Spotting Warning Signs

Warning signs often come together. Spotting them early lets the team make small changes before risk grows and before formal steps are needed.^[4]

What to watch for

• Emotional: irritability, anxiety, low mood, or tearfulness after tough appointments.
• Cognitive: forgetfulness, indecision, taking longer to spot patterns, or repeatedly re-reading prescriptions.
• Behavioural: pulling back from others, conflict, missed breaks, lateness, or unpaid extra hours that hide workload. ^[2]
• Physical: tiredness, headaches, eye strain, poor sleep, minor illnesses, or increasing reliance on caffeine.

Situations that increase risk

Risk is highest when clinics run late and urgent walk-ins clash with tightly packed schedules. Home visits mean long drives, changing environments and broken recovery time. New systems and refurbishments temporarily add mental load and split attention.^[5][7]

Team prompts that make action easy

Short, regular check-ins raise issues without blame. A simple "Any task you'd like a second pair of eyes on?" makes shared safety normal. Teams can spot which appointments are likely to need more time and adjust before pressure builds.^[6][3]

• Two quick prompts: "Who is shielding phone interruptions during refraction?"; "Any late slots we should turn into buffer time today?" ^[6]

Recording without stigma

Capture facts, not opinions.^[8]

Write down what was seen or heard, when it happened, who was there, and how it affected the service. If appointments move or buffer time is added, record who decided, what changed, and why it was safer. Keep personal health details in HR or occupational health records.

Review and escalate when needed

Check after one to two weeks to see if the changes helped. If risk remains, involve occupational health, consider temporary role changes, or pause clinics under Standard 11. Keep communication supportive and focused on patient safety and a safe return to full duties.^[3][1]

References (numbered in text) Why we include references

1. New GOC Standards launched — General Optical Council (01 Jan 2025) Find (opens in a new tab)
2. Work-related stress — Health and Safety Executive (HSE) Find (opens in a new tab)
3. Looking after your team’s health and wellbeing guide — NHS England (3 April 2023) Find (opens in a new tab)
4. Burn‑out an "occupational phenomenon": International Classification of Diseases — World Health Organization (28 May 2019) Find (opens in a new tab)
5. Demerouti E; Bakker AB; Nachreiner F; Schaufeli WB. The Job Demands–Resources Model of Burnout. Journal of Applied Psychology (2001) Find (opens in a new tab)
6. Brian J. Franklin; Tejal K. Gandhi; David W. Bates; Nadia Huancahuari; Charles A. Morris; Madelyn Pearson; Michelle Beth Bass; Eric Goralnick. Impact of multidisciplinary team huddles on patient safety. BMJ Quality & Safety (2020) Find (opens in a new tab)
7. Laura K. Barger; Brian E. Cade; Najib T. Ayas; John W. Cronin; Bernard Rosner; Frank E. Speizer; Charles A. Czeisler; for the Harvard Work Hours, Health, and Safety Group. Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns. New England Journal of Medicine (2005) Find (opens in a new tab)
8. A just culture guide — NHS England (2018) Find (opens in a new tab)