Clinical governance in optometric practice guidance

The healthcare landscape is ever evolving, and the field of optometry is no exception. As primary eye care providers, optometrists play a critical role in delivering high-quality, patient-centred services. This revised and updated governance guidance reflects this dynamic environment, offering a robust framework to support professionals in maintaining and enhancing standards of care.

This updated guidance builds upon its 2015 predecessor, integrating advances in clinical practices, regulatory expectations and patient safety strategies. Its central themes – safety culture, insight, involvement and improvement – underscore a shift from traditional compliance-focused approaches to a system that promotes innovation, learning and collaboration. This has been written to support each nation’s Quality in Optometry toolkit and employers’ internal clinical governance standard operating procedures, providing a high-level overview of current culture and good practice. We highlight the importance of psychological safety within teams, fostering a just culture that prioritises learning over blame.

This foreword is a call to action for all optometrists and practice teams. By embracing the principles outlined here, we can collectively enhance standards of care, ensuring that optometry remains at the forefront of patient-centred, high-quality healthcare delivery.

Dr Gillian Rudduck MCOptom, President, The College of Optometrists

The College of Optometrists defines Clinical governance as the system through which health organisations, including optometry practices, are accountable for continuously improving the quality of their services and safeguarding high standards of care. Its purpose is to enable environments to be created in which clinical excellence can flourish, and patient safety can be maintained. In doing so, clinical governance includes quality assurance and improvement, as well as risk and incident management.

Clinical governance is an essential framework that supports continuous improvement in healthcare, ensuring good outcomes for both patients and practitioners. It is not about blame or singling out individuals for criticism but about fostering a culture that values learning and development. By reflecting on work practices and embracing change, clinical governance helps create a safer and more effective environment for everyone involved.

This guidance is for primary care optometry, delivering core optometric and optical services. Where an optometry practice may have expanded the scope and range of clinical services provided, into areas such as community ophthalmology or cosmetic healthcare, a different governance regulatory regime should be followed in addition to the one set out on this page. This typically requires registration with the Care Quality Commission, Health Improvement Scotland, Healthcare Inspectorate Wales or the Regulation and Quality Improvement Authority, depending on where in the UK the practice is based. The College of Optometrists’ Expanding Scope of Practice guidance provides a structured framework to safely expand a clinician's or practice's clinical scope.

This guidance is designed to help practitioners use clinical governance to improve their professional practice either as a contractor, clinical lead optometrist or employed clinician. It replaces the previous College of Optometrists’ Clinical governance in optometric practice document, which was published in 2015.

Quality improvement and excellence in optometry

Clinical governance in optometric practice guidance

Foreword

Introduction

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