The changing face of the High Street (2024)

When a person is lucky enough to live to 100, alongside the steady procession of baked goods, flowers and a card from the King – there is one inevitability.

Questions. What is the secret to a long life? Was it the morning tai chi or the long walks through the dales? The daily crossword or a positive outlook? Perhaps a nightly whisky is the key to a birthday cake that treads the line between celebratory treat and fire hazard.

For this edition, OT explores the question of High Street longevity by speaking with staff from longstanding optometry practices across the UK about what they believe has contributed to their practice’s success.The future of the High Street is also examined by investigating how technology is changing care – and how the optical regulator is working to catch up with the changing landscape of online sales.

The centenarians

We’re quite grounded people – we like to be involved in every aspect of the patient experience

The optometrist duo worked alongside each other for 11 years before Alan’s retirement.

“We had a very gradual transition period, trying to get to a point where the we were ready and the patients were ready,” Lucy shared.

As a newly-qualified optometrist, Lucy observed that there can be a temptation to get through the different elements of the sight test quickly. But through observing her father, she learned the importance of taking time.

“When dad and I were working together, I would see him bringing in his patients. And then I would happen to pass the corridor around 20 minutes in to hear him say, ‘So, how are your eyes?’,” she said.

Alan shared with OT that he never cut corners with the time allocated to the eye examination.

“You need to take the time to listen to what they have to say,” he said.

“If you try and rush through you will not get that picture of the individual you’re dealing with,” Alan highlighted.

Alan remembers how his father, Cecil, would come home after a day examining eyes to do a further hour of work at a card table. “He was a very honest gentleman, always very well dressed,” Alan recalled.

The pair worked together for a decade before his father’s retirement, with Cecil remaining actively involved until the age of 78.

As the first chairman of Optometry Northern Ireland, Alan has welcomed the evolution of optometry over the course of his career to provide more care in the community and relieve pressure on secondary care.

“Those who are training to become optometrists now have arrived at a great time now that we’re much more recognised as a primary care provider. That was not always the case,” he said.

Alan qualified in 1976 after completing his training at City, University of London and his pre-registration year at the London Refraction Hospital.

He returned to Belfast to begin work at the family optometry practice during The Troubles.

“It was a strange experience. I spent four years in London, and came back into the middle of what might have been described as a war zone,” Alan shared.

A former practice in Bangor was obliterated after a bomb was placed outside the door. No one was in the practice at the time and there were no injuries.

The incident that sticks out in Alan’s mind occurred at the Belfast city centre practice one night after the shutters had been drawn and the business was closed for the day.

The practice bookkeeper was sitting at a desk by the window, and Alan had just sat down in his consulting room chair when a bomb went off on the other side of the city hall.

“All of a sudden, I was lifted off my seat and landed on the floor,” he said.

While neither were injured, Alan remembers his bookkeeper picking glass out of her hair. “When we pulled up the shutters, I heard an English accent from one of the soldiers across the other side going ‘Blimey, there’s somebody in there’,” he said.

The history of the practice can be traced through boxes at Alan’s home, with optical instruments dating back to the late 19th century, ingenious century-old advertisem*nts, and around 50 pairs of vintage frames.

On a holiday two years ago, Alan and his wife came across a black and white photo in a practice that was previously the Cork branch for Harris Rundle for more than half a century before being sold by Cecil to Patrick Crowley.

“I thought, ‘Oh my goodness, it’s my grandfather’,” he shared.

“There’s a nice sort of symmetry in that the practice is now run by his grand-daughter,” Alan observed.

While Harris Rundle was travelling the length and breadth of Ireland to oversee his many practices, across the Irish Sea in Wales, two brothers established Phillips Opticians in 1922 in Pontywaun.

Wilf Phillips, an optometrist, and Percy Phillips, a jeweller, developed a network of practices in the South Wales Valleys – with five remaining practices now run by dispensing optician and director, Lee Price.

