She talks to Chris Bennett about her career, the challenges facing domiciliary eye care, and about being the first woman to be elected on the FODO councilJayne Rawlinson is the first woman to be given a place on the council of the Federation of Ophthalmic and Dispensing Opticians (FODO) and for the last two years she has been the managing director of Luton-based domiciliary eye care provider Healthcall.
Rawlinson made this long journey, both geographically and professionally, through a range of nursing management and hospital management posts. She is clearly a woman keen to deliver service and success, a trait others recognised in her from early days of nursing.
'When I first started I can remember one of the porters saying: ÒYou want the matron's job don't you?Ó And I said: ÒYes, I doÓ.'
She moved from Scotland to work at King's College Hospital and did a variety of nurse management jobs in the NHS before taken on marketing and management roles at the private Portland Hospital.
promotional activities
'I went there in 1983 to commission a paediatric unit and was promoted to a range of nursing posts including assistant director of nursing services,' she recalls.
Then followed a stint in marketing, a choice made for characteristically pragmatic reasons: 'I wanted to run a hospital and that was going to get me there a lot quicker than nursing,' she adds.
She later worked for a day surgery and construction company and then returned to the Portland as director of operations.
Her entry into optometry came two years ago when she was approached by Healthcall to run its optical division and bring some of that experience with her.
'The reason I accepted was that I had enjoyed the day surgery but optics seemed to be a clinical service which sat within primary care. There was also the retailing end which was a challenge.
'Because of my private healthcare experience, Healthcall wanted me to come in and review the business. I also had marketing expertise.'
Rawlinson says how historically domiciliary providers have operated in a rather ad hoc way. 'It was like, ÒWe have three optoms, where shall we send them tomorrow?Ó
'After the introduction of new guidelines there was much more stringent control, much more attention to counter-fraud services, for instance, so the whole thing had been flipped on its head.'
However, Nestor, the £500m parent company of Healthcall, believes it has a role to play in eye care. Although she had experience of healthcare services, Rawlinson brought no preconceptions about the optical business with her.
'I approached it with a fresh eye. I could see there was a major opportunity but I was very surprised that the role of the optometrist had not been extended more.'
The contrast with acute health is stark, she says. In that arena, the transfer of skills over the last 10 years has come on in leaps and bounds.
'In optics you have a group of individuals who are highly skilled and trained, who are not performing all of the tasks that they might.'
As an ex-hospital manager she believes there are clear economic benefits. 'If you take someone out of the hospital service and put them in front of an optometrist there are real savings to be made.'
She believes the problem of why clinicians' skills are not used more stem from the bizarre business model the profession works to. This devalues the optometry role and relies on product sales for profit. Opticians provide such a great service for such a paltry fee.
'Frankly, no one is going to get rich testing eyes,' she says. 'But,' she adds, 'the profession has done that to itself.'
'Having a clinical background myself, it does enrage me to see people devaluing something that has enormous benefit to the patients. I appreciate that you have to create competitive advantage but still maintain the quality and the ethical stance, that's something that is important to me personally,' she says, adding that this can be done while remaining a profitable part of a modern plc.
These issues are most pressing in the domiciliary area where the patients can often be the most clinically needy, but often, the poorest members of society.
Rawlinson is candid about the issues facing the domiciliary providers and admits that until proper funding arrives it will be hard for businesses to provide a good service to people in their own homes.
'Our market is predominantly within care homes. We do provide a service for sheltered accommodation and some day units but even that is contentious. There is a cost attached to getting people to the day centre. But if you provide other services Ð hearing, chiropody and sight Ð it makes good economic sense. We need to work with the DoH and the PCTs to educate them in that. But that is the only commercially viably way of doing it. If we had to do it any other way we might as well pack up our bags.'
Rawlinson says she is mindful of her commitment to Healthcall's 120 staff and 25 optometrists, who rely on the business remaining sound. The group conducts 87,000 examinations a year with 25 teams out each day and follow-up visits from dispensers. To maintain that service the business must be viable.
'What we and try and do for the people at home is try and fit them in with the rest of our normal days because that's the only commercially viable way of doing it, what invariably happens is that we say, ÒYes, we will come and test your eyes but we don't know when that will be, it's perhaps six or eight weeks before we are in that areaÓ.' That is an issue she is currently applying her effort towards.
Domiciliary challenges
Healthcall is passionate about domiciliary eye care, says Rawlinson, but the same challenges face all domiciliary providers. As part of her FODO role, Rawlinson chairs the domiciliary eye care group in which the providers work together.
'We have got to ensure that domiciliary providers are delivering to a certain code of conduct which fits in with the expectations of the PCTs and the DoH.
'Eye care ranks below the hairdresser in care homes. We can mobilise a team, which is not cheap, and send them to test maybe 10 patients, only to be met at the door and told that the hairdresser is there this morning. So that's one of the areas we need to work on and educate care workers in the homes about.
'One thing that really makes my blood boil was when we found was there was incentivisation in the market where individuals and companies were trying to get into nursing homes by saying, Òwe will test the eyes of the staff and give you free glassesÓ. I believe that is an inducement and it is ethically unacceptable.'
Healthcall decided to try and give itself a competitive edge through training, by educating carers about good eye care and simple things like good lighting.
'In a lot of the care homes we go into, a glow worm would emit more light. Because the care staff are trying to create a homely and cosy atmosphere, you can't see a blessed thing. As part of our added value we teach the staff about the importance of lighting, about the importance of contrast, not to put potatoes and fish on a white plate. It's not rocket science, but it makes a huge difference.'
unseen and forgotten
Rawlinson is not so up-beat about those 500,000 patients at home who the RNIB identified in its report Unseen and Forgotten, and are denied optometric services.
'The people at home are a lot harder to service, until the reimbursement is different you can't service them equitably. I think it is important that in domiciliary we keep banging the drum. If we were to walk away tomorrow there would be huge problems for the patients. GPs and the government would have to provide the services. There are discussions among the domiciliary providers as to how we can get an increase to the fee.'
