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Introducing a tiered eye exam choice

Clinical director at Pinders Opticians, Hannah Shooter, on how the independent introduced a three tier eye examination option across its practices

Hannah Shooter

All five Pinders Opticians practices offer patients three eye examination options. We established this approach in 2012 after we realised that offering optical coherence tomography (OCT) simply as an add-on to the normal NHS sight test had a very low uptake.

Having invested in OCT in three of our five practices, we wanted our patients to have access to and embrace this technology that allows us to understand their individual needs and requirements, especially if they are above a certain age or have a family history of a condition such as glaucoma.

Researching our options, we initially introduced a two tier system that recognised a standard and an advanced eye examination. However, patients still saw this as a high and a low option in terms of cost, and uptake was lower than we had hoped for.

Three levels of working

Reassessing our options, we expanded our tiers and now offer three choices of eye examination: bronze, silver and gold. 

While the bronze is our entry level examination and includes a standard eye exam that is covered by the NHS sight test voucher, the gold examination is the most comprehensive that we offer and includes digital or 3D imaging and a full visual fields scan. For patients who pick our gold option, they also receive all images and reports on a USB stick to take away with them.

Our silver examination varies between our branches as we only have OCT in three practices. Therefore, in the other two branches, the offering is built around the other technology that is available, such as digital photography, and the pricing structure is adjusted accordingly.

This examination is also designed to cater for patients who may have eye care issues, such as dry eye, because the appointment time is slightly longer, giving the optometrist time to further investigate and discuss this with the patient.

Across all of our practices, the silver examination is what our optometrists and front of house staff recommend as standard. As an optometrist, I would want everyone to upgrade, and that’s what we tell staff. But we do understand that it’s people’s choice and not everyone will upgrade.

"As an optometrist, I would want everyone to upgrade, and that's what we tell staff. But we do understand that it's people's choice and not everyone will upgrade"

In practice

Before introducing the tiered system, we looked at what technology and expertise we have in practice and asked ourselves what we could offer in each different tier and how we could ensure they differentiated themselves from each other.

We also looked at our patient base and asked ourselves what we felt was a reasonable and affordable pricing structure.

Staff were then given training on the “extras” that are available in each tier. For example, with OCT, everyone had a scan done so they could better understand the benefits of it. It also helped them to feel more confident when speaking to patients about the technology.

Continued, regular training is run with optical assistants to help maintain their knowledge and support uptake.

As a group, we are very heavily-geared towards an eye plan approach. And while the bronze eye examination is included in these plans, we also offer the silver examination as an upgrade at a reduced rate.

Overall, the three tiers of choice is an approach that works particularly well for us. We have found that patients like to be given a choice.

Around 40% of our patients upgrade to the silver option, and once they have upgraded, they normally see the benefit and upgrade time and time again.

Three steps to success

  1. Keep your patient demographic in mind when setting the tiered fees
  2. Think about how you are going to differentiate between each tier
  3. Make sure staff are trained and comfortable with the new format.