PRACTICE MATTERS
Developing thoughts This month, Phil Mullins looks at the benefits and logistics of going fully private
Are you ready to go private? Since the moment that the universal NHS eye examination was removed, and Margaret Thatcher said that a private eye exam would cost around £10, the optical profession has been fighting for the NHS to pay a fair and reasonable fee for general ophthalmic services. Obviously, we have not been helped by elements of our profession giving their services away for free, but what is the alternative? During the Covid-19 pandemic, there have been a growing number of voices contemplating going totally private, particularly as the NHS has been painfully slow in responding to our profession or recognising the importance of frontline optometry and the part it plays in the nation’s overall health. This has forced many to look at those practices that only deal with private patients, and wonder whether this represents the future for independents in the UK.
DO YOUR HOMEWORK However, before plunging headlong into changing your entire business model, you need to consider certain issues – and whether you can overcome them. The first big question is: do you really want to see only private patients? Do you really want to cut off a complete section of your community? Of course, some over 60s are happy to pay for private care, but many can’t afford it. And what about children? This is before you look at families, many of whom may have lost their income during the pandemic. Are you going to leave these patients to the multiples? Secondly, do you have enough private patients currently to survive? Although you will attract new patients, you will rely heavily on your current patient base – at least initially. Your average annual patient spend will be higher, but you will be seeing
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Vision Now SEPTEMBER 2020
fewer patients. This calculation has changed post lockdown, with many practices seeing far fewer patients; however, the conversion rate is very much higher and, in many cases, average dispensing values are up too. This may not continue as the world returns to normal, but it does show that fewer patients can still work as a business model. The next step is to get a real grip of your costs, so you can calculate what to charge. Bear in mind that you may have to extend your examination time and possibly invest in higher grade equipment if you are charging higher private fees. Once you have calculated how much to charge, and how many patients you will need to see, look at how you will collect the fees. Will it be pay as you go, or via payment plans? Will you spread payments over a period with a third party, such as Eyeplan or Iris Vision Care, or via your own direct debit system? Only having done the due diligence outlined above should you look to go totally private. If you do head in that direction, make sure you consider staff training, marketing, and how to communicate your plans with your existing patients. What will you do about the children of your private patients? Will you alter frame prices? And most importantly: do you have a plan B?
SOFTLY, SOFTLY APPROACH But why go totally private? Why not wean yourself off your NHS reliance, and move a larger proportion of patients to private elements of your business? Having a form of payment plan is essential as it enables you to increase income, add loyalty and differentiate from the NHS offering. It also enables you to build private services such as dry eye, glaucoma and diabetic monitoring, myopia control lenses for children, and ortho-k for vision correction.
If you’re thinking about locking out NHS patients: be prepared
All of the above are private services, which can be charged at a correct level without having to discount a single pair of spectacles. When you sign up patients to a fees plan covering their eye examinations, make sure that it offers value. Include fundus image or optical coherence tomography, annual examinations, and extended payment options for spectacles. And if you want to, lower prices on the spectacles themselves. You will also need to consider how to handle NHS upgrades. Do you simply take what you can claim off the total, or do you promote an upgrade price? It might end up being the same financially, but it’s how you promote it to patients that is important. As you can see, there are many things to consider regarding going private. I do believe that the future of the independent market is towards the private end of the market, but it will be alongside a mix of NHS patients, with either full or partial NHS funding, which will enable you to offer your clinical care to the wider elements of your community. In the meantime, let’s hope that the NHS will see sense and begin to recognise the importance of eyecare and increase the funding, which will help the whole profession and industry.