Rawlinson is upbeat about the future and says that the steering groups and DoH understand the issues facing optics.
'Just in terms of general optics, I can see a real willingness. It is almost like someone has put the light on. If they can expand the role of the optometrist and move some of the services into the high street they can make real differences in terms of things like cataract waiting lists.'
She cites the referral route for cataract, involving optometrists can reduce the need for 11 patient trips down to five.
'The DoH are absolutely committed with £53m for cataracts and £4m to be ring-fenced to look at the management of other eye conditions and it is keen to include the primary provider Ð the optometrist.'
Whether that will stretch to full deregulation Rawlinson is not prepared to guess. What she does believe is that there are massive opportunities for optometrists to take the initiative. With the number of optometrists increasing and salaries falling those pressures will increase, she adds.
'If optoms want to be considered as true clinicians they have to go down the CET line. It's a big challenge but I get the sense that some optometrists have not faced up to it yet. Salaries have become much more stable in the last two years and recruitment has become easier. As the role of the optometrist is extended there will be a need for more people in different job roles. The universities and the profession understand this,' she says.
'I've seen the change in salaries but the changing role of optometrists, the extended role, will have a bigger impact.'
She believes it is good timing in terms of extra people coming into the marketplace but what they have got to be smart about is developing that extended role.
'They can't hang around and mull it over for the next few years, they have got to get on and work with the [DoH] and with the optical steering group Ð that's happening.'
Rawlinson says routes forward for this expansion are plain to see in other professions where different tiers of learning have been introduced. 'If there was a core level to which [optometrists] were trained and those who wanted to do more go off and do additional training. There are examples of that in other professions.'
She is clearly making change happen within optometry and despite being FODO's first woman councillor her gender rarely has relevance.
'I've never really considered it, there are some examples in the profession Rosie Varley [at the GOC], and Bryony Pawinska at the College, so I really think it is evolving. In terms of FODO, I think I am there to contribute. I don't think it has been a case of let's keep women out.'
For the future, Rawlinson has clear goals to develop Healthcall's service through education and start to provide services for those 500,000 people at home.
improving quality of life
'I'm really proud of our service. We make a difference and I will be pleased when we can dispel the myth that domiciliary is all about ripping people off and claiming for dead patients because that is not what we are about. It gives me a huge amount of satisfaction to see someone in the latter days of their life who you have made a difference to.
'If you can prevent them falling over, you keep them out of hospital, improve the quality of their life and remove a burden from carers. They have all got a story to tell.'Jayne Rawlinson is the first woman to be given a place on the council of the Federation of Ophthalmic and Dispensing Opticians (FODO) and for the last two years she has been the managing director of Luton-based domiciliary eye care provider Healthcall.
Rawlinson made this long journey, both geographically and professionally, through a range of nursing management and hospital management posts. She is clearly a woman keen to deliver service and success, a trait others recognised in her from early days of nursing.
'When I first started I can remember one of the porters saying: ÒYou want the matron's job don't you?Ó And I said: ÒYes, I doÓ.'
She moved from Scotland to work at King's College Hospital and did a variety of nurse management jobs in the NHS before taken on marketing and management roles at the private Portland Hospital.
promotional activities
'I went there in 1983 to commission a paediatric unit and was promoted to a range of nursing posts including assistant director of nursing services,' she recalls.
Then followed a stint in marketing, a choice made for characteristically pragmatic reasons: 'I wanted to run a hospital and that was going to get me there a lot quicker than nursing,' she adds.
She later worked for a day surgery and construction company and then returned to the Portland as director of operations.
Her entry into optometry came two years ago when she was approached by Healthcall to run its optical division and bring some of that experience with her.
'The reason I accepted was that I had enjoyed the day surgery but optics seemed to be a clinical service which sat within primary care. There was also the retailing end which was a challenge.
'Because of my private healthcare experience, Healthcall wanted me to come in and review the business. I also had marketing expertise.'
Rawlinson says how historically domiciliary providers have operated in a rather ad hoc way. 'It was like, ÒWe have three optoms, where shall we send them tomorrow?Ó
'After the introduction of new guidelines there was much more stringent control, much more attention to counter-fraud services, for instance, so the whole thing had been flipped on its head.'
However, Nestor, the £500m parent company of Healthcall, believes it has a role to play in eye care. Although she had experience of healthcare services, Rawlinson brought no preconceptions about the optical business with her.
'I approached it with a fresh eye. I could see there was a major opportunity but I was very surprised that the role of the optometrist had not been extended more.'
The contrast with acute health is stark, she says. In that arena, the transfer of skills over the last 10 years has come on in leaps and bounds.
'In optics you have a group of individuals who are highly skilled and trained, who are not performing all of the tasks that they might.'
As an ex-hospital manager she believes there are clear economic benefits. 'If you take someone out of the hospital service and put them in front of an optometrist there are real savings to be made.'
She believes the problem of why clinicians' skills are not used more stem from the bizarre business model the profession works to. This devalues the optometry role and relies on product sales for profit. Opticians provide such a great service for such a paltry fee.
'Frankly, no one is going to get rich testing eyes,' she says. 'But,' she adds, 'the profession has done that to itself.'
'Having a clinical background myself, it does enrage me to see people devaluing something that has enormous benefit to the patients. I appreciate that you have to create competitive advantage but still maintain the quality and the ethical stance, that's something that is important to me personally,' she says, adding that this can be done while remaining a profitable part of a modern plc.
These issues are most pressing in the domiciliary area where the patients can often be the most clinically needy, but often, the poorest members of society.
Rawlinson is candid about the issues facing the domiciliary providers and admits that until proper funding arrives it will be hard for businesses to provide a good service to people in their own homes.
'Our market is predominantly within care homes. We do provide a service for sheltered accommodation and some day units but even that is contentious. There is a cost attached to getting people to the day centre. But if you provide other services Ð hearing, chiropody and sight Ð it makes good economic sense. We need to work with the DoH and the PCTs to educate them in that. But that is the only commercially viably way of doing it. If we had to do it any other way we might as well pack up our bags.'