Price originally joined the practice in 1996, attracted by the idea of working for a traditional South Wales Valley company with a premier reputation.

“There’s a real sense of community here,” he shared.

“Almost every day a patient will bump into a friend at the practice,” Price said.

He took over sole directorship of Phillips Opticians in 2019, less than a year before the first COVID-19 lockdown.

All but a small group of staff were placed on furlough – dubbed by their colleagues the ‘The Fab Five.’

Reflecting on the responsibility of steering the practice and his 21 team members through the pandemic, Price described the experience as a learning curve.

“It was a baptism of fire,” Price shared.

“We didn’t know what would happen next. We had to do whatever we could to keep ahead,” he said.

During lockdown, Caroline Jenkins was the sole optometrist working at Phillips Opticians – which acted as an eye care hub for the Caerphilly region.

She saw patients with everything from severe hay fever and gardening injuries to retinal tears and orbital cellulitis. Jenkins shared that reflecting on that time period feels surreal.

“It feels almost like another world,” she said.

“I was glad to keep busy and have a purpose. I didn’t want to let down the patients,” she shared.

After completing her pre-registration year with Phillips Opticians in 2001, Jenkins worked for a variety of independent and multiple practices before returning to the business in 2019.

“It was nice and straightforward. I slotted back in like I had never left,” she reflected.

Jenkins appreciates being able to spend time with patients – some of whom have record cards dating back to the 1940s.

“There’s definite loyalty. Often patients are quite proud that they've never been anywhere else,” she said.

Almost every day a patient will bump into a friend at the practice

When asked about the success of the practice, Price pays tribute to the value of longstanding employees. Practice administrator, Sue Winnel, has worked at the business for 50 years.

While staff are spread across five practices, they come together for birthdays and the annual Christmas party.

“We have very high staff retention. There’s lots of people who have been here for over a decade,” Price explained.

As a 14-year-old, Thomas Walls travelled from the Orkney Islands to Edinburgh. He initially apprenticed as a cabinet maker before becoming a scientific instrument maker, specialising in magic lanterns and ships instruments.

His ophthalmic and scientific instrument business, Thomas J Walls, was established in 1888.

Optometrists, George Rodger and Lyn Smalridge, who studied together at Glasgow Caledonian University, now lead the 136-year-old business.

Although the original Forest Road practice has now transformed into a coffee shop, it has kept the Thomas J Walls name – which is worked in marble on the front step and above the window – and interior features.

Smalridge, who started at the practice in 1983, recalls a dimly lit building with the floor space separated into testing cubicles by wooden panelling. There was no advertising in the window – only a black vase, which often did not contain flowers.

A heavy velvet curtain separated the public area at the front from the offices at the back.

“People would be waiting out front and suddenly staff would emerge from behind this red curtain as though they were coming from stage left,” Smalridge recalled.

Rodger, who joined the practice as a pre-registration student in the late 1970s, described his first impression of the practice as “Dickensian.” He encouraged staff to introduce new equipment – such as a slit lamp and keratometer.

People want accessible care. But they also want that personal touch

Smalridge, who had become accustomed to the bright lights and frame displays of Dollond & Aitchison in his previous role, was also a proponent of modernising the practice.

“There was certainly an initial reluctance to these young guys, as we were then, coming in and making all these changes, but it wouldn’t have survived otherwise,” Smalridge shared.

After working the practice for more than three decades, Smalridge and Rodger have seen third and fourth generations of the same family.

The great-granddaughter of Thomas J Walls, who is now in her 90s, would regularly come into the practice to have her eyes tested.

“She would tell us stories of her childhood sitting in the practice,” Rodger said.

While the practice has invested in new equipment, they have maintained a focus on a quality service.

When Rodger and Smalridge moved to their current Goldenacre Terrace premises, around 80% of their patient base followed.

“We’ve never advertised. We’ve never done sales or ‘buy one, get one free’,” Rodger highlighted.

