General Optical Council: Commercial practices and patient safety in the primary eye care sector (23 September 2026)

Summary

The General Optical Council (GOC) commissioned Shift Insight to carry out research to explore how commercial practices in primary eye care may affect patient safety, patient experience and the working lives of individual registrants. This work forms part of the GOC’s wider thematic review of commercial practices and patient safety.

The research focused on four areas identified by earlier GOC work:

• booking practices (including overbooking, rolling clinics and ‘ghost clinics’)

• short sight test times

• sales targets and incentives

• price transparency.

Fieldwork involved in-depth interviews with four stakeholder groups:

• Individual registrants – optometrists and dispensing opticians

• Business registrants – owners, directors and practice managers of GOC-registered optical businesses

• Non-registered eye care staff – for example, optical assistants

• Patient representative organisations – Healthwatch, Royal National Institute of Blind People (RNIB), Thomas Pocklington Trust, SeeAbility and Glaucoma UK.

Content

The report found:

• Across all stakeholder groups, booking practices, sight test times, sales targets and price transparency were seen as interlinked and shaped heavily by the low NHS General Ophthalmic Services (GOS) sight test fee in England, which was thought to drive a reliance on retail income. Comments on GOS were largely from participants in England. Some individual and business registrants in Scotland and Wales said their NHS contracts reduced retail pressure.

• Many business registrants felt that commercial practices such as overbooking were not only essential to remaining financially viable, but also had positive impacts on patients by ensuring wider access to care.

• Individual registrants and patient representative organisations more frequently described risks of commercial practices linked to rushed communication, reduced patient understanding and reduced likelihood of returning for routine care. While these were not felt to pose immediate safety concerns, they were said to have meaningful long-term risks to eye health.

• ndividual registrants and non-registered staff reported that high patient numbers, short sight test times and sales pressure contributed to personal stress, missed breaks, burnout, and some optometrists and dispensing opticians choosing to leave multiples or the profession altogether.

• While commercial drivers were largely thought to sit outside the GOC’s remit, many stakeholders believed the GOC could strengthen its stance on expectations for safe practice in commercial environments, as well as being more vocal in supporting wider sector change, such as lobbying for change to funding structures.