The care franchise

Historically, domiciliary eye care has had a poor reputation in optometry. The cause has not been helped by poor quality equipment, mass testing of residents, and even NHS fraud. Add to that a shortage of qualified domiciliary opticians and too many unsuitable practitioners who lack confidence for domiciliary eye care. Some practitioners are afraid of domiciliary eye care because of a lack of understanding or a bad initial experience. After qualifying, most opticians go straight into a high street practice and are never given the opportunity to work in a domiciliary environment. Few have used specialised on-site eye testing equipment, dealt with patients with dementia, physical disabilities or unusual pathologies, and until they are exposed to this approach and given the chance to build confidence many are understandably put off. The NHS's perception of domiciliary provision, whether by an independent or a domiciliary company, has not helped. The fees provided barely covered costs, therefore attracting a lower standard of care. Patients who already had a lower quality of life due to their primary health complaints had their problems exacerbated through poor eye care. Ten years ago, Vision Call was set up in Scotland, to try to overcome some of the problems associated with domiciliary eye care. The initial aim was to provide quality care to patients who were unable to access the community optometrist, or on-site corporate eye care. The service was rapidly taken up by care homes, learning disability centres, sheltered housing complexes and businesses, due to the widespread lack of provision. Demand grew quickly, allowing the quality of service to move to a higher level, including the use of portable autorefractors and digital tonopens for testing, and a full range of portable equipment. After testing for a while it was noted that patients all wore the same frames, as selection was limited at the voucher values. Individuality was not taken into account, so a range of over 100 budget-priced frames was developed, provided within the NHs voucher value. The need for optometrists to help supply this service grew rapidly. Despite the reluctance to provide domiciliary eye care, recruitment was simple when Vision Call's approach was demonstrated. Opticians appreciated that they could supply the same quality of eye care at residential homes as they could in practice. We initially planned to stay within central Scotland, allowing easy travelling for the teams, and keeping the overall costs low, a necessity with the low fees generated from NHS tests. But the larger groups of homes and businesses requested that the provision be supplied to their other sites in Scotland and later throughout the UK. What does this all have to do with franchising? Vision Call was well controlled and overseen by the owning optician Ð someone with a vested interest in the care of the patients and the service provided Ð and supported by the employed professional staff. It was realised that further expansion was impossible, as this would reduce the professional direction that only an owner could provide. The company continued to grow, becoming the largest provided of dimiciliary eye care in Scotland until the decision two years ago to franchise outlets elsewhere in the UK. The principle is based on the fact that optometrist partners care for the business, but also benefit from partnership with a large company both in experience, marketing and reduced costs, without losing the personal service of an independent. The company invested a considerable amount of money updating IT services to allow growth, including computerised monitoring of phone calls, electronic ordering and delivery, and marketing programmes.