Clinical services and care for the community

OT asked experts in retail for the context, and heard from practices about the challenges, what optometry brings to communities, and the initiatives that could help to turn the fate of the High Street around.

High costs and low confidence

Andrew Goodacre, CEO of the British Independent Retailers Association, told OT: “High Streets are integral to communities for providing essential services and creating a sense of belonging.”

A combination of low consumer confidence and high costs are putting pressure on the High Street. Goodacre said: “This year alone, we have seen a 135% increase in business rates, 7% increase in national living wage, significant increases in national insurance contributions, energy costs remaining very high and rents increasing. High Street businesses want to remain competitive, but the profit margins are decreasing all the time.”

Measures that could support the High Street would include “true business rates reform,” as well as a focus on safety to reduce anti-social behaviour and retail crime.

Optometry practices play a vital role in the diversity and services in this space, with Goodacre sharing: “Offering essential services is crucial. I believe we could have more health services on our High Streets and in our small towns. They are great for footfall, giving people a reason to visit, and optometrists are an important essential service.”

Valli Opticians, Blackburn: Clinical and community-based

Nazmeen Ahmed, is an optometrist and joint venture partner at Valli Opticians on Richmond Terrace in Blackburn. The practice has been established for more than 40 years, initially as AJ Spurrett Opticians. It was acquired by Valli Opticians in 2012 and became the company’s first joint venture partnership in 2018.

Discussing the role of optometry practices in a High Street setting, Ahmed told OT: “We view our role as both clinical and community-based. As a local healthcare provider, we contribute to the wellbeing of residents while also supporting local initiatives, schools, and charities.”

“Our long-standing presence has allowed us to build multi-generational relationships, reinforcing our commitment to the communities we serve,” she added.

Across the group, 17 practices are located on High Streets, in shopping centres, and in village settings. Ahmed said: “Each location reflects the character of its local community, and we value the individuality of every area we serve.”

Our long-standing presence has allowed us to build multi-generational relationships, reinforcing our commitment to the communities we serve

Ahmed told OT: “Independent practices, particularly those on High Streets, face increasing competition from large retail chains and online eyewear providers. Rising operational costs – including rent, staffing, and utilities – further add to the pressure.”

Maintaining a balance between providing high-quality, personalised clinical care, and ensuring commercial sustainability, is a challenge for many independents, she said.

In a practical sense, improvements such as parking facilities outside of the optical practice would make access easier, particularly for patients with mobility challenges or visual impairment, Ahmed noted.

She also suggested: “Collaborative local initiatives that encourage residents to support independent businesses can have a meaningful impact. Community events and partnerships between local enterprises, councils, and residents can also reinvigorate High Streets and foster a renewed sense of civic pride.”

Decreasing footfall

The British Retail Consortium (BRC), an association for UK retail businesses, tracks footfall across High Streets, shopping centres, and retail parks in the UK.

Out of these areas, the BRC has found that High Streets are consistently the most poorly performing, with September figures showing a 2.5% reduction in footfall on the High Street (year-on-year).

Business rates continue to be a major issue for businesses on the High Street.

Guy Leman, senior communications executive at the BRC, described it as a “broken, outdated system.”

He shared statistics from the organisation that found: “In the last five or six years, that in 60% of shop closures, business rates has played a significant factor in the decision making.”

Consumer confidence has also been affected coming out of the pandemic, with energy prices rising, and political uncertainty adding to a reluctance to spend.

People know we will look after them

Wilkie’s Eyecare, Alexandria: Consistency of service

Wilkie’s Eyecare has been meeting the vision needs of patients in Alexandria in West Dunbartonshire for more than 60 years.

Practice director, Sian Wilkie, explained that what the practice brings to the High Street and local community is “consistency, professionalism, and service,” adding: “People know we will look after them.”

Wilkie described the challenges posed to businesses in the town centre from a lack of investment and footfall. As an independent practice, Wilkie’s Eyecare faces challenges in attracting new patients, competition with multiples, and from online sales.

Considering what could make a difference for businesses based on High Streets, Wilkie said: “Social media, customer service, and loyalty go so far. But the challenge that faces our High Streets is the lack of responsibility taken for its success.”

Wilkie was successful in a campaign to have Alexandria recognised as a Business Improvement District (BID), through which businesses can pay a levy to help implement positive changes.

“My drive was to save our Main Street. Alexandria still has a good number of small independent businesses, but we are all struggling,” Wilkie said.

Becoming a BID gave local businesses a voice, Wilkie said: “It also gave us influence on where money should be spent and opened the door to bring in positive changes like our seasonal market days. My ambition is to get businesses to fully realise what we can do when we work together and that our community will support us if we ask them to do so.”

Engagement from all businesses may take some time, as business owners are “tired of being let down,” Wilkie said, but added: “We hope that the BID will start changing people’s opinions and breathe new engagement from businesses and the community.”

The BID has planned a Christmas light switch-on event, which has garnered community support.

Wilkie added: “We have also been able to secure funding from West Dunbartonshire Council to start improvements to Main Street, which are currently at the consultation stage.”

Remaining optimistic as a trusted service

Andrew Bridges, director of professional services at Leightons, shared: “The landscape for High Street optometry is evolving fast, and the pressures facing independent practices are significant.”

Bridges described the challenges that have faced practices arising from increased operational costs, declining footfall, the convenience of online shopping, alongside the wider economic climate and cost-of-living pressures.

Bridges said: “Many more people are understandably more cautious with their spending – even when it comes to essential eye and hearing care.”

