A growing need to transform eye care and potential ways change could be achieved have been outlined by optical professional bodies in response to a government consultation.
In October, the government set out its intentions to overhaul the NHS, stating that it was ‘broken, but not beaten’ and invited an open conversation about its future.
The Association of Optometrists (AOP), the College of Optometrists and the Association of British Dispensing Opticians (ABDO) submitted responses.
The AOP highlighted in its response that optometry was one of the four pillars of primary care alongside dentistry, pharmacy and general practice.
It said that by moving between 50-75% of hospital outpatient activity into primary care optometry, essential capacity in the NHS could be created.
Adam Sampson, chief executive of the AOP, said: ‘Fundamental to any redress in our healthcare system will be the ability to seize on the readiness and clinical skills that already exist within the primary care workforce, moving away from a hospital-centric funding approach. This hinges on digital connectivity, hospital tariff reform, enhanced service contracting arrangements and integrated care board composition.
‘If we can get these components right, eye care delivered on the high street will help drive the NHS towards prevention and improved standards, and reduce inequality of access for patients. We need to cut the shameful incidence of irreversible, avoidable sight loss that we currently see as a direct result of the NHS backlog and an inconsistent commissioning approach.’
The AOP made 13 recommendations for change, which included: ensuring the best examples of enhanced service provision were replicated throughout the country; establishing a new role for primary eye care; ensuring the NHS app directed patients with eye-related queries to primary eye care by default; ensure that the fees paid for enhanced primary eye care services are self-sustaining and sufficiently financially attractive to providers; mandating a national system of digital connectivity, interoperability and communication to capitalise on the opportunities of current and next generation technology.
Three big shifts
Dr Gillian Rudduck, president of the College, said it was a critical moment to shape future NHS eye care services delivery to ensure the profession ended the ongoing eye health crisis in England.
‘Optometrists have the necessary clinical skills to provide more NHS services than they are currently commissioned to perform, and our current health system in England isn’t using their skills to their full potential.
‘By implementing the government’s three big shifts for the NHS in England and prioritising eye care services in the first phase of the 10-year health plan, optometrists can help cut the long waiting times for hospital eye care, reduce the reliance on local GPs, and help preserve people’s sight and independence for longer,’ Dr Rudduck said.
The College said it supported the government’s three shifts for the NHS in England, which were: hospital to community, analogue to digital, and sickness to prevention.
It highlighted there were over 14,000 optometrists in England who were a key part of the NHS workforce and had the clinical skills to provide more services than currently commissioned to do.
The professional body added that access to primary eye care schemes, such as community minor and urgent eye care services and pre/post-operative cataract support pathways, should be available to all patients.
Plan of action
ABDO said its responses addressed long-standing systemic challenges and inefficiencies in the commissioning and delivery of eye care services across England.
ABDO CEO Alistair Bridge said: ‘We are all aware of the huge challenges within the NHS and the suggested “three big shifts in healthcare” are long overdue. A greater focus on community rather than hospital care, and investing more in prevention, mean dispensing opticians (DOs) could play an even bigger role in their patients’ clinical care in the future.’
It highlighted short-term actions for change, which included: NHS email for all primary care clinicians, widening of enhanced eye care pathways, CPD funding for DOs and the addition of DOs to the ophthalmic performers list.
Long-term actions included addressing the under-funding on the GOS sight test and supporting practices to deliver the NHS green agenda to become net zero.
Max Halford, ABDO’s clinical lead, said: ‘We recognise that there will be opportunities for our members to help in the shift of work from hospital to community, to ensure patients are seen in a timely manner, local to their home and by registered clinicians they know and trust.
‘For this to happen, we need to ensure that DOs and their colleagues in the wider eye care professions have access to digital technologies that will ensure patient data is easily accessed across the healthcare system.’
