdown on appointment cancellations, and on the wider High Street.

For the Hakim Group, practices will continue operating as they were before the new national restrictions were introduced, Luke Wren, head of business development, told OT, delivering care prioritised based on need. He said: “Practices are continuing to employ additional safety measures, with all team members equipped with full personal protective equipment (PPE) and with strict social distancing procedures in place.”

“Every touchpoint and all frames are also sanitised regularly after each use, with appointments lengthened to allow the consulting rooms to be thoroughly cleaned after each patient’s visit,” Mr Wren added.

With COVID measures already in place, many practices shared with OT their plans to continue utilising their new processes.

Dan McGhee, director of professional services at Vision Express said: “We are pleased that optometrists can continue to offer all eye care services during the latest period of restrictions. As a sector, we are much better prepared and are now well practised at delivering care safely.”

Mr McGhee added that customer research indicates patients have felt safe and confident in stores since they reopened in summer, and practices plan to continue following adapted processes advised by the amber phase guidance.

Reflecting on the introduction of the new restrictions, Nicholas Rumney, senior optometrist and chairman of BBR Optometry, explained that the practice had already increased infection control and social distancing measures.

“We had recently embraced an internal tier of upgraded social distancing and protection, with more staff wearing masks and more screens, based on guidance from professional bodies, so I think it is with a sense of resignation that we have prepared for this next lockdown,” he said.

The practice has not elected to furlough anyone other than directors who work part-time at this stage, Mr Rumney said, adding: “We are fluid and can work quickly.”

The practice has also continued to work hard to ensure emergency slots are kept available, Mr Rumney explained. “We are a ‘divert destination’ from eye casualty, so even if conventional examination and dispensing drops, we are here for clinical services including independent prescribing.”

While the practice will continue to remain open, Mr Rumney expressed sympathy for fellow High Street businesses, commenting: “We are acutely aware that our colleagues on the High Street, such as hairdressers, shops and pubs, do not have the luxury of being classed as essential and we hope they are there when we emerge. Never have we valued our hybrid role more.”

Changing demand and the footfall impact

Leightons Opticians and Hearing Care expects to see a change in levels of demand during the next lockdown. Ryan Leighton, CEO of Leightons Opticians and Hearing Care, told OT: “We foresee that demand for more routine eye examinations is likely to reduce, by about 10% from the current levels.”

Patients with a clinical need will still want to be seen, however, Mr Leighton acknowledged, continuing: “With greater clinical need and more time with patients, we anticipate an improvement in the conversion rate and average transaction values.”

The company are hopeful that, from a commercial perspective, the outcome will be “fairly stable” compared to last year’s performance.

Mohamed Ayyaz Kasmani, director and principle optometrist of Feltham Eyecare Centre, told OT he had been anticipating the lockdown, and has already seen an impact on patient numbers, commenting: “I do expect some patients will want to stay at home and there will be a negative impact on business as we have had a few patients call to cancel their appointments.”

“On the other hand, we have had patients who have spectacles to collect asking if we will be open,” he noted.

The practice will be continuing its locked-door policy and safety measures. It is also continuing to utilise the AOP’s telephone triage system when booking patients.

Anthony Josephson, optometrist and owner of Maskell + Josephson Optometrists shared his conflicted feelings over the new lockdown, recognising the “devastating delays in care” during the initial lockdown earlier this year, and also noting: “People are really struggling with being locked in and restricted month after month.”

Based in Greater Manchester, the practice and local areas have been facing restrictions for several months already, and while Mr Josephson said he had felt supportive of a lockdown, “provided it was full-on, as short as it could be and enforced,” he shared his concerns over the effectiveness of restrictions so far, and that the approach would “hurt many businesses that need not be hurt.”

Maskell


With two practices, in Altrincham and Warrington, Mr Josephson expects to see the lockdown impact each site very differently. The Altrincham practice has existed for over 50 years, and been in its current location for over 37, while the second practice is based in Warrington town centre, and only opened at the start of September.

“We have been operating on around 60% capacity since mid-June,” Mr Josephson explained, with longer consultations, allocated cleaning time and optometrists now carrying out pre-screening. “This has resulted in a busy, booked-up clinic-since then.”

However, the practice has recently seen an increase in same-day cancellations, Mr Josephson said, which he suggests is due to a “lack of willingness of some to come in for something they feel happy to wait a bit for.”