“We don’t over-emphasise the commercial side of things,” he said.

This personal service sees them trust their patients to take two or three frames away without paying a deposit if they want to show their family members different options.

When it comes to the secrets of a successful, long-running business partnership, Smalridge reflected that because they had been friends at university, this formed a solid foundation for their business relationship.

“Over the years, we’ve been through all the various things in our personal lives – marriages, children being born, deaths. We’ve been through that together, so it is more than simply a working relationship,” he said.

“You have an appreciation for the person, not simply as a colleague,” Smalridge shared.

Rodger and Smalridge have overseen more than 12 pre-registration students during their tenure – some of whom have now retired.

While their own retirement is on the horizon, they want to ensure that people with the same values will write the next chapter of the practice’s history.

“Part of the reason that we’re still here in 2024, is that it has been trying to find the right people to carry it on,” Smalridge said.

“You’ve built the place up over 40 years, and you want to know that it is going into good hands,” he said.

Rodger observed that fresh ideas and leadership have helped to keep the optometry practice relevant throughout its history.

Thomas J Walls Jnr convinced his father to expand and modernise into the Forrest Road premises in 1934. Then Ronnie Anderson invested in frame and lens manufacture in the “post-NHS boom years.”

Contact lens pioneer, Stuart Macfarlane, who became a specialist in artificial eyes, went on to receive an OBE for services to optics.

“Now it is time for new blood with the enthusiasm of youth to carry on the legacy of all these decades,” Rodger shared.

A century in Aberdeen

Thoughts on the future

When it comes to healthcare, the personal, face-to-face element is crucial

He shared that patient behaviour has changed as digital technology has enabled people to access more products and services online.

“People love to shop for stuff in their jammies without leaving the house if they can. That’s fed into the way people want to access healthcare. They want it quickly, easily and remotely where possible,” Cameron observed.

During the pandemic, Cameron and his team invested in video conferencing software, cameras and headsets to enable patients to be triaged remotely.

His practice developed a set of written instructions for patients to follow when taking photographs or videos of anterior segment issues.

“We found when you do triage carefully – a thorough history combined with good quality smartphone images – you can actually manage a lot more than you think remotely,” Cameron shared.

However, he still believes that the dawn of a solely remote eye examinations is some way off.

“Although smartphones can do a lot, the sort of tech you need to examine an eye properly cannot be easily condensed into smartphone or certainly not for many years,” he said.

“More than that, when it comes to healthcare, the personal, face-to-face element is crucial,” he said.

The multiple view

Specsavers clinical efficiency lead, Phil Gray, told OT that the company carefully monitors how care is being delivered in developed countries across the world.

“In the US, for example, telehealth and more recently, teleoptometry, have been evolving for many years. If done in the right way, we believe remote care delivery will provide patients with better access to care in remote and rural locations,” he said.

Gray added that the General Optical Council (GOC) has recently proposed a new standard relating to how to utilise data in decision-making that has been generated by digital technology.

“This all points to the recognition that none of us can stop technology – rather we need to focus our work on finding how to use the appropriate technologies in a way that is most effective and beneficial for our patients,” he said.

Online contact lens sales

Given the popularity of changing the colour of your eyes, I think people need to be aware that these are not just aesthetic products

Chong added that two thirds of the websites examined through the research were run by companies operating outside of the UK.

He emphasised that the requirements under the Opticians Act – such as contact lenses being sold under the supervision of a registered eye care professional – are there for a reason. “Contact lenses are not risk-free. There is a risk of infection if we don’t use contact lenses properly, and if these contact lenses are of poor quality, it might pose a more significant risk,” he said.

Chong shared that on many of the websites, coloured contact lenses are advertised alongside cosmetic products – which may lead to the misapprehension that the lenses are not a medical device.

“Given the popularity of changing the colour of your eyes, I think people need to be aware that these are not just aesthetic products,” he said.

The role of the regulator