Adapting your optometry business in a cost-of-living crisis

Here, Garrey Haase and Mehul Patel spoke to OT about the changes they have implemented in response to these pressures.

Have you experienced any business impacts due to the cost-of-living increases in recent years?

Garrey Haase (GH): Business rates have gone up significantly, as have electricity and utilities bills, in the past two years. Whilst we can talk about the gross profit, and we can say that that has been quite good, the net profit has come down because of the additional costs to the business.

The biggest impact has been that we have to think very carefully about the staff, and the number of members of the team that we have. With National Insurance Contributions (NIC) increasing over the past 12 months and minimum wage going up over the past three or four years, we have had to make sure we can cater for the demands of the business, without going too heavy on staff numbers. The practice would benefit from an additional staff member, but the associated costs mean it’s not possible currently.

In terms of how our business is doing, I’m delighted to say that both practices are doing well. I think that’s because we have our niche: people know that we’re different to the average High Street practice. But of course, the margins and the profits have gone down.

Mehul Patel (MP): Generally, compared to where the practice was in 2012, we should have doubled eye test numbers. But actually, we are in decline.

That means that what used to cost X before, is now eating into practice profits. What I’ve done as a practice owner, to be resilient and stay on top of the game, is reduce my use of locums. If I have extra demand, I will employ a locum – that is the definition of locuming.

My wife is an optometrist, so she and I are able to take over testing in half-day or quarter-day clinics. We are lucky to be able to do this for the business. We are stepping in a little bit more, and I’m seeing this in other practices too, where directors are testing more than they were previously.

My wife is an optometrist, so she and I are able to take over testing in half-day or quarter-day clinics. We are lucky to be able to do this for the business

Has your local community been important in the context of the cost-of-living crisis?

GH: In Howden, we’re the only opticians in the town. We have been there 11 years, and over that time, we have built a very loyal base. We have a patient healthcare scheme, which lots of our patients are signed up to. That has been important, because it has meant patients do come back. They receive regular clinical appointments with us, which means that they visit the practice all the time – every six months, at least.

In Knaresborough, we struggled for a number of years because we were on the High Street, and the High Street is not a destination. It’s really a place people pass through.

In January of this year, we moved the practice to Market Place, which is more of a destination. People come here and wander around. Since moving, we have had more local people coming to see us. Obviously, it cost a lot of money to do that, but the impact is that, in the first three months, we had more new patients than we did in the whole of the previous year. We’re not the only practice in the town, but we have seen a huge uptake since we moved, because people are now aware that there is an independent. We are local – I live here, and that has been really important.

MP: We are in a shopping centre, which has extremely high occupancy. We’ve done pretty well, whereas other local shopping centres haven’t. I’m a great believer of having a shopping centre business rather than a High Street business, because there is more winter in UK than there is summer. If our weather turned into Mauritius tomorrow, I would move my business to the High Street. We always see a drop in footfall in the summer, but this is more than made up by footfall in the winter, when shopping centres thrive.

What are the biggest cost increases that you have seen in the past two years?

MP: Energy prices have gone up because we’re coming out of our fixed-term contract. The biggest bill was in April last year. Business rates have gone up – that’s the big one. Plus, in April 2025, we had our biggest ever NI bill, and I’m still holding that cost.

When you scale a business of my size, you’re going to have a massive output of NI. But I’ve only now, over a year later, seen the impact of NI, energy bills, and rates increases coming through. The rates have gone up again in 2026, and so has the minimum wage. Every time minimum wage increases by 6%, it is coming out of my net profits.

Is there anything specific you do to mitigate against cost-of-living increases?

GH: We have made sure that the heaters in both practices are on timers. We’ve made the staff aware that energy costs have gone up. We are making sure we watch what we use. At the end of the day, you still need to heat the building or make it cooler if necessary. We renewed all our electric contracts last year. We used an agent to make sure we got the best deal, rather than just shopping around ourselves, and that helped us.

Has the cost-of-living crisis had an impact on staff?

GH: It hasn’t been an issue. I’m fortunate that all of my staff are aware of the cost-of-living, but they also manage their finances well. Also, we’ve kept them well above minimum wage.

MP: Where costs and the wages have gone up, we have had to cut down on the headcounts where we need to. We made changes front of house – the demand is still there for phone calls and triage, but we have reduced our numbers. If my business had grown in time in relation to volume, we would have required more optical assistants, but I have fewer now.

Have you made any other business pivots to ensure that you can keep serving your patients in the same way?

GH: The biggest thing that we have done is promote our healthcare scheme. For a small monthly fee, all clinical appointments are free. We call it YES, which is the Yorkshire Eyewear Scheme.

Patients receive two optical coherence tomography (OCT) scans a year. If they are on contact lenses, there is a small additional fee, and their contact lens checks are included. Eye examinations are also included if the patient is private – obviously, we do NHS too. If patients join the scheme, they also get a discount on their glasses.

We don’t advertise it, but we also offer Direct Debit for patients who may be struggling to pay for their glasses. If somebody suggests that things are a bit tight, we take a deposit and then spread the cost over no more than six payments.

MP: The business pivot for me is that my wife and I can do a half-day testing day. If the needs of the business require a half-day clinic rather than a full day, for example on a Saturday, me and my wife are able to still enjoy our time with our family, but do the half-day. That is a big business pivot that we’ve made this year.

If I’m serving my patients’ needs, then I’m serving the business’ needs

How have you made sure you are covering your own business needs, whilst also making sure patients are still looked after in the way that you want them to be?

GH: The way I look at it is that if I’m serving my patients’ needs, then I’m serving the business’ needs. Ultimately, the business revolves around patients’ needs. We have always put the patient first. We have a very clear pricing structure for frames, and we don’t really deviate from that. We don’t give discounts unless you’re part of the scheme.

The other thing that we’ve done, in terms of business needs, is introduce myopia management. We now do a lot of myopia management, and that generates patient loyalty, and Direct Debits. We’ve also introduced a dry eye clinic. We’re investing all the time in technology and in schemes.

Since 2020, we have tried to get as many patients on Direct Debit as possible, because that then breeds loyalty. Patients then feel like they have an obligation to come to us, because they’re paying for it. We don’t have to open the doors, and we still get money coming in on that side of the business.

Something we introduced two years ago, because we see patients every six months for an OCT or a contact lens check, is book the next appointment before they leave their current one. Appointments are booked six months in advance. That also means we can manage our diaries much better.

A message to everybody is that, whilst it is tough, patients will stay if you offer the right service. If you look after your patients, your patients will look after you – that is what we have learnt. We all appreciate that the cost-of-living has gone up, but we’re very resilient. We’ve been through economic crisis before.