As a well-established business and with a healthy direct debit income, Mr Josephson expects the Altrincham practice will not need to furlough any staff, adding: “Even on reduced capacity, we’ll weather it through. It will be a challenge, but we are prepared for this far more than we were in March.”

“The new site in Warrington is a different story,” Mr Josephson told OT. “We don’t have the database of people waiting to see us. We don’t have people phoning us up for emergency appointments as they are not aware we are there yet.”

With footfall “plummeting” over the past six weeks, and expected to continue dropping through lockdown, Mr Josephson added: “The reduced footfall in Warrington will be very hurtful as we need those people walking past to find out we exist.”

Aiming to support other local businesses, Maskell & Josephson Optometrists plans to promote local independent businesses throughout the next lockdown, particularly those that will remain operational under new models, such as click and collect or deliveries.

“Many have been hanging on by a thread since the end of the last lockdown and a lot fear this upcoming stretch may well be the proverbial straw that breaks the camel’s back. I do hope not. A High Street is only as good as the businesses that trade there,” Mr Josephson said. “With every lost business and vacant unit, a little bit of the soul that makes up the town dies.”

Providing a key service

Following the advice from the professional bodies, Bayfields Opticians & Audiologists has been proactive in reassuring patients that the practices will be offering routine appointments.

Royston Bayfield, founder and CEO, told OT: “It’s a worrying time for many people, without the additional uncertainty of whether or not they can access health services.”

The practices have reacted to the changing needs of patients. Following the demand seen once practices had reopened in summer, some Bayfields Opticians practices have extended opening hours to meet demand, particularly while COVID-19 safety processes have restricted how many clients could be seen a day.

The practices are also able to offer consultancy over the phone, or online, Mr Bayfield noted, adding: “Some services, such as the free online hearing test, mean that some people may not need to visit the practices in person.”

Like many, the team has invested in ensuring the practices are safe for clients and employees, including developing its ‘BaySafe’ model to provide care in a safe environment. The team has also invested in purchasing and fitting specialist equipment, from PPE and UVC sterilisers, to automatic phoropter heads and frame-fitting iPad technology.

Giles Edmonds, clinical services director and practice owner in Sutton Coldfield and Mere Green, noted the key role optometrists have played in looking after eye health during the pandemic and thanked colleagues for their work.

“It’s important that we can relieve some of the strain on NHS eye clinics and help prevent a future eye care crisis,” he added.

Allegro Optical, too, has shared the message with patients that the practice will remain open through the second lockdown as an essential service. Speaking to OT, Sheryl Doe, managing director and dispensing optician said: “We feel we are providing a vital service at a time when hospitals are facing large backlogs.”

The practice is following public health advice, with appropriate PPE and infection control measures in place, Ms Doe added, and are encouraging patients not to delay their eye care.

“With the most common eye conditions including age-related macular degeneration, cataracts and glaucoma all easily detected during a routine sight test, we encourage anyone who needs a sight test to contact their local practice to book an appointment and not to put off their eye care,” Ms Doe said.

Poems, posts and optometrist Barbie: communicating updates to patients

“If you have an eye problem / we are here for you / for your parents, for your children / for your neighbours too…” So begins BBR Optometry’s poem for patients, reminding them that the practice is still open, sharing the measures the practice has in place, and encouraging patients not to ignore any vision issues.

Emily Davies, dispensing optician at BBR Optometry told OT how she has been using social media to engage patients and communicate important updates in a creative way.

With regularly updating information on lockdown, it can be easy for things to be missed, Ms Davies suggested, adding that the practice’s eye-catching social media posts aim to engage and inform patients.

barbie
BBR Optometry has been reassuring patients that the practice is still open for their eye care needs through creative and colourful posts


From the initial lockdown and throughout the year, the practice has been updating patients through email, website and social media platforms. Ms Davies said: “We tried to keep our patient base as up-to-date as possible, and Facebook, Twitter and Instagram were instrumental in this, as well as email.”

“As well as working to anticipate what is coming next and update patients as soon as we can, we work really hard to be friendly and approachable, Ms Davies continued. “We hope that all of our patients always feel that they can pick up the phone and give us a call for any clarity they require – and many of them have done this over lockdown and continue to do so.”