From vicious to virtuous circles
The power of our annual workforce survey lies in the number of registrants who participate. Therefore, I’d like to begin this blog by thanking all 4,575 students, dispensing opticians and optometrists who took the time to share their experiences this year. The response rate is higher than we’ve achieved in recent years, which shows that you want your voices to be heard.
We ask the same core set of questions each year, which allows us to track trends, but we also seek to innovate. This year we added new questions enabling us to provide fresh insights on working patterns and career development among other areas. We also created space for you to share your thoughts on workplace challenges. Many comments focused on concerns around commercial pressures making it difficult to provide patients with sufficient care.
There’s no escaping that this year’s research makes for sobering reading, for example:
- Job satisfaction has declined since last year. Key factors contributing to dissatisfaction include not feeling valued, high workloads, poor salaries, limited career progression opportunities, and commercial pressures that can detract from patient care quality.
- Harassment, bullying or abuse has not reduced since last year, nor has discrimination, and incidence of both types of behaviour continues to be higher than in the NHS staff survey. Most of this behaviour is not reported by registrants, the main reason being a lack of confidence in the reporting process that anything will be done about it.
- Significant proportions of registrants report sometimes or regularly experiencing poor working conditions, including working beyond their hours, feeling unable to cope with their workload, and finding it difficult to provide patients with a sufficient level of care.
In the last 12 months:
There are correlations in the data that reveal a vicious circle that we need to break as a sector. For example, those registrants who find it difficult to provide patients with sufficient care are significantly more likely to be dissatisfied in their job. Experiencing negative working conditions correlates with difficulties providing patients with sufficient care, as does experiencing harassment, bullying or abuse at work, and the same is true for experiencing discrimination. Registrants experiencing poor working conditions and who find it difficult to provide patients with sufficient care are much more likely to plan to leave the professions in the next two years.
The data also reveals some stark inequalities in experience. Registrants who are female, have a disability or are aged under 35 are more likely to experience harassment, bullying or abuse. Those from ethnic minority backgrounds are more likely to experience harassment, bullying or abuse specifically from managers, other colleagues, and tutors, lecturers or supervisors. The same four groups are also more likely to experience discrimination at work. Shockingly, nearly a quarter (24%) of registrants who have a disability plan to leave the profession in the next 12-24 months. They are more likely to intend to leave to reduce stress, burnout and fatigue, due to heavy workloads and pressure to meet targets, and due to lack of employer support.
Some people question whether regulators have a valid role in workplace EDI matters, but the clear link between workplace culture and patient safety demonstrated by this research gives healthcare regulators a clear mandate to act. We’ve made creating fairer and more inclusive eye care services one of the three objectives in our draft 2025-30 corporate strategy. Later this month, our governing council is set to approve tougher professional standards that will explicitly reference behaviour between colleagues and require businesses to put in place support for registrants who have experienced discrimination, bullying or harassment in the workplace. And EDI issues are already becoming a more prominent feature of our fitness to practise caseload.
The negative experiences of registrants in our research contrast to a more optimistic outlook for the sector that has characterised the policy environment in last year, whether that’s opening the degree apprenticeship route for dispensing options or stronger recognition of the wider role that optometrists can play in delivering more clinical services in communities. Ending on a positive note, our research continues to show strong appetite for gaining additional skills and shows a correlation between delivering enhanced services and greater job satisfaction.
However, if the sector is to maximise these opportunities, not least in the context of workforce capacity pressures, it needs to make careers in eye care as attractive as possible and retain as many current members of the workforce as it can. Surely, it will only achieve these things by addressing the negative workplace culture and stark inequalities revealed by this research.
There must be a collective interest in turning the current vicious circle into a virtuous circle in which a growing, diverse, happy and upskilled workforce serves a wider range of eye care needs. Given this shared ambition, we look forward to combining forces with a wide range of partners, working collaboratively together to make progress on this important agenda.