Rawlinson says she is mindful of her commitment to Healthcall's 120 staff and 25 optometrists, who rely on the business remaining sound. The group conducts 87,000 examinations a year with 25 teams out each day and follow-up visits from dispensers. To maintain that service the business must be viable.
'What we and try and do for the people at home is try and fit them in with the rest of our normal days because that's the only commercially viable way of doing it, what invariably happens is that we say, ÒYes, we will come and test your eyes but we don't know when that will be, it's perhaps six or eight weeks before we are in that areaÓ.' That is an issue she is currently applying her effort towards.
Domiciliary challenges
Healthcall is passionate about domiciliary eye care, says Rawlinson, but the same challenges face all domiciliary providers. As part of her FODO role, Rawlinson chairs the domiciliary eye care group in which the providers work together.
'We have got to ensure that domiciliary providers are delivering to a certain code of conduct which fits in with the expectations of the PCTs and the DoH.
'Eye care ranks below the hairdresser in care homes. We can mobilise a team, which is not cheap, and send them to test maybe 10 patients, only to be met at the door and told that the hairdresser is there this morning. So that's one of the areas we need to work on and educate care workers in the homes about.
'One thing that really makes my blood boil was when we found was there was incentivisation in the market where individuals and companies were trying to get into nursing homes by saying, Òwe will test the eyes of the staff and give you free glassesÓ. I believe that is an inducement and it is ethically unacceptable.'
Healthcall decided to try and give itself a competitive edge through training, by educating carers about good eye care and simple things like good lighting.
'In a lot of the care homes we go into, a glow worm would emit more light. Because the care staff are trying to create a homely and cosy atmosphere, you can't see a blessed thing. As part of our added value we teach the staff about the importance of lighting, about the importance of contrast, not to put potatoes and fish on a white plate. It's not rocket science, but it makes a huge difference.'
unseen and forgotten
Rawlinson is not so up-beat about those 500,000 patients at home who the RNIB identified in its report Unseen and Forgotten, and are denied optometric services.
'The people at home are a lot harder to service, until the reimbursement is different you can't service them equitably. I think it is important that in domiciliary we keep banging the drum. If we were to walk away tomorrow there would be huge problems for the patients. GPs and the government would have to provide the services. There are discussions among the domiciliary providers as to how we can get an increase to the fee.'
Rawlinson is upbeat about the future and says that the steering groups and DoH understand the issues facing optics.
'Just in terms of general optics, I can see a real willingness. It is almost like someone has put the light on. If they can expand the role of the optometrist and move some of the services into the high street they can make real differences in terms of things like cataract waiting lists.'
She cites the referral route for cataract, involving optometrists can reduce the need for 11 patient trips down to five.
'The DoH are absolutely committed with £53m for cataracts and £4m to be ring-fenced to look at the management of other eye conditions and it is keen to include the primary provider Ð the optometrist.'
Whether that will stretch to full deregulation Rawlinson is not prepared to guess. What she does believe is that there are massive opportunities for optometrists to take the initiative. With the number of optometrists increasing and salaries falling those pressures will increase, she adds.
'If optoms want to be considered as true clinicians they have to go down the CET line. It's a big challenge but I get the sense that some optometrists have not faced up to it yet. Salaries have become much more stable in the last two years and recruitment has become easier. As the role of the optometrist is extended there will be a need for more people in different job roles. The universities and the profession understand this,' she says.
'I've seen the change in salaries but the changing role of optometrists, the extended role, will have a bigger impact.'
She believes it is good timing in terms of extra people coming into the marketplace but what they have got to be smart about is developing that extended role.
'They can't hang around and mull it over for the next few years, they have got to get on and work with the [DoH] and with the optical steering group Ð that's happening.'
Rawlinson says routes forward for this expansion are plain to see in other professions where different tiers of learning have been introduced. 'If there was a core level to which [optometrists] were trained and those who wanted to do more go off and do additional training. There are examples of that in other professions.'
She is clearly making change happen within optometry and despite being FODO's first woman councillor her gender rarely has relevance.
'I've never really considered it, there are some examples in the profession Rosie Varley [at the GOC], and Bryony Pawinska at the College, so I really think it is evolving. In terms of FODO, I think I am there to contribute. I don't think it has been a case of let's keep women out.'
For the future, Rawlinson has clear goals to develop Healthcall's service through education and start to provide services for those 500,000 people at home.
improving quality of life
'I'm really proud of our service. We make a difference and I will be pleased when we can dispel the myth that domiciliary is all about ripping people off and claiming for dead patients because that is not what we are about. It gives me a huge amount of satisfaction to see someone in the latter days of their life who you have made a difference to.
'If you can prevent them falling over, you keep them out of hospital, improve the quality of their life and remove a burden from carers. They have all got a story to tell.'Jayne Rawlinson is the first woman to be given a place on the council of the Federation of Ophthalmic and Dispensing Opticians (FODO) and for the last two years she has been the managing director of Luton-based domiciliary eye care provider Healthcall.
Rawlinson made this long journey, both geographically and professionally, through a range of nursing management and hospital management posts. She is clearly a woman keen to deliver service and success, a trait others recognised in her from early days of nursing.
'When I first started I can remember one of the porters saying: ÒYou want the matron's job don't you?Ó And I said: ÒYes, I doÓ.'
She moved from Scotland to work at King's College Hospital and did a variety of nurse management jobs in the NHS before taken on marketing and management roles at the private Portland Hospital.
promotional activities
'I went there in 1983 to commission a paediatric unit and was promoted to a range of nursing posts including assistant director of nursing services,' she recalls.
Then followed a stint in marketing, a choice made for characteristically pragmatic reasons: 'I wanted to run a hospital and that was going to get me there a lot quicker than nursing,' she adds.
She later worked for a day surgery and construction company and then returned to the Portland as director of operations.
Her entry into optometry came two years ago when she was approached by Healthcall to run its optical division and bring some of that experience with her.
