Political, economic, social and technological forces in England have resulted in the country’s largest optical retailer repositioning its offering towards clinical services.
Speaking at Optrafair 2016 last weekend, Specsavers co-founder Doug Perkins presented his plans for growing enhanced optical services (EOS) at the multiple.
Many others across the exhibition and conference hall at Birmingham NEC also highlighted the need for more clinical services on the high street – in the midst of crowded hospitals and growing demand for eye care from an aging population.
Delegates heard how the latest technology was set to impact on practice and of the need to work together, speak with one voice, and learn from more successful eye care delivery pathways in Scotland and Wales.
Perkins told Optrafair: ‘The bankruptcy of the NHS is one which is associated with the ophthalmologists and their resources being restricted. All the issues regarding the poor service that are coming out and the government’s deficit – it’s all linked together.
‘I believe that we are just scraping in as being able to call ourselves part of primary healthcare and there is a danger of us being categorised as retail optical shops unless we are prepared to change our model.’
[CaptionComponent="2496"]Perkins said he could not understand the complacency of the profession in the face of these challenges and other threats hanging over the industry.
‘We need to be able to change our model, and fortunately in this country we have that capability. In many countries they don’t have that ability to change their model. But we have been university trained for the full scope of services on primary care – the fact is we just don’t use it.
‘The saving grace, bizarrely is the bankruptcy of the health service. They’ve got to do something. One way or another EOS is going to arrive in our communities but it’s not a certainty it’s going to arrive in optometry and I’m sure most people here realise that.’
He added: ‘There is no place for complacency, we need determination and vision to see what the possibilities are.’
Cross-sector backing
Locsu executive chairman Alan Tinger agreed with Perkins. He told Optician at the exhibition’s Association Lounge that practitioners must become ‘doctors of the eye’ in order to survive on the high street.
However, latest GOC research showed only 19% of patients go to the opticians as their first port of call with an eye problem, compared with 54% who head to their GP and 10% to the pharmacist.
Tinger emphasised there was no use changing public perceptions without a fully upskilled workforce and community eye service contracts across more regions in England. ‘We need to have an accredited workforce and the right workforce. At the moment it is a postcode lottery,’ he said. ‘We won’t be happy until we have 100% coverage.’
Enhanced services were just one strand of the Foresight Project launched last month by Tinger, the Foresight chairman, which also covered topics including technology inside and out of practice, 3D printing and new optical appliances set to arrive in the marketplace.
Supporting Foresight was also a priority for Federation of (Ophthalmic and Dispensing) Opticians head of policy and strategy Ann Blackmore, who told Optician at the show that the findings would help to move primary care into the community. High street practices had the capacity to do much more within the core competencies.
Blackmore said: ‘We need to think about healthcare in the future not how it used to be. Some people don’t want to do it but you need to know what your niche is.’
She also commented on news last month that the GOS fee would again be frozen meaning NHS sight tests in England would remain at £21.31 for 2016-17, causing a good deal of discontent among practitioners. However, Blackmore took a more positive view.
She said: ‘Having it frozen is in some respects a success because they haven’t taken it away.’
Blackmore emphasised that keeping GOS national was a priority for Fodo. ‘At the moment you can walk into any practice you want and have a sight test done. We want this to carry on being in community practices around the country,’ she added.
Postcode lottery
Perkins noted during his speech that NHS England was not learning from evidence coming from Wales and Scotland around delivering primary eye care in the community.
He added: ‘We’ve got a model now based on commissioning in 211 regions of the country. Nobody is winning from this model. It’s much too inconsistent, much too small an area and the contracts are much too short. We need to improve significantly and I believe that to get out of this postcode lottery the devolution model in Gretaer Manchester is the way forward.
‘That’s an area that has 12 CCGs coming together serving the needs of 2.5 million people – and that’s about the population of Wales. So when we get evidence from those territories it will be something NHS England will not be able to hide away from.’
Finally, Perkins called for optical leaders to work together in order to evolve education in enhanced services, gather evidence and deliver a stronger message to the NHS.
He added: ‘There’s a lot of major bodies involved in leading optometry, and there’s plenty of money involved. There’s a lot of faith and trust, but there’s not enough working together. Because we’re not even joined up as a profession we can’t work together to achieve what we need to achieve.
‘If we all make EOS the number one project we can make a difference. We all have to be prepared to work together. The Optical Confederation was formed for that very function and it’s not doing that. It’s probably not their fault, it’s everybody’s fault.
‘We all need to realise the conditions and environment we are facing and say the past is the past, draw a line, and say if the Optical Confederation is not the model let’s find something that is the model and let’s go forward together.’
Research confirms urgent eye care need
[CaptionComponent="2497"]Researchers speaking at Optrafair presented hard evidence of the surge in eye conditions among the UK population and outlined new diagnosis and treatment developments.
Professor John Lawrenson of City University London and Professor Kathryn Saunders (pictured) of Ulster University featured in an extensive CET programme over the three-day event.
On the opening morning Professor Lawrenson delivered a lecture on the impact of technological advances in the scope of optometric practice. He reported findings from a study at City identifying increased investment in Perkins and Goldmann tonometers, fundus photography and autorefractors within practices as time goes by.
Optical practices in Scotland were more likely to have such equipment, it was found. In total 81% of practices used Perkins/Goldmann in 2013 compared with 47% in 1987, while 98% had a visual field screener compared with 41% in 1987, reflecting changes over time.
In addition, research also showed a considerable climb in the number of practices investing in OCT equipment. While 2% of practices had an OCT in 2007, 15% had the technology as of 2013 and 43% anticipated buying one in the next 12 months. ‘It is very likely we are going to be up to 70% of practices [having an OCT],’ Prof Lawrenson said.
He hoped wider adoption of OCT and FDT (frequency doubling technology) within practice might help improve detection levels for glaucoma, with 60% of patients still going undetected. ‘Depending on if you want to maximise detection or maximise specificity you can decide which parameters you want to look at,’ he added.
Meanwhile, Prof Saunders reported back on the outcomes of the Northern Ireland Childhood Errors of Refraction (Nicer) study, released earlier this year. The study found myopia levels among children in Northern Ireland to be twice as prevalent as the 1960s, and that the development of myopia was more common in the 6-13 year age group than in the ages of 12-20.
‘This might not be what you experience in practice but it is what the data is telling us,’ she said. ‘It is nice to have evidence for why the NHS should be paying us for that. We need to be the people offering these treatments’.
