On the frontline 12: Keeping healthy and safe in the optical practice

What non-optical legislation should we be aware of? 

We cover health and safety in the Level 3 optical assistant (OA) apprenticeship but what do OAs based in an optical practice need to learn and why? 

All practices have legal obligations under the Health and Safety at Work Act (HSWA) 1974. It is the most important and main piece of health and safety at work legislation – it is updated twice each year. 

The Act has two main objectives: 

• To protect all people at work
• To protect people not at work from those who are 

The Act applies to all workplaces regardless of their size and makes all employees responsible for health and safety – it is not only the responsibility of managers and employers. 

I have tried to identify the main regulations that effect optical practices and this is my list: 

1. Management of Health and Safety at Work Regulations 1999 – This includes implementing proper disposal methods for controlled, clinical and offensive materials
2. The Workplace (health, safety and welfare) Regulations 1992 – Some examples include implementing measures to prevent slips, trips and falls, such as proper flooring and clear walkways. Ensure safe entry and exit points in the practice. Take precautions against falling objects, particularly in storage areas. Provide adequate restroom facilities for staff and patients. Ensure availability of drinking water and areas for staff to take breaks and eat meals.
3. The Health & Safety Display Screen Equipment (DSE) Regulations 1992 - Patients using computers and other display screen equipment, must comply with the Health and Safety (Display Screen Equipment) Regulations 1992. This involves conducting DSE work station risk assessments and providing eye examinations.
4. Personal Protective Equipment (PPE) at Work Regulations 1992 amended 2022 – All employees must be provided with appropriate PPE at no cost to the employee.
5. The Manual Handling Operations Regulations 1992 – The Manual Handling Operations Regulations 1992 (as amended in 2002) are designed to prevent injuries caused by manual handling activities in the workplace.
6. The Provision and Use of Work Equipment Regulations – The Provision and Use of Work Equipment Regulations 1998 (PUWER) are designed to ensure that work equipment is safe and suitable for its intended use. In an optician’s practice, these regulations apply to all equipment used by staff, including diagnostic tools, machinery and general workplace equipment. 
7. The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (Riddor) – Reporting of injuries, diseases and dangerous occurrences with more serous occurrences or near misses reported to the Health and Safety Executive.
8. The Working Time Regulations 1998 – Maximum working week (48 hours), rest breaks, daily and weekly rest periods and paid holiday entitlement. 
9. Control of Substances Hazardous to Health 2002 (COSHH) –  Control of substances hazardous to health – keeping substances locked away from members of the public, those with allergic reactions and individuals not trained to handle them. This can include acetone, lens cleaner, contact lens solutions (eg hydrogen peroxide), ophthalmic drugs and general cleaning products.
10. The Environmental Protection Act 1990 (EPA) –  The EPA covers waste management in England, Scotland and Wales. It makes the rules for waste management. This includes legal responsibilities for waste collection, removal and disposal, including the disposal of clinical waste. All businesses that produce, move, store, treat, dispose of, or recycle waste must comply with the EPA. 

In the optical industry we now more than ever are trying to back sustainability, particularly with our high use of plastic and finding novel ways of reducing usage. 

What must we do in practice to legally be safe to open our doors? 

Basic health and safety obligations of employers summary” 

• ‘What you need to know’ HSE poster clearly displayed with all sections completed
• An up to date COSHH assessment
• An accident book,
• Fire risk assessed (see below)
• Appropriate fire extinguishers, 
• Clearly signed and unobstructed escape routes 
• Smoke detectors, fire alarms, and emergency lighting maintained/tested regularly.
• PAT (portable appliance) testing now replaced with Inspection and Testing of Electrical Equipment (ITEE) Nov 2024 (BS7671)
• Practice risk assessment has been carried out 

All employers have responsibilities towards their staff and patients in relation to safe working practices and safety at work. 

Carry out a risk assessment 

Why do UK optical high street practices have risk assessments? This is a legal requirement under health and safety laws such as the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999. 

Here is why risk assessments are critical in optical practices: 

1 Patient safety 

• Clinical procedures: Optometrists and other optical professionals perform clinical tasks, such as eye examinations, contact lens fittings and diagnosing eye conditions. Any errors or oversight can pose risks to the patient’s health, so risk assessments help identify and mitigate potential hazards. 
• Infection control: The use of shared equipment (eg slit lamps, ophthalmoscopes, tonometers and rigid gas permeable contact lens fitting sets) can spread infections if not cleaned properly. Risk assessments are essential to ensure that hygiene protocols are followed, reducing the chance of cross-contamination.
• Emergency situations: Risks, such as medical emergencies (eg a patient fainting or having a sudden allergic reaction), need to be identified. Having clear procedures in place can help staff react swiftly and appropriately. 

2 Staff safety 

• Workplace hazards: Optical practices involve a range of potential hazards for staff. This includes the use of tools, the risk of repetitive strain injuries from extended periods of close work, or exposure to hazardous chemicals (eg some lens-cleaning chemicals, fumes from tint baths and lens edging). Risk assessments help identify these dangers and guide how to avoid or reduce the risks. 
• Ergonomics: Because optometrists spend long hours potentially leaning over patients while performing eye examinations, this can lead to musculoskeletal problems. Risk assessments help in assessing and improving workstation design and practices to minimise strain. For example, using a phoropter rather than retinoscope/trial frame. 