'The reason I accepted was that I had enjoyed the day surgery but optics seemed to be a clinical service which sat within primary care. There was also the retailing end which was a challenge.
'Because of my private healthcare experience, Healthcall wanted me to come in and review the business. I also had marketing expertise.'
Rawlinson says how historically domiciliary providers have operated in a rather ad hoc way. 'It was like, ÒWe have three optoms, where shall we send them tomorrow?Ó
'After the introduction of new guidelines there was much more stringent control, much more attention to counter-fraud services, for instance, so the whole thing had been flipped on its head.'
However, Nestor, the £500m parent company of Healthcall, believes it has a role to play in eye care. Although she had experience of healthcare services, Rawlinson brought no preconceptions about the optical business with her.
'I approached it with a fresh eye. I could see there was a major opportunity but I was very surprised that the role of the optometrist had not been extended more.'
The contrast with acute health is stark, she says. In that arena, the transfer of skills over the last 10 years has come on in leaps and bounds.
'In optics you have a group of individuals who are highly skilled and trained, who are not performing all of the tasks that they might.'
As an ex-hospital manager she believes there are clear economic benefits. 'If you take someone out of the hospital service and put them in front of an optometrist there are real savings to be made.'
She believes the problem of why clinicians' skills are not used more stem from the bizarre business model the profession works to. This devalues the optometry role and relies on product sales for profit. Opticians provide such a great service for such a paltry fee.
'Frankly, no one is going to get rich testing eyes,' she says. 'But,' she adds, 'the profession has done that to itself.'
'Having a clinical background myself, it does enrage me to see people devaluing something that has enormous benefit to the patients. I appreciate that you have to create competitive advantage but still maintain the quality and the ethical stance, that's something that is important to me personally,' she says, adding that this can be done while remaining a profitable part of a modern plc.
These issues are most pressing in the domiciliary area where the patients can often be the most clinically needy, but often, the poorest members of society.
Rawlinson is candid about the issues facing the domiciliary providers and admits that until proper funding arrives it will be hard for businesses to provide a good service to people in their own homes.
'Our market is predominantly within care homes. We do provide a service for sheltered accommodation and some day units but even that is contentious. There is a cost attached to getting people to the day centre. But if you provide other services Ð hearing, chiropody and sight Ð it makes good economic sense. We need to work with the DoH and the PCTs to educate them in that. But that is the only commercially viably way of doing it. If we had to do it any other way we might as well pack up our bags.'
Rawlinson says she is mindful of her commitment to Healthcall's 120 staff and 25 optometrists, who rely on the business remaining sound. The group conducts 87,000 examinations a year with 25 teams out each day and follow-up visits from dispensers. To maintain that service the business must be viable.
'What we and try and do for the people at home is try and fit them in with the rest of our normal days because that's the only commercially viable way of doing it, what invariably happens is that we say, ÒYes, we will come and test your eyes but we don't know when that will be, it's perhaps six or eight weeks before we are in that areaÓ.' That is an issue she is currently applying her effort towards.
Domiciliary challenges
Healthcall is passionate about domiciliary eye care, says Rawlinson, but the same challenges face all domiciliary providers. As part of her FODO role, Rawlinson chairs the domiciliary eye care group in which the providers work together.
'We have got to ensure that domiciliary providers are delivering to a certain code of conduct which fits in with the expectations of the PCTs and the DoH.
'Eye care ranks below the hairdresser in care homes. We can mobilise a team, which is not cheap, and send them to test maybe 10 patients, only to be met at the door and told that the hairdresser is there this morning. So that's one of the areas we need to work on and educate care workers in the homes about.
'One thing that really makes my blood boil was when we found was there was incentivisation in the market where individuals and companies were trying to get into nursing homes by saying, Òwe will test the eyes of the staff and give you free glassesÓ. I believe that is an inducement and it is ethically unacceptable.'
Healthcall decided to try and give itself a competitive edge through training, by educating carers about good eye care and simple things like good lighting.
'In a lot of the care homes we go into, a glow worm would emit more light. Because the care staff are trying to create a homely and cosy atmosphere, you can't see a blessed thing. As part of our added value we teach the staff about the importance of lighting, about the importance of contrast, not to put potatoes and fish on a white plate. It's not rocket science, but it makes a huge difference.'
unseen and forgotten
Rawlinson is not so up-beat about those 500,000 patients at home who the RNIB identified in its report Unseen and Forgotten, and are denied optometric services.
'The people at home are a lot harder to service, until the reimbursement is different you can't service them equitably. I think it is important that in domiciliary we keep banging the drum. If we were to walk away tomorrow there would be huge problems for the patients. GPs and the government would have to provide the services. There are discussions among the domiciliary providers as to how we can get an increase to the fee.'
Rawlinson is upbeat about the future and says that the steering groups and DoH understand the issues facing optics.
'Just in terms of general optics, I can see a real willingness. It is almost like someone has put the light on. If they can expand the role of the optometrist and move some of the services into the high street they can make real differences in terms of things like cataract waiting lists.'
She cites the referral route for cataract, involving optometrists can reduce the need for 11 patient trips down to five.
'The DoH are absolutely committed with £53m for cataracts and £4m to be ring-fenced to look at the management of other eye conditions and it is keen to include the primary provider Ð the optometrist.'
Whether that will stretch to full deregulation Rawlinson is not prepared to guess. What she does believe is that there are massive opportunities for optometrists to take the initiative. With the number of optometrists increasing and salaries falling those pressures will increase, she adds.
'If optoms want to be considered as true clinicians they have to go down the CET line. It's a big challenge but I get the sense that some optometrists have not faced up to it yet. Salaries have become much more stable in the last two years and recruitment has become easier. As the role of the optometrist is extended there will be a need for more people in different job roles. The universities and the profession understand this,' she says.
'I've seen the change in salaries but the changing role of optometrists, the extended role, will have a bigger impact.'
She believes it is good timing in terms of extra people coming into the marketplace but what they have got to be smart about is developing that extended role.
