Glaucoma and community optometry was considered at a Westminster Hall debate on April 30 after being raised by Jim Shannon MP. Shannon, who is the Democratic Union Party’s spokesperson for health, called for MPs to do something about this issue now to save sight further down the line. He noted that while his constituents in Strangford, Northern Ireland, asked him to raise this issue, sight loss problems were evident across the UK.
‘I understand that health is devolved in all the regions, but it is clear that we need joined-up thinking to a joint problem,’ he said. Shannon highlighted that visual impairment and sight loss cost the economy £36bn each year and 22 people lost their vision to preventable causes each week. We can work alongside the optometrists and the opticians and have a partnership whereby people can have their eyesight tests done more often,’ Shannon said.
He noted that sight loss often meant the loss of independence and confidence, which could be prevented through early diagnosis and checks. Shannon focused on glaucoma and shared data from Specsavers that showed there were 30,000 referrals for glaucoma in people aged 40 to 60 in the last year and many more have been missed.
A progressive strategy
Shannon shared his own story about when it was suggested he attend an optical practice for an eye examination after a chance sight test during a visit to a university. He was presented with a graph that highlighted issues relating to glaucoma, which needed to be addressed quickly as his father had glaucoma. Fortunately for Shannon, only regular checks were recommended.
During the debate, Shannon stressed the importance of eye examinations and likened them to an MOT for a car: ‘The eyes may be known as the window to the soul, but they are also undoubtedly the window to the view of overall health that can be found in an eye test. Eye tests are imperative for finding an early diagnosis of diabetes, for example, and a host of other health concerns.’
He said optometrists had a key role in identifying signs of glaucoma during routine tests and could monitor and manage patients with stable glaucoma. ‘In Northern Ireland, there are two glaucoma referral and refinement pathways. By contrast to England, they are available at all community practices as long as clinicians have the right accreditation in glaucoma care. It is fortunate that my GP service and many others have such access.
‘Through the services, patients have their glaucoma tests completed in the community and the results are then shared securely with the patient’s ophthalmologist. This joined-up approach helps to streamline the experience for the patient and ensures that optometry practices and ophthalmologists work together for the benefit of the patient.’
Shannon noted that these types of services could shift from secondary to primary care and at almost no cost to the taxpayer given that it used existing capacity. Shannon then called for a progressive strategy going forward: ‘Optometrists are the ones who are properly trained in the pathway.
'We must ensure that pathways are clear and that funding is available to ensure that, instead of 22 people a week losing their sight in the United Kingdom of Great Britain and Northern Ireland, no one at all loses their sight and their independent life – something that could have been prevented.’
Cross-party support
Andrew Gwynne, the Labour MP for Denton and Reddish and shadow minister for social care, attended the debate and was in agreement with Shannon. ‘With 6,000 high street opticians serving communities across the country, we cannot afford to sit back and waste their incredible potential. We will work with high street opticians to beat the backlog and to get the system moving again.
‘By utilising community capacity, we can free up specialists in the NHS to support those patients with the greatest need, providing greater accessibility, convenient care and, most importantly for all of us taxpayers, better value for money for the public purse,’ Gwynne said.
In response, Andrew Stephenson, MP for Pendle and minister of state in the department of health and social care, said the Conservative party was committed to making greater use of community optometry to alleviate pressures in secondary care. ‘Many integrated care boards are already commissioning a greater range of services on the high street, including minor and urgent eye care services, pre and post-cataract checks, and glaucoma referral filtering and glaucoma monitoring,’ Stephenson said.