October 2024 - Ensuring patient centred care

Patient-centred care is a crucial approach that places the patient at the heart of their eye health journey. Given the ubiquitous nature of online and remote interactions, as well as the rapidly developing world of artificial intelligence, the human element to any patient encounter is even more valuable. 

As the GOC states, “patient well-being/care is an optical professional’s primary concern and must be at the heart of all decisions made about patient care (Standard 1). Optical professionals must be able to employ an adaptative and personalised approach to patient care, considering the patient’s social, clinical, personal and cultural needs whilst challenging their own conscious and unconscious bias (Standards 4 and 13).”

Trust is crucial in the patient optometrist relationship as studies have shown that patients' trust in their healthcare provider correlates to a range of positive outcomes. Trust is a two way process and several physicians argue that being able to build trust with patients [is] as important as medical knowledge. [1]

Understanding the patient perspective helps to make sense of communication in the consultation as taking the ‘patient’s eye view’ can make some behaviours seems less puzzling.

Why is patient centred care important? 

Patient-centred care is a core component of optometry and a positive patient-optometrist relationship fosters deeper patient engagement and can result in higher quality care and outcomes. 

Whilst a routine optometry appointment may seem straightforward, or even exciting to some, others may feel anxious about the experience. In particular, patients can feel inhibited when surrounded by unfamiliar machines in a dark testing room and may not understand the practices and processes of their eye test, which can make them feel vulnerable. It is only when they are out of the testing room and with the dispensing optometrist that they may feel comfortable enough to ask questions about their eye health care. Choosing new spectacles can also cause anxiety for some as they are unsure about what suits them and are afraid of making a costly mistake. We are all individuals and patient centred care is therefore important because it involves prioritising those individual needs, preferences and values, resulting in improved quality of care. 

How can learners prioritise the patient voice?

By adopting these strategies, optometry and ophthalmic dispensing learners can ensure that the patient voice is at the centre of their clinical practice, leading to better care outcomes and stronger relationships. 

  • Active listening: Learners should be encouraged to listen attentively to their patients' concerns and symptoms without interruptions.
  • Questioning: Use open questions to give the patient an opportunity to express their thoughts, feelings or concerns. In the opening phase of the consultation patients find it easier to answer questions that do not use the word ‘problems’. For instance, ‘How have your eyes been?’ or ‘Have you noticed anything different about your eyes?’ rather than ‘Do you have any problems with your eyes?’ [2] Encouraging patients to ask questions and express their preferences regarding treatment plans fosters a two-way dialogue.
  • Clear explanations: Use simple language when explaining diagnoses, treatment options and procedures to ensure patients fully understand their condition. Similarly, talk through and describe each procedure or test before it is performed so that the patient knows what to expect.
  • Communication and body language: As the GOC highlights in Outcome 2.2, learners must “act upon non-verbal cues from patients or carers that could indicate discomfort, a lack of understanding or an inability to give informed consent.” Dispensing Optician and ABDO College examiner, Sue Deal suggests that “mirroring is a useful tool in communication. It means that you mirror the body language of the person you are communicating with, to help to build empathy and create a bond between you.”
  • Empathy and respect: Trainee optometrists and ophthalmic dispensing learners must show genuine concern for their patients' wellbeing. Furthermore, it is important to be mindful and respectful of cultural, linguistic and socioeconomic differences that might impact care delivery. Learners should then adapt their care appropriately.
  • Trust their patients' judgement: For instance, affirmative phrases such as 'I know you’ll be able to do it' or ‘I know you understand how serious this illness is’ empowers patients. [1] Empowering patients and involving them in their eye care is therefore essential to ensure successful clinical outcomes.
  • Remote consultations: With the rise of online consultations, clinicians must ensure their patients feel supported, even through a screen. As discussed, with any patient consultation, maintaining eye contact and open body language will help build trust and patient satisfaction. Sharing guidance regarding the video consultation prior to the appointment will also help the patient to feel at ease as they know what to expect.

How can learners employ an adaptive and personalised approach to patient care?