'They can't hang around and mull it over for the next few years, they have got to get on and work with the [DoH] and with the optical steering group Ð that's happening.'
Rawlinson says routes forward for this expansion are plain to see in other professions where different tiers of learning have been introduced. 'If there was a core level to which [optometrists] were trained and those who wanted to do more go off and do additional training. There are examples of that in other professions.'
She is clearly making change happen within optometry and despite being FODO's first woman councillor her gender rarely has relevance.
'I've never really considered it, there are some examples in the profession Rosie Varley [at the GOC], and Bryony Pawinska at the College, so I really think it is evolving. In terms of FODO, I think I am there to contribute. I don't think it has been a case of let's keep women out.'
For the future, Rawlinson has clear goals to develop Healthcall's service through education and start to provide services for those 500,000 people at home.
improving quality of life
'I'm really proud of our service. We make a difference and I will be pleased when we can dispel the myth that domiciliary is all about ripping people off and claiming for dead patients because that is not what we are about. It gives me a huge amount of satisfaction to see someone in the latter days of their life who you have made a difference to.
'If you can prevent them falling over, you keep them out of hospital, improve the quality of their life and remove a burden from carers. They have all got a story to tell.'Jayne Rawlinson is the first woman to be given a place on the council of the Federation of Ophthalmic and Dispensing Opticians (FODO) and for the last two years she has been the managing director of Luton-based domiciliary eye care provider Healthcall.
Rawlinson made this long journey, both geographically and professionally, through a range of nursing management and hospital management posts. She is clearly a woman keen to deliver service and success, a trait others recognised in her from early days of nursing.
'When I first started I can remember one of the porters saying: ÒYou want the matron's job don't you?Ó And I said: ÒYes, I doÓ.'
She moved from Scotland to work at King's College Hospital and did a variety of nurse management jobs in the NHS before taken on marketing and management roles at the private Portland Hospital.
promotional activities
'I went there in 1983 to commission a paediatric unit and was promoted to a range of nursing posts including assistant director of nursing services,' she recalls.
Then followed a stint in marketing, a choice made for characteristically pragmatic reasons: 'I wanted to run a hospital and that was going to get me there a lot quicker than nursing,' she adds.
She later worked for a day surgery and construction company and then returned to the Portland as director of operations.
Her entry into optometry came two years ago when she was approached by Healthcall to run its optical division and bring some of that experience with her.
'The reason I accepted was that I had enjoyed the day surgery but optics seemed to be a clinical service which sat within primary care. There was also the retailing end which was a challenge.
'Because of my private healthcare experience, Healthcall wanted me to come in and review the business. I also had marketing expertise.'
Rawlinson says how historically domiciliary providers have operated in a rather ad hoc way. 'It was like, ÒWe have three optoms, where shall we send them tomorrow?Ó
'After the introduction of new guidelines there was much more stringent control, much more attention to counter-fraud services, for instance, so the whole thing had been flipped on its head.'
However, Nestor, the £500m parent company of Healthcall, believes it has a role to play in eye care. Although she had experience of healthcare services, Rawlinson brought no preconceptions about the optical business with her.
'I approached it with a fresh eye. I could see there was a major opportunity but I was very surprised that the role of the optometrist had not been extended more.'
The contrast with acute health is stark, she says. In that arena, the transfer of skills over the last 10 years has come on in leaps and bounds.
'In optics you have a group of individuals who are highly skilled and trained, who are not performing all of the tasks that they might.'
As an ex-hospital manager she believes there are clear economic benefits. 'If you take someone out of the hospital service and put them in front of an optometrist there are real savings to be made.'
She believes the problem of why clinicians' skills are not used more stem from the bizarre business model the profession works to. This devalues the optometry role and relies on product sales for profit. Opticians provide such a great service for such a paltry fee.
'Frankly, no one is going to get rich testing eyes,' she says. 'But,' she adds, 'the profession has done that to itself.'
'Having a clinical background myself, it does enrage me to see people devaluing something that has enormous benefit to the patients. I appreciate that you have to create competitive advantage but still maintain the quality and the ethical stance, that's something that is important to me personally,' she says, adding that this can be done while remaining a profitable part of a modern plc.
These issues are most pressing in the domiciliary area where the patients can often be the most clinically needy, but often, the poorest members of society.
Rawlinson is candid about the issues facing the domiciliary providers and admits that until proper funding arrives it will be hard for businesses to provide a good service to people in their own homes.
'Our market is predominantly within care homes. We do provide a service for sheltered accommodation and some day units but even that is contentious. There is a cost attached to getting people to the day centre. But if you provide other services Ð hearing, chiropody and sight Ð it makes good economic sense. We need to work with the DoH and the PCTs to educate them in that. But that is the only commercially viably way of doing it. If we had to do it any other way we might as well pack up our bags.'
Rawlinson says she is mindful of her commitment to Healthcall's 120 staff and 25 optometrists, who rely on the business remaining sound. The group conducts 87,000 examinations a year with 25 teams out each day and follow-up visits from dispensers. To maintain that service the business must be viable.
'What we and try and do for the people at home is try and fit them in with the rest of our normal days because that's the only commercially viable way of doing it, what invariably happens is that we say, ÒYes, we will come and test your eyes but we don't know when that will be, it's perhaps six or eight weeks before we are in that areaÓ.' That is an issue she is currently applying her effort towards.
Domiciliary challenges
Healthcall is passionate about domiciliary eye care, says Rawlinson, but the same challenges face all domiciliary providers. As part of her FODO role, Rawlinson chairs the domiciliary eye care group in which the providers work together.
'We have got to ensure that domiciliary providers are delivering to a certain code of conduct which fits in with the expectations of the PCTs and the DoH.
'Eye care ranks below the hairdresser in care homes. We can mobilise a team, which is not cheap, and send them to test maybe 10 patients, only to be met at the door and told that the hairdresser is there this morning. So that's one of the areas we need to work on and educate care workers in the homes about.
