Commercial practices and patient safety: a thematic review (General Optical Council, October 2026)

Summary

The General Optical Council (GOC) is undertaking a series of thematic reviews to support delivery of their strategic objective to ‘prevent harm through agile regulation’. The first thematic review, carried out during 2025-26, looked at commercial practices and patient safety in eye care services.  

Content

The commercial nature of eye care services is an inherent feature of the sector. When it operates well, this brings several benefits for patients including by spurring innovation that widens access to services and improves the quality of care. However, before undertaking this review, our research and wider engagement highlighted that some commercial practices could pose a risk to patients and potentially put undue pressure on registrants. 

The aim in carrying out this review was to help us understand the nature and extent of these practices and their impacts, and to identify any interventions that GOC and the wider sector could take to help mitigate against these.  

The review considered five key areas:  

• sales targets and incentives 

• booking practices 

• sight testing times 

• transparency of pricing and NHS financial support  

• sight tests for young children aged 0-5 years.   

Key findings 

The review identified: 

• Widespread concerns among registrants about their ability to deliver safe patient care, despite high levels of patient satisfaction and public confidence in eye care services.  

• Concerns about stress and burnout among registrants in the face of workplace pressures, including high patient volumes and target-driven environments, with students and early career professionals particularly affected. 

• Barriers that may discourage some people from accessing eye care services, with potential implications for longer-term eye health outcomes. These include a lack of online price transparency and information about eligibility for NHS financial support, concerns about pressure selling deterring people from routine sight tests, and a minority of businesses not providing sight tests for young children.  

• No direct evidence that commercial practices are causing harm to patients, although limited data on patient outcomes makes their impact on patient care difficult to assess. 

Recommendations and next steps 

The report concludes that addressing the issues identified will require action across the sector. While regulation has an important role to play, it highlights the need for strong leadership, positive workplace cultures and environments that support registrants to raise concerns.  

The GOC's planned work includes reviewing the Standards for Optical Businesses and supplementary guidance, as well as working with education providers to ensure newly qualified professionals are equipped to manage commercial pressures whilst maintaining safe patient care.