June sees a huge number of eye-related awareness events. There is Diabetes Awareness Week (June 12-18), Macular Week (19-25 June), Glaucoma Awareness Week (June 26 to July 2) and the whole of June is taken up by Cataract Awareness Month.
We all know the importance of these events. As well as raising the profile of conditions with the public and policy makers, it is a timely reminder for us to review our levels of knowledge in these areas and think about what the future might hold for us as registrants. I’ve written before in these columns about enhanced services for glaucoma and cataract but less so about systemic conditions.
As I approach my 43rd birthday (yes, I did have an uphill paper-round) I have become more aware of my own mortality. Mark Twain famously said: ‘Do not complain about growing old, it is a privilege denied to many.’ Of course, that is very true but there are many things that we can do to help those who trust us with their care to enjoy that privilege as general health conditions are so often covered in the consulting room.
The most common of these are diabetes, hypertension and high cholesterol. We all have a good understanding of what these conditions can do in terms of ocular and general health. I firmly believe that as clinical practice evolves, we will offer more holistic health care alongside a growing portfolio of enhanced services and our more traditional sight tests and contact lens work.
General practice simply cannot cope with the volume of people that need to access services and we are perfectly placed to offer first-line advice, sign-posting and even physical screening services within our practices. The number of general practitioners is not rising to meet the growing population and is, instead, shrinking in real terms by some measures. Then there is a growing role for other primary care practitioners, including our sector, in raising awareness, screening and even delivery. In May 2023 alone, over £645m was allocated to widen pharmacy services. It is happening.
The UK population curve clearly shows we are an ageing society and with that comes a number of comorbidities and associated challenges for all walks of healthcare. We’re seeing the proliferation of general health services in community optical practices already.
Some of the figures about these conditions are startling. According to Diabetes UK, one in 15 people have diabetes, including one million who have type 2, but are yet to be diagnosed.
The NHS estimates one in four adults in the UK is hypertensive. The British Heart Foundation says as many as five million may not know they are at risk. They also estimate that as many as half of all adults in the UK are living with cholesterol higher than the national recommendations.
So, what should we be doing? Well, we will all be in a different place if we increase our working knowledge of these conditions and the different types of medications and blood tests that underpin their management. To build up a general knowledge of the types of blood tests that are relevant to general practice start with the sources below:
For medications, the good old BNF (British National Formulary) is still my first port of call, online these days, to understand modes of action, interactions and side effects. I remember when these things were only available in print, but then again, I remember very clearly in the 1990s when a Cadbury’s Freddo was only 10p.
There are some fantastic resources providing guidance on pharmacology, management and normal ranges for blood pressure in CPD modules and sessions. Independent prescribers will develop an increased depth of understanding in some of these topics.
While this column hopefully serves as a prompt for many of us to revisit some of these themes or perhaps to look at them afresh, it is clear to me that we will be talking about, educating, sign-posting and even carrying out screening services linked to these conditions more and more in the future.
This is undoubtedly important for registrants but there is also a role for support colleagues in our practices. I’m sure I’ll pick up in a future column about how vital I believe this cohort of people will be to unlocking the challenges posed by increased need for access to General NHS Services and ophthalmology alike.
Depending on when you are reading this I may be 43 already. A good friend of mine makes me a wonderful birthday cake every year. I must remember to exercise more moderation in my 44th year or my Lercanidipine HCL may need to be a higher dose, plus, at my age, I get an annual HbA1c test, and I don’t want the reading to be any higher.
- Fun Fact: The Freddo was originally launched in 1973 at just 2p but then discontinued in 1979, only to be relaunched in 1994. •Paul Morris is director of professional advancement at Specsavers UK & Ireland.