'One thing that really makes my blood boil was when we found was there was incentivisation in the market where individuals and companies were trying to get into nursing homes by saying, Òwe will test the eyes of the staff and give you free glassesÓ. I believe that is an inducement and it is ethically unacceptable.'
Healthcall decided to try and give itself a competitive edge through training, by educating carers about good eye care and simple things like good lighting.
'In a lot of the care homes we go into, a glow worm would emit more light. Because the care staff are trying to create a homely and cosy atmosphere, you can't see a blessed thing. As part of our added value we teach the staff about the importance of lighting, about the importance of contrast, not to put potatoes and fish on a white plate. It's not rocket science, but it makes a huge difference.'
unseen and forgotten
Rawlinson is not so up-beat about those 500,000 patients at home who the RNIB identified in its report Unseen and Forgotten, and are denied optometric services.
'The people at home are a lot harder to service, until the reimbursement is different you can't service them equitably. I think it is important that in domiciliary we keep banging the drum. If we were to walk away tomorrow there would be huge problems for the patients. GPs and the government would have to provide the services. There are discussions among the domiciliary providers as to how we can get an increase to the fee.'
Rawlinson is upbeat about the future and says that the steering groups and DoH understand the issues facing optics.
'Just in terms of general optics, I can see a real willingness. It is almost like someone has put the light on. If they can expand the role of the optometrist and move some of the services into the high street they can make real differences in terms of things like cataract waiting lists.'
She cites the referral route for cataract, involving optometrists can reduce the need for 11 patient trips down to five.
'The DoH are absolutely committed with £53m for cataracts and £4m to be ring-fenced to look at the management of other eye conditions and it is keen to include the primary provider Ð the optometrist.'
Whether that will stretch to full deregulation Rawlinson is not prepared to guess. What she does believe is that there are massive opportunities for optometrists to take the initiative. With the number of optometrists increasing and salaries falling those pressures will increase, she adds.
'If optoms want to be considered as true clinicians they have to go down the CET line. It's a big challenge but I get the sense that some optometrists have not faced up to it yet. Salaries have become much more stable in the last two years and recruitment has become easier. As the role of the optometrist is extended there will be a need for more people in different job roles. The universities and the profession understand this,' she says.
'I've seen the change in salaries but the changing role of optometrists, the extended role, will have a bigger impact.'
She believes it is good timing in terms of extra people coming into the marketplace but what they have got to be smart about is developing that extended role.
'They can't hang around and mull it over for the next few years, they have got to get on and work with the [DoH] and with the optical steering group Ð that's happening.'
Rawlinson says routes forward for this expansion are plain to see in other professions where different tiers of learning have been introduced. 'If there was a core level to which [optometrists] were trained and those who wanted to do more go off and do additional training. There are examples of that in other professions.'
She is clearly making change happen within optometry and despite being FODO's first woman councillor her gender rarely has relevance.
'I've never really considered it, there are some examples in the profession Rosie Varley [at the GOC], and Bryony Pawinska at the College, so I really think it is evolving. In terms of FODO, I think I am there to contribute. I don't think it has been a case of let's keep women out.'
For the future, Rawlinson has clear goals to develop Healthcall's service through education and start to provide services for those 500,000 people at home.
improving quality of life
'I'm really proud of our service. We make a difference and I will be pleased when we can dispel the myth that domiciliary is all about ripping people off and claiming for dead patients because that is not what we are about. It gives me a huge amount of satisfaction to see someone in the latter days of their life who you have made a difference to.
'If you can prevent them falling over, you keep them out of hospital, improve the quality of their life and remove a burden from carers. They have all got a story to tell.'Jayne Rawlinson is the first woman to be given a place on the council of the Federation of Ophthalmic and Dispensing Opticians (FODO) and for the last two years she has been the managing director of Luton-based domiciliary eye care provider Healthcall.
Rawlinson made this long journey, both geographically and professionally, through a range of nursing management and hospital management posts. She is clearly a woman keen to deliver service and success, a trait others recognised in her from early days of nursing.
'When I first started I can remember one of the porters saying: ÒYou want the matron's job don't you?Ó And I said: ÒYes, I doÓ.'
She moved from Scotland to work at King's College Hospital and did a variety of nurse management jobs in the NHS before taken on marketing and management roles at the private Portland Hospital.
promotional activities
'I went there in 1983 to commission a paediatric unit and was promoted to a range of nursing posts including assistant director of nursing services,' she recalls.
Then followed a stint in marketing, a choice made for characteristically pragmatic reasons: 'I wanted to run a hospital and that was going to get me there a lot quicker than nursing,' she adds.
She later worked for a day surgery and construction company and then returned to the Portland as director of operations.
Her entry into optometry came two years ago when she was approached by Healthcall to run its optical division and bring some of that experience with her.
'The reason I accepted was that I had enjoyed the day surgery but optics seemed to be a clinical service which sat within primary care. There was also the retailing end which was a challenge.
'Because of my private healthcare experience, Healthcall wanted me to come in and review the business. I also had marketing expertise.'
Rawlinson says how historically domiciliary providers have operated in a rather ad hoc way. 'It was like, ÒWe have three optoms, where shall we send them tomorrow?Ó
'After the introduction of new guidelines there was much more stringent control, much more attention to counter-fraud services, for instance, so the whole thing had been flipped on its head.'
However, Nestor, the £500m parent company of Healthcall, believes it has a role to play in eye care. Although she had experience of healthcare services, Rawlinson brought no preconceptions about the optical business with her.
'I approached it with a fresh eye. I could see there was a major opportunity but I was very surprised that the role of the optometrist had not been extended more.'
The contrast with acute health is stark, she says. In that arena, the transfer of skills over the last 10 years has come on in leaps and bounds.
'In optics you have a group of individuals who are highly skilled and trained, who are not performing all of the tasks that they might.'
As an ex-hospital manager she believes there are clear economic benefits. 'If you take someone out of the hospital service and put them in front of an optometrist there are real savings to be made.'
She believes the problem of why clinicians' skills are not used more stem from the bizarre business model the profession works to. This devalues the optometry role and relies on product sales for profit. Opticians provide such a great service for such a paltry fee.