  • Learners must get to know their patients, but patients should also know who is treating them. It is important for learners to introduce themselves and their role to their patients. Learners should also be encouraged to read up on past notes prior to consultations and take notes during the consultation. Documenting their daily routines, work settings and visual symptoms or issues enables learners to gather information to create a tailored treatment plan. [3]  
  • Shared decision-making. Learners must involve patients in decisions about their eye care by discussing pros and cons of treatment options. This empowers patients to take an active role in their own care. Urge learners to ask specific questions relevant for the particular patient. For instance, when a patient mentions regular computer use, it cues the learner to ask precise questions to gain a better understanding of their vision concerns. Knowing patient circumstances allows learners to recommend suitable solutions.
  • Mapping the patient journey. The patient journey begins from the moment they make their appointment. Learners should be encouraged to treat patients as partners in their healthcare journey, working together to ensure optimal outcomes. A cardiologist described speaking to his patients about identifying their priorities: “I want to do things with you, not to you. I want to ask you not just what the matter is, but what matters to you.” [1]
  • Learners need to adapt their approach depending on the patient and circumstances. Consider using a variety of ways to communicate information to patients; verbal, thorough the use of diagrams or models for in person explanations. February 2024's Topic of the month looks at building confidence in communicating with patients.
  • Learn from patient experiences. Use feedback to improve understanding of patient perspectives. This could involve reflecting on what patients liked or disliked about the care they received.
  • Encourage learners to engage in continuous learning. Students can stay informed about patient-centred care principles through courses, workshops, or seminars.
  • Use simulated patient scenarios to practise ways to interact and work with patients. Incorporating role playing exercises in the learning environment helps students to practice patient centred care with peers or instructors, focusing on how to elicit the patient’s voice during consultations. Similarly, using case studies with a patient centred focus helps develop an appreciation of patient preferences and values. Group discussions with peers on how to prioritise the patient voice will help generate a wealth of ideas and strategies.
  • Lead with compassion. January 2024's Topic of the month looks at how compassion brings about significant outcomes. These videos provide an overview of compassion in practice, and are also available on The College of Optometrists' YouTube channel.
  • Foster a sense of openness and honesty to help build trust with patients.
  • Walsall and Wolverhampton NHS Trusts have put in place a Patient Experience Enabling Strategy with the aim of supporting and empowering all staff within their respective Trusts to put patient experience at the heart of everything they do.

Keep updated 

If you would like to be kept up to date with the work of SPOKE, please email spokehub@college-optometrists.org to be added to our Advisory Review Group. Similarly, please email with your views of Topic of the month or any suggested themes you would like to see covered. 

References and Bibliography 

[1]  Green. J and Wolfson. D, September-October 2023 “Physician Perspectives on Building Trust with Patients,” in “Time to Rebuild: Essays on Trust in Health Care and Science,” ed. Lauren A. Taylor, Gregory E. Kaebnick, and Mildred Z.Solomon, special report, Hastings Center Report 53, no. 5 (2023): S86-S90.DOI: 10.1002/hast.1528

[2] Webb. Helena et al 25 March 2022 Communication and the patient perspective in the eye examination (C-101626) - The College of Optometrists

[3 What Does Patient-Centered Care Mean for Optometry Practices? 

Cropper. B The Change Forum Putting Patients First, 5 Key Principles and Practice Areas thechangeforum.com

Deal. S 1 February 2021 OA Corner Part 2: Communication - ABDO

Khoshnevis. A (2015, Feb 11). Traditional Patient Care vs. Patient Centered Care: The Importance of Speaking to the Patient at the Time of Need. Eyes On Eyecare

Koka, Sreenivas and Raz, Galya 29 June 2016 Value-based dentistry: Putting the patient first. Faculty Dental Journal 

Webb. H et al, 25 March 2022 Communication and the patient perspective in the eye examination, College of Optometrists 

General Optical Council Requirements for Approved Qualifications in Optometry or Dispensing Optics Outcomes for Registration Standards for Approved Qualifications Quality Assurance and Enhancement Method

NHS England » Developing patient centred care