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A flagship for independent UK optics a model practice that's difficult to fault and the kind of practice anyone would aspire to visit or work for - that's how the judges of the 2008 Independent Practice of the Year described this year's winning entry.
BBR Optometry was founded in Hereford nearly 40 years ago and has delivered a high standard of care, both specialised and general, to its patients over those years. From OCT retinal examination to pre and post-Lasik assessment, the practice offers an extensive menu of clinical techniques. But managing director Nick Rumney argues that, while laudable, this is ultimately of limited value without other components soundly underpinning the success of the business.
The practice took the decision back in 1989 to move away from what Rumney describes as 'the single item of service, known as the sight test'.
He continues: 'In 1999, the reversion to free of charge sight tests led directly to us clearly differentiating the NHS sight test as a fundamentally flawed and limited process, and to offer our NHS patients the opportunity to choose their level of care,' he explains.
BBR's private eye examination costs £41 and may include pupil dilation, retinal photography, slit-lamp examination, pressures and fields. Adult patients eligible for NHS sight tests are asked to pay an additional fee of £21 to provide these extra services, which the practice believes are essential for a comprehensive eye examination. Supplementary diagnostic examinations such as gonioscopy, pachymetry and DVLA fields are charged at £21 each, or £30 for two or more techniques.
Not everyone pays the full charges or has the extended examination. NHS patients can opt for a 'basic NHS test' when they book an appointment, and there is a lower charge for under-21s not otherwise eligible for NHS help. The practice also points out that visually impaired patients (under a low vision scheme) and those under active hospital care are often adequately covered by the NHS sight test, and most children do not need the extended examination.
Going that extra mile
So are patients prepared to pay extra and what effect has this had on the business?
Rumney says that as recently as two years ago, 20 per cent of adult NHS patients had opted for the extended examination but today uptake is 62 per cent, with a target of 75 per cent by September this year. This system, along with supplementary fees for repeat fields and pressures, and charges for specialist services such as low vision and dry eye assessment, has increased the fees-based element of practice turnover from 8 per cent to 21 per cent within just three months.
Offering either a 40-minute extended examination or 20-minute basic test when the appointment is booked, rather than leaving discussion of the assessments required until the patient reaches the consulting room, has been one of the reasons for this success.
At the same time, BBR has invested heavily in equipment and a wide skills base. The latest addition has been 3D-OCT and a new combined instrument for more effective pre-screening is about to be road-tested. The practice employs five optometrists, dispensing staff are all qualified and clinical assistants hold the diploma in Clinical Assistants in Optometry. Staff are involved in key organisations in the area, including the Local Optical Committee, Victoria Eye Unit and Herefordshire Primary Care Trust, plus being members of national optical and optometric professional bodies.
The practice is firmly established in the local community having originally been founded by optometrists Angela and Peter Bishop in 1969. Fifteen years ago it took on a new partner to become Bishop, Bishop & Rumney. In 2005, the Bishops retired from practice and a year later the name was changed to BBR Optometry, conveniently derived from the names of the three then directors, Stephanie Bonner, Nicholas Black and Rumney.
Bishop, Bishop & Rumney had used the title optometrist for nearly 20 years to describe their work. Changing its name to BBR Optometry allowed the practice to focus on the fact that it has grown into new clinical areas, and dropping the names reflects the contribution of a diverse practice team with a variety of skills rather than the partners alone.
The practice was one of the first in the UK to win an Eye Care Award, taking Specialist Practice of the Year in 1995, and Rumney went on to receive the Contribution to Optics Award the following year. But he says that winning two Optician Awards this year - BBR also won the Business Initiative Award - has given the whole team the strength of knowing that the direction the business is heading in is indeed the correct one.
'You can aim for a high level of clinical excellence and make it,' he observes. 'People keep telling us you can either go for clinical or commercial but not both - I don't necessarily believe that's right.'
Winning the awards and being able to take the whole staff along to the ceremony has also been hugely motivating for the team.
'It's sent a real buzz through the whole practice,' says Rumney. 'Everyone from the cleaner to the directors knows they've contributed.'