'Frankly, no one is going to get rich testing eyes,' she says. 'But,' she adds, 'the profession has done that to itself.'
'Having a clinical background myself, it does enrage me to see people devaluing something that has enormous benefit to the patients. I appreciate that you have to create competitive advantage but still maintain the quality and the ethical stance, that's something that is important to me personally,' she says, adding that this can be done while remaining a profitable part of a modern plc.
These issues are most pressing in the domiciliary area where the patients can often be the most clinically needy, but often, the poorest members of society.
Rawlinson is candid about the issues facing the domiciliary providers and admits that until proper funding arrives it will be hard for businesses to provide a good service to people in their own homes.
'Our market is predominantly within care homes. We do provide a service for sheltered accommodation and some day units but even that is contentious. There is a cost attached to getting people to the day centre. But if you provide other services Ð hearing, chiropody and sight Ð it makes good economic sense. We need to work with the DoH and the PCTs to educate them in that. But that is the only commercially viably way of doing it. If we had to do it any other way we might as well pack up our bags.'
Rawlinson says she is mindful of her commitment to Healthcall's 120 staff and 25 optometrists, who rely on the business remaining sound. The group conducts 87,000 examinations a year with 25 teams out each day and follow-up visits from dispensers. To maintain that service the business must be viable.
'What we and try and do for the people at home is try and fit them in with the rest of our normal days because that's the only commercially viable way of doing it, what invariably happens is that we say, ÒYes, we will come and test your eyes but we don't know when that will be, it's perhaps six or eight weeks before we are in that areaÓ.' That is an issue she is currently applying her effort towards.
Domiciliary challenges
Healthcall is passionate about domiciliary eye care, says Rawlinson, but the same challenges face all domiciliary providers. As part of her FODO role, Rawlinson chairs the domiciliary eye care group in which the providers work together.
'We have got to ensure that domiciliary providers are delivering to a certain code of conduct which fits in with the expectations of the PCTs and the DoH.
'Eye care ranks below the hairdresser in care homes. We can mobilise a team, which is not cheap, and send them to test maybe 10 patients, only to be met at the door and told that the hairdresser is there this morning. So that's one of the areas we need to work on and educate care workers in the homes about.
'One thing that really makes my blood boil was when we found was there was incentivisation in the market where individuals and companies were trying to get into nursing homes by saying, Òwe will test the eyes of the staff and give you free glassesÓ. I believe that is an inducement and it is ethically unacceptable.'
Healthcall decided to try and give itself a competitive edge through training, by educating carers about good eye care and simple things like good lighting.
'In a lot of the care homes we go into, a glow worm would emit more light. Because the care staff are trying to create a homely and cosy atmosphere, you can't see a blessed thing. As part of our added value we teach the staff about the importance of lighting, about the importance of contrast, not to put potatoes and fish on a white plate. It's not rocket science, but it makes a huge difference.'
unseen and forgotten
Rawlinson is not so up-beat about those 500,000 patients at home who the RNIB identified in its report Unseen and Forgotten, and are denied optometric services.
'The people at home are a lot harder to service, until the reimbursement is different you can't service them equitably. I think it is important that in domiciliary we keep banging the drum. If we were to walk away tomorrow there would be huge problems for the patients. GPs and the government would have to provide the services. There are discussions among the domiciliary providers as to how we can get an increase to the fee.'
Rawlinson is upbeat about the future and says that the steering groups and DoH understand the issues facing optics.
'Just in terms of general optics, I can see a real willingness. It is almost like someone has put the light on. If they can expand the role of the optometrist and move some of the services into the high street they can make real differences in terms of things like cataract waiting lists.'
She cites the referral route for cataract, involving optometrists can reduce the need for 11 patient trips down to five.
'The DoH are absolutely committed with £53m for cataracts and £4m to be ring-fenced to look at the management of other eye conditions and it is keen to include the primary provider Ð the optometrist.'
Whether that will stretch to full deregulation Rawlinson is not prepared to guess. What she does believe is that there are massive opportunities for optometrists to take the initiative. With the number of optometrists increasing and salaries falling those pressures will increase, she adds.
'If optoms want to be considered as true clinicians they have to go down the CET line. It's a big challenge but I get the sense that some optometrists have not faced up to it yet. Salaries have become much more stable in the last two years and recruitment has become easier. As the role of the optometrist is extended there will be a need for more people in different job roles. The universities and the profession understand this,' she says.
'I've seen the change in salaries but the changing role of optometrists, the extended role, will have a bigger impact.'
She believes it is good timing in terms of extra people coming into the marketplace but what they have got to be smart about is developing that extended role.
'They can't hang around and mull it over for the next few years, they have got to get on and work with the [DoH] and with the optical steering group Ð that's happening.'
Rawlinson says routes forward for this expansion are plain to see in other professions where different tiers of learning have been introduced. 'If there was a core level to which [optometrists] were trained and those who wanted to do more go off and do additional training. There are examples of that in other professions.'
She is clearly making change happen within optometry and despite being FODO's first woman councillor her gender rarely has relevance.
'I've never really considered it, there are some examples in the profession Rosie Varley [at the GOC], and Bryony Pawinska at the College, so I really think it is evolving. In terms of FODO, I think I am there to contribute. I don't think it has been a case of let's keep women out.'
For the future, Rawlinson has clear goals to develop Healthcall's service through education and start to provide services for those 500,000 people at home.
improving quality of life
'I'm really proud of our service. We make a difference and I will be pleased when we can dispel the myth that domiciliary is all about ripping people off and claiming for dead patients because that is not what we are about. It gives me a huge amount of satisfaction to see someone in the latter days of their life who you have made a difference to.
'If you can prevent them falling over, you keep them out of hospital, improve the quality of their life and remove a burden from carers. They have all got a story to tell.'Jayne Rawlinson is the first woman to be given a place on the council of the Federation of Ophthalmic and Dispensing Opticians (FODO) and for the last two years she has been the managing director of Luton-based domiciliary eye care provider Healthcall.
