The discussion

Back to work priorities

Optometrist and OT  clinical editor for multimedia, Ceri Smith-Jaynes, and East London practice owner, Simon Rose, discuss what independent practices need to do to secure their businesses over the next few months

woman wearing glasses

As lockdown restrictions in the UK begin to ease, thousands of optometrists will be wondering how best to navigate the undoubtedly challenging weeks and months ahead. For independent practice owners, operating without the support network that multiples benefit from, the near-future might appear especially daunting.

Practices will now need to set their priorities, both in the short and longer term. That might include shoring up their finances, adjusting to staff returning to work, adapting to new behaviours and expectations from customers and patients, and ensuring their technology is up to scratch both for marketing purposes and in case of an increased demand for remote consultations in the future.

Returning staff

Simon Rose, who has practices in Essex and in Hackney, believes that adjusting to new ways of working will be the first challenge that he and his staff will face. After furloughing staff, adjustments made to his own working patterns meant he reassessed how he was running his practices previously. He found that he could take on more work himself than he had realised, and now believes that his practices can never go back to their old way of operating.

“We're going to have to change the way we work completely,” he said. “I don't think we'll ever answer the phones in the practice again - someone could do that offsite, for example, with access to our systems. I think that's really important, because then we can focus on the patients that are in the practice.”

We’re going to need much better lines of communication - to update our website faster; have better signage. All the classic things that the 'big boys' have got access to, that you don't consider doing because you are too busy testing eyes

Simon Rose

From an optometrist perspective, Ceri Smith-Jaynes believes that the near future will feel austere for staff, partly due to unpredictable patient numbers and insecure finances. She said: “The practice may not have enough work for all the staff to return to their usual hours at first. I’m not sure if we’ll have a tidal wave of patients with pathology to deal with, or if we’ll find that people don’t present to the practice for fear of proximity and we end up very quiet.

“I expect the practice purse strings will be pulled tight; we can’t expect shiny new equipment, bonuses, pay rises and staff parties. We may have to be flexible with working hours, especially as staff juggle work and childcare arrangements.”

We're going to have to change the way we work completely

Simon Rose

Ms Smith-Jaynes also thinks returning staff “may have to prioritise certain patients at the risk of upsetting others”, and that it’s likely that they’ll need to “be flexible about the roles we take on, for example delivering spectacles and lenses to minimise contact.”

Improving marketing 

In such a difficult climate, practices are likely to have to rethink their marketing if they’re going to be able to compete with multiples, which traditionally have the support of a corporate machine behind them. It’s something that Simon Rose has reflected on in recent weeks, coming to the conclusion that his practices (“ordinary, old-fashioned opticians”) will need to up their game when it comes to digital channels including social media and their website.

Multi-channel communication with patients will be crucial, reminding them of the relationships we have built over the years and the service we offer

Ceri Smith-Jaynes

Mr Rose believes independents are vulnerable in situations where they cannot have traditional face-to-face contact with their customers and patients. He says of his practices’ altered relationship with their patients: “We’re going to need much better lines of communication - to update our website faster; have better signage. All the classic things that the 'big boys' have got access to, that you don't consider doing because you are too busy testing eyes.”

Ms Smith-Jaynes is OT’s clinical multimedia editor as well as an optometrist, and has some practical advice for practice owners who don’t know where to start: “Embedding a video, showing the practice team and how the practice is adapting during the crisis, would add a human element to the website,” she said. 

Clinical technology 

The need for improved technology is likely to extend to equipment too, according to Mr Rose, who is already seeing an increased need for clinical tech that works remotely. Aside from requests for video and telephone consultations from patients, he also looked into automated information acquisition for those patients who were required to isolate completely, and developed a way of imaging patients without needing to be in the same room. The pieces of equipment that proved the most useful include the Optopol Revo FC, which allows for remote control from anywhere, and an OCT fundus camera that allows him “to do virtually everything.” His next challenge is working out how carry out refractions remotely, and he’s currently looking for a machine that will help in this.