The challenge is in adapting without compromising, he suggested, sharing: “We’re continuously investing in training, technology, and patient experience to make sure every visit feels worthwhile – not just as a check-up but as an important part of their overall wellbeing.”

“Despite the challenges, we’re optimistic. There’s a huge opportunity to reimagine the High Street as a place for experiences, connection, and trusted local services,” Bridges told OT.

He continued: “Independent optometry practices like ours already play a key role in that transformation. We offer something online retailers can’t – expert clinical care, genuine human interaction, and a sense of continuity that’s rooted in the community.”

We believe practices like ours will remain anchors of trust and expertise – blending medical precision with genuine human care

To support businesses in the future, Bridges suggested more support and investment directed towards making town centres accessible and attractive could encourage people to spend time locally.

Collaboration with Integrated Care Boards could also help drive positive change on a healthcare level, he noted.

“By supporting shared-care schemes and recognising the value of community optometry, we can provide accessible, high-quality care in familiar settings, helping to reduce pressure on other parts of the NHS,” Bridges said.

Reflecting on the place for optometry practices as part of community High Streets, Bridges commented: “As the High Street continues to evolve, we believe practices like ours will remain anchors of trust and expertise – blending medical precision with genuine human care, and helping people live their lives to the fullest.”

Vision Express Gloucester: bringing the High Street to life

Saleem Patel, optometrist and director of Vision Express Gloucester, has observed regeneration efforts in the local area with new and recognisable retailers opening on the High Street.

The practice, which has a 30-year history in the town, recently moved from a shopping centre to a space on the High Street, and has seen a lift in footfall.

Commenting on the regeneration efforts, Patel told OT: “You do see there is a lot of work being done on the High Street, and there has been more activity in the last 18 months than there has been in the past.”

“Hopefully, we as a business are a contributor to bringing the High Street back to life again,” he said.

Patel has seen first-hand the effects that optometry practices can have on fellow businesses.

“When we left the shopping centre, the manager of a neighbouring cafe told me, ‘Now that you’ve gone, I’m going to lose a lot of my customers that come for a coffee when they are in for an eye test,’” he shared.

The practice runs four or five clinics daily, Patel said, with patients often attending appointments with partners, children, or parents.

He said: “That’s driving more people into the town centres, hopefully using other services that the town has to offer, not just the services we have.”

SeeSaw Opticians, Kings Heath: Informing and educating

SeeSaw Opticians in Kings Heath was established in 2018, but optics has been in Adam Georgiou’s family for 80 years.

In recent years, Georgiou has recognised a shift in consumer behaviours and expectations. Initially after the pandemic, there was a general trend towards health as a paramount concern for consumers, he noted, but that has changed in the years that followed.

Georgiou said: “I’ve noticed a pattern where people’s expectations of how long things should take has altered massively,” likening this to an ‘Amazon-mindset.’

He also highlighted a lack of understanding of the role of optometrists, sharing: “I don’t think enough has been done to escalate the importance of who we are and what we do.”

Georgiou reflected: “If I had a magic wand, I would love people to be advised and educated of the importance of optometry practices – to get people to the High Streets to understand that, without your local optometry provider, where would we be?”

Online retailers pose a particular challenge for independent practices, while the rising costs of running a business are a concern – and reflected across the broader High Street.

Georgiou explained: “With everything going up, we’re seeing a demise in how many shops are on the High Street. Where once we were bouncing off the Argos and the Burton and all the multiples that were helpers but weren’t in optics – the High Street would pull people in. It was almost like an Aladdin’s cave.”

Now ‘to-let’ signs and eateries abound, and the volume of footfall has dropped.

Collaboration and community engagement could support change, Georgiou suggested, recognising the potential for optometry practices in this area to provide health education, support local events, and partner with other businesses to promote the High Street.

SeeSaw Opticians has always been involved in organising events and activities for the local community, including hosting the Community Day Out in Kings Heath.

Frames are showcased, education leaflets are handed out, the optometrist and dispensing optician are on-site, and fun and games are held.

Kings Heath is a low traffic neighbourhood, and so the practice arranges for a food van and trampoline to be set up in the street.

Georgiou said: “We reach out to the other independents to say: ‘we’re all unique in what we offer, but we’re strong together and if we can unite as independents, we can make a real difference’.”

Optometry practices as community anchors

Sarah Joyce, director of optometry at Specsavers, highlighted: “Optometry practices are more than healthcare providers – they're community anchors. They offer trusted, accessible care that improves lives, supports the NHS, and brings people into town centres.”

Practices contribute to the local economy by creating jobs, offering career pathways, and investing in bricks and mortar spaces that enhance the High Street experience, Joyce added, noting that Specsavers’ investment in the High Street supports local economies through footfall as well as retail and clinical roles.

“They also play a vital social role – supporting people experiencing homelessness, visiting schools and educating children on the importance of eye and ear health as well as fundraising and volunteering, and supporting local sports teams, organisations and events,” Joyce shared.

The optometry workforce has the technology and skills to support the NHS with services in primary care.

Joyce said: “Our communities deserve equitable access to services for eye and ear health on our High Streets. Ending the current postcode lottery, particularly in England, will help avoid preventable sight and address hearing loss.”

“Community optometry and audiology are already a High Street success story, delivering vital care closer to home, but there’s scope to go further,” she added.

The desire from NHS leaders and policymakers to shift services from hospitals into community care provides a “golden opportunity” to embed optometry further into neighbourhood health models, Joyce shared.

“If commissioned consistently, services like glaucoma monitoring and urgent eye care could transform access while helping support High Streets,” she said.