Rawlinson made this long journey, both geographically and professionally, through a range of nursing management and hospital management posts. She is clearly a woman keen to deliver service and success, a trait others recognised in her from early days of nursing.
'When I first started I can remember one of the porters saying: ÒYou want the matron's job don't you?Ó And I said: ÒYes, I doÓ.'
She moved from Scotland to work at King's College Hospital and did a variety of nurse management jobs in the NHS before taken on marketing and management roles at the private Portland Hospital.
promotional activities
'I went there in 1983 to commission a paediatric unit and was promoted to a range of nursing posts including assistant director of nursing services,' she recalls.
Then followed a stint in marketing, a choice made for characteristically pragmatic reasons: 'I wanted to run a hospital and that was going to get me there a lot quicker than nursing,' she adds.
She later worked for a day surgery and construction company and then returned to the Portland as director of operations.
Her entry into optometry came two years ago when she was approached by Healthcall to run its optical division and bring some of that experience with her.
'The reason I accepted was that I had enjoyed the day surgery but optics seemed to be a clinical service which sat within primary care. There was also the retailing end which was a challenge.
'Because of my private healthcare experience, Healthcall wanted me to come in and review the business. I also had marketing expertise.'
Rawlinson says how historically domiciliary providers have operated in a rather ad hoc way. 'It was like, ÒWe have three optoms, where shall we send them tomorrow?Ó
'After the introduction of new guidelines there was much more stringent control, much more attention to counter-fraud services, for instance, so the whole thing had been flipped on its head.'
However, Nestor, the £500m parent company of Healthcall, believes it has a role to play in eye care. Although she had experience of healthcare services, Rawlinson brought no preconceptions about the optical business with her.
'I approached it with a fresh eye. I could see there was a major opportunity but I was very surprised that the role of the optometrist had not been extended more.'
The contrast with acute health is stark, she says. In that arena, the transfer of skills over the last 10 years has come on in leaps and bounds.
'In optics you have a group of individuals who are highly skilled and trained, who are not performing all of the tasks that they might.'
As an ex-hospital manager she believes there are clear economic benefits. 'If you take someone out of the hospital service and put them in front of an optometrist there are real savings to be made.'
She believes the problem of why clinicians' skills are not used more stem from the bizarre business model the profession works to. This devalues the optometry role and relies on product sales for profit. Opticians provide such a great service for such a paltry fee.
'Frankly, no one is going to get rich testing eyes,' she says. 'But,' she adds, 'the profession has done that to itself.'
'Having a clinical background myself, it does enrage me to see people devaluing something that has enormous benefit to the patients. I appreciate that you have to create competitive advantage but still maintain the quality and the ethical stance, that's something that is important to me personally,' she says, adding that this can be done while remaining a profitable part of a modern plc.
These issues are most pressing in the domiciliary area where the patients can often be the most clinically needy, but often, the poorest members of society.
Rawlinson is candid about the issues facing the domiciliary providers and admits that until proper funding arrives it will be hard for businesses to provide a good service to people in their own homes.
'Our market is predominantly within care homes. We do provide a service for sheltered accommodation and some day units but even that is contentious. There is a cost attached to getting people to the day centre. But if you provide other services Ð hearing, chiropody and sight Ð it makes good economic sense. We need to work with the DoH and the PCTs to educate them in that. But that is the only commercially viably way of doing it. If we had to do it any other way we might as well pack up our bags.'
Rawlinson says she is mindful of her commitment to Healthcall's 120 staff and 25 optometrists, who rely on the business remaining sound. The group conducts 87,000 examinations a year with 25 teams out each day and follow-up visits from dispensers. To maintain that service the business must be viable.
'What we and try and do for the people at home is try and fit them in with the rest of our normal days because that's the only commercially viable way of doing it, what invariably happens is that we say, ÒYes, we will come and test your eyes but we don't know when that will be, it's perhaps six or eight weeks before we are in that areaÓ.' That is an issue she is currently applying her effort towards.
Domiciliary challenges
Healthcall is passionate about domiciliary eye care, says Rawlinson, but the same challenges face all domiciliary providers. As part of her FODO role, Rawlinson chairs the domiciliary eye care group in which the providers work together.
'We have got to ensure that domiciliary providers are delivering to a certain code of conduct which fits in with the expectations of the PCTs and the DoH.
'Eye care ranks below the hairdresser in care homes. We can mobilise a team, which is not cheap, and send them to test maybe 10 patients, only to be met at the door and told that the hairdresser is there this morning. So that's one of the areas we need to work on and educate care workers in the homes about.
'One thing that really makes my blood boil was when we found was there was incentivisation in the market where individuals and companies were trying to get into nursing homes by saying, Òwe will test the eyes of the staff and give you free glassesÓ. I believe that is an inducement and it is ethically unacceptable.'
Healthcall decided to try and give itself a competitive edge through training, by educating carers about good eye care and simple things like good lighting.
'In a lot of the care homes we go into, a glow worm would emit more light. Because the care staff are trying to create a homely and cosy atmosphere, you can't see a blessed thing. As part of our added value we teach the staff about the importance of lighting, about the importance of contrast, not to put potatoes and fish on a white plate. It's not rocket science, but it makes a huge difference.'
unseen and forgotten
Rawlinson is not so up-beat about those 500,000 patients at home who the RNIB identified in its report Unseen and Forgotten, and are denied optometric services.
'The people at home are a lot harder to service, until the reimbursement is different you can't service them equitably. I think it is important that in domiciliary we keep banging the drum. If we were to walk away tomorrow there would be huge problems for the patients. GPs and the government would have to provide the services. There are discussions among the domiciliary providers as to how we can get an increase to the fee.'
Rawlinson is upbeat about the future and says that the steering groups and DoH understand the issues facing optics.
'Just in terms of general optics, I can see a real willingness. It is almost like someone has put the light on. If they can expand the role of the optometrist and move some of the services into the high street they can make real differences in terms of things like cataract waiting lists.'
She cite
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