Simon Rose
Practice owner Simon Rose with the Optopol Revo FC, which he has found helpful during the lockdown and wants other optometrists to know about

Changes to purchasing habits

Tied to marketing is the increasing problem of patients and customers turning to the internet, rather than to High Street practices, when looking to purchase new eye wear. This is likely to be exacerbated if social distancing restrictions remain in place for an extended period of time, leading to a negative impact on practice finances.

Ms Smith-Jaynes, however, is confident that with the right strategy optometrists can make both new and potential customers recognise the value of their expertise.

She said: “Those of us who spend a large proportion of our time in practice making small adjustments to frames understand that remote dispensing is less than ideal for many patients. I hope we have cultivated enough patients over the years who appreciate the difference. Those who don’t soon will. It’s a similar scenario to having a cheaper competitor open on your street – some patients go, but many come back next time and stay for good.”

She adds: “Multi-channel communication with patients will be crucial, reminding them of the relationships we have built over the years and the service we offer.”

Reducing infection risk

Ms Smith-Jaynes believes that infection control needs to be the first concern for optometrists and practice owners. Questions need to be asked immediately: “Will there be enough PPE, soap, hand gel and wipes, and will there be sneeze guards or face-shields? Can I wear easy-to-wash clothing rather than my dry-clean suits? How will we communicate with all the patients before they attend so they are prepared to follow protocol, and will we be supported in enforcing those rules? Can I have extra time to clean up and will there be appropriate clinical equipment - non air-puff tonometer, fundus camera?”

She adds that “staff training and a clear protocol, as well as good leadership to ensure everyone understands and adheres,” is vital.

Mr Rose emphasises the need for optometrists to be able to access COVID testing, due to the close proximity they need to have with patients. “I'm desperate to try and develop ways of not being in such close proximity to people, and if we do have to get close, find ways of being in front of them for the minimum amount of time,” he told OT.

Increased numbers of patients could be expected now that practices are reopening, due to the lack of sight testing that has taken place in recent months. Mr Rose believes that “there will be a surge in normal optometric activity, but more so there is going to be a surge in clinical eye care, which some practices will be geared up to do and some won't.”

Ms Smith-Jaynes agrees: “People will have different feelings about the risks and amount of mitigation required.”

She believes that communicating the safety message to patients needs to happen “before they attend, using phone calls, letters, social media and signage.”

When they attend “we need to demonstrate a slick protocol so they see us taking things seriously, and explain that we have cleaned the chair/lenses/equipment. Before lockdown, I was telling the next patient to ‘give me a few minutes to clean everything down then I’ll call you through…’ and they all understood and were happy to wait,” she says.

The future

Alongside repositioning marketing efforts, ensuring a safe and sterile environment and managing the wellbeing of returning staff, morale will need to be kept high so that staff can focus on creating the best environments for patients and thus continue bringing them into practice.

Ms Smith-Jaynes urges staff to operate with increased sensitivity towards each other when they return to work: “At first we’ll be pleased to see each other and to swap stories, but it won’t have been all about sourdough and Joe Wicks for everyone,” she says. “Members of staff may have had a bad experience during lockdown, and we’ll need to be mindful of this. The practice owner will have been and will continue to be under immense pressure to generate practice income, and we need to be sensitive to the stress they continue to experience. I hope we’ll collectively feel driven to get the practice back on its feet and work efficiently.”

Mr Rose is optimistic that the industry will eventually see benefits come from practices’ prolonged closures: “It's bringing the practices together, the profession together, in many ways,” he says, “and certainly changing the way we work and the risk versus reward.”

He adds: “It’s all about changing the way we work, being proactive, and challenging everything we do.”

Ms Smith-Jaynes also believes that the long-term outlook can be positive, as long as practices are willing to adapt. She says: “There may be a rise in support and sympathy for the small businesses on the High Street and conscientious buying from those who can afford to choose. Others will be on a budget and will buy cheaply from whomever is offering. There has been a decline in independent practices for some years now and I expect we will continue to lose some. The remaining ones will be strong and adaptable, and I hope they can shine through.”