Sales targets and incentives: getting the balance right between commercial success and patient care
Commercial considerations are an important part of any healthcare business. Optical businesses, like many organisations, use sales targets and incentive schemes to measure performance, support growth and motivate staff. However, our recent thematic review highlights the importance of ensuring these arrangements support, rather than undermine, patient-centred care.
Understanding the challenge
Our thematic review explored how commercial practices in primary eye care can affect patients, registrants and businesses. While we found no direct evidence of patient harm arising from commercial practices, the review identified concerns about public confidence, professional autonomy and workforce wellbeing where commercial and clinical priorities are perceived to be in tension.
Sales targets and incentives were a particular area of focus. Some patients reported feeling pressure to purchase products or services, while some registrants described pressure to promote higher-value products or meet commercial objectives. More than 30% of registrants in our registrant survey reported feeling pressure to sell particular types of glasses or contact lenses that would generate more income for the business, and almost a quarter said they had experienced pressure to recommend products or services they believed were unnecessary for the patient.
Why this matters
Trust is fundamental to effective eye care. Patients need confidence that clinical recommendations are based on their individual needs and best interests.
The review found that perceived pressure selling may discourage some people from accessing eye care services. This is significant because reduced engagement with routine eye examinations can have implications for early detection of eye conditions and the prevention of sight loss.
The impact is not limited to patients. Registrants who reported pressure to achieve commercial targets were also more likely to report stress, workload strain, lower job satisfaction and intentions to leave the profession. These findings reinforce the close connection between workforce wellbeing and the delivery of high-quality care.
Creating the right culture
The review does not suggest that targets and incentives are inherently problematic. Rather, it highlights the importance of how they are designed and implemented.
Commercial measures should sit alongside, and never outweigh, considerations such as patient outcomes, quality of care and professional judgement. Registrants must feel able to make decisions based on clinical need without concern that commercial objectives will take precedence.
A positive organisational culture is also essential. Staff should feel supported to raise concerns, discuss pressures openly and exercise their professional judgement confidently. Businesses that successfully balance commercial performance with patient-centred care are more likely to foster trust, retain staff and maintain high standards of practice.
Looking ahead
As part of our response to the thematic review, we will consider how our Standards for Optical Businesses can further support professional autonomy, patient-centred decision-making and healthy workplace cultures. We will also explore whether additional guidance and education may help professionals navigate commercial pressures while continuing to prioritise patient safety and wellbeing.
Commercial success and patient care should not be competing objectives. By ensuring that targets and incentives support professional judgement and patient interests, businesses can build environments where patients, registrants and organisations all thrive.
