Fairness in Patient Care

Fairness means holding the same standards for every patient, whatever their age, culture, disability or ability to pay. It also means being open about options, risks and costs. ^[1][5]

Consistent recommendations

Advice should be based on clinical need and evidence, not on perceived affluence or persuasion skills. ^[1][2]

Where two options are clinically similar, explain both plainly, including costs and what ongoing care they will need. ^[2]

Prioritising equitably

When clinics run late, prioritise by clinical risk and vulnerability, not by convenience or who is most assertive. Give clear follow-up advice and a prompt new appointment to anyone deferred, and record the reason. ^[1][6]

Ways to build in fairness

• Use standard information templates and talk through options in a set order. ^[2][1]

• Make prices easy to find and understand. ^[1]

• Review dispensing data to check for unexplained differences by age, language or disability. ^[1]

Transparency in commercial contexts

Keep clinical advice separate from sales points. Be clear when a suggestion is about durability or style rather than clinical benefit. Treat every patient with the same courtesy whatever they choose; do not imply that lower-cost options mean lesser care. ^[1][3]

Accessibility within fairness

Offer information in large print or other formats on request. Provide interpreters where needed for consent or complex choices. Record agreed reasonable adjustments and a review date. ^[4][5]

Documentation essentials

• Note the options discussed, with risks and costs explained. ^[2]
• Capture the patient’s priorities, the option chosen, and any follow-up advice. ^[2][6]
• Record an objective reason for any deferral or escalation. ^[1]

Guarding against subtle bias

Watch for patterns such as spending more time with some groups or defaulting to certain products by age or gender. Peer review can help spot and correct drift; feed what you learn into training and scripts. ^[7][1]

Personal beliefs and referral

Optical professionals may hold religious, moral, political or personal beliefs, but these must not prejudice patient care. If a belief prevents you from providing a service—such as prescribing, fitting or referring—you must ensure the patient is safely referred to another appropriate provider without delay. ^[3][1]

Patients should not feel judged or abandoned. Explain the referral clearly, record the reason factually (without unnecessary detail about your beliefs), and confirm that the patient knows where to continue care. This balances professional integrity with the duty to protect patients’ rights and access to safe treatment. ^[3]

Feedback loops

Invite brief patient comments on clarity and respect. Reviewing themes monthly and sharing fixes often helps. Small tweaks to scripts can remove pressure while keeping conversations efficient. ^[1][2]

References (numbered in text) Why we include references

1. 13. Show respect for fairness to others and do not discriminate — Standards of practice for optometrists and dispensing opticians. General Optical Council (GOC). Find (opens in a new tab)
2. Shared decision making (NICE guideline NG197). National Institute for Health and Care Excellence (NICE). Published 17 June 2021. Find (opens in a new tab)
3. Personal beliefs and medical practice. General Medical Council (GMC). Find (opens in a new tab)
4. Accessible information standard – implementation guidance. NHS England. Published 30 June 2025. Find (opens in a new tab)
5. Reasonable adjustments: a legal duty. Public Health England / GOV.UK. Published 8 May 2016; last updated 15 September 2020. Find (opens in a new tab)
6. Safety-netting in routine primary care consultations: an observational study using video-recorded UK consultations. British Journal of General Practice, 2019. Find (opens in a new tab)
7. FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Medical Ethics. 2017. Find (opens in a new tab)