3 Fire and environmental hazards 

• Building safety: Any premises, including optical practices, must comply with fire safety regulations. A risk assessment helps to identify fire hazards, emergency evacuation routes, and ensure that appropriate fire-fighting equipment (extinguishers/fire doors) are available and functional.
• Environmental hazards: Risk assessments can help identify environmental factors in the practice, like poor lighting (lack of emergency lighting), temperatures being either too hot or too cold, which could affect staff and patient health and safety. 

4 Regulatory compliance 

• General legal requirements: The Health and Safety at Work Act and other relevant legislation require employers to take a proactive approach to identifying and managing health and safety risks. Failure to conduct risk assessments could result in legal consequences, including fines or closure. 

• Professional standards: Optical practices are also regulated by professional bodies such as the General Optical Council (GOC) and College of Optometrists, which require that practices demonstrate proper safety standards. Risk assessments are part of meeting these professional obligations. 

5 Insurance and liability 

• Insurance requirements: Insurance companies often require documented risk assessments as part of the policy. A risk assessment may help reduce premiums by demonstrating proactive safety management. 
• Contract compliance: General Ophthalmic Services (GOS) contractors are audited by the NHS. Health and safety compliance is an important part of the inspection process and losing its GOS contract could be catastrophic for any optical business.
• Reducing liability: By identifying and addressing potential risks, optical practices can reduce the likelihood of accidents, which can be costly and damaging to their reputation. 

Maintain the health, safety and security of yourself, customers and others in the workplace by identifying risks and taking appropriate action to keep people safe. 

To keep yourself, staff and the public safe in practice there are a number of things we should carry out in order to comply with health and safety laws and regulations. We should: 

• Carry out annual risk assessments and keep logs as proof of completion. Risk assessments should be updated whenever new procedures or new equipment are brought into the practice, so that any knock-on effects can be looked at. 
• Maintain all optical equipment regularly and keep service logs of maintenance carried out and any replacement parts/consumables required.
• First aid trained persons must be on site and be able to administer basic first aid if required.
• Maintaining good personal hygiene – washing hands regularly and where required, using hand sanitising liquid in between. Making sure any cuts, sores or open wounds are also kept clean and covered at all times.
• Keeping the practice clear at all times of items that can cause an accident or near miss. For example, clearing full or empty boxes away from the shop floor, no loose carpet tiles or edges, chairs put back neatly under desks.
• Ensure ophthalmic drugs are stored under lock and key and where appropriate refrigerated, in a separate fridge to that used for staff lunches. 

How to use and maintain optical equipment 

All staff must be fully and accurately trained on how to use all optical equipment in practice and must not attempt to use or move any equipment without proper training. This includes tools for glasses repairs and adjustments, optical machinery used for pre-screening and sight tests.  

This is to ensure they are used safely and properly with no risks to the staff or patients while in use. Machines must: 

• Be cleaned before and after each patient with anti-bacterial cleaning wipes. They should also be cleaned in front of each patient before operation – be seen to be clean. 
• Be regularly properly maintained by a trained professional and maintenance logs must be kept on site detailing what has been carried out and when.
• Have bulbs, fuses, paper rolls and ink topped up and changed when required. 
• Have chin and head rests adjusted before being used by the patient to avoid an injury or near miss. We must also inform a patient of a possible flash before for example if a fundus camera is used as the patient may be light sensitive or epileptic. 

First aid procedures, accident and incident reporting and evacuation processes 

All staff must know where the nearest fire exit and call points are to the store in case of emergency. They must also be aware of the specific evacuation procedures, the primary and/or secondary assembly point and who to report to for confirming attendance. Be aware and, if needed, able to identify and operate the correct fire extinguisher for the fire. First aid trained persons must be able to:  

• Carry out basic first aid to someone who may need it and be able to put them into the recovery position before emergency services arrive.
• Know where the first aid kit is kept and how to fill out the accident log including patient details, time and date of incident, nature of incident and any witnesses involved. 

In summary, health and safety laws and procedures are fundamental to ensuring that optical assistants in retail environments can work safely and effectively. These laws cover a wide range of areas, from physical safety and hygiene practices to mental well-being and customer safety.  

Manager perspectives 

‘My apprentice carrying out this research has proved really useful in our practice, I’ve basically used what she produced for her assignment for my staff training, which I often find I can do with the apprenticeship course materials’’ 

‘I am quite new to working in an optician’s practice and I did not realise that everyone in the practice is responsible for health and safety and noticing/removing potential hazards.’  

• Tony Douglass currently works part-time at UCLan as a lecturer in ophthalmic dispensing and part-time as a tutor on Training 2000 level 3 Optical Assistant apprenticeship.  
• Douglass designed, developed, and managed the level 3 Optical Assistant Apprenticeship course at Training 2000, and was involved in the development and delivery of the benchmark Btec level 4 certificate in optical dispensing, which started hundreds of students’ careers in optics with around 70% of students going onto further study as a dispensing optician. Douglass is also an experienced author and presenter of CPD lectures and discussion workshops with audiences of up to 500. He also previously worked as a part-time lecturer in ophthalmic dispensing at Anglia Ruskin University.