There is no denying that the NHS as a functional body is in crisis. Why this is the case will be a topic of debate for many years to come and much of the money that should go to front-line healthcare will yet again be wasted on business managers, who will likely achieve nothing. However, our role on the front line must be to transform what we do for our patients if we are to avoid seeing increasing numbers of them suffer preventable sight loss.
It was heartening to read the interview given by Janice Foster, CEO at Locsu, at the end of last year. She highlighted the importance of the Optometry First Initiative in 2023, stating: ‘We’re working on a strategy, together with the whole sector. Optometry First is very much a sector-owned initiative. We see 2023 being a very big year for Optometry First. We want people to be getting their best eye care possible within primary care at the first opportunity, as opposed to going anywhere else.’ It is a mammoth task but, nevertheless, one we must all address.
At the outset, it is vital to tackle the elephant in the room. After reading the interview, I, in my own small way, set about trying to find out why so many people do not regularly visit their optometrist or see them as the first point of call if they have eye problems. The answers given lie at the heart of why progress often appears slow. Invariably, the answers pointed to the fact that ‘opticians’ were not seen as medical professionals. They were not even seen as paramedical. Put simply, for many years this profession has been led down a path of overt retail commercialism. There are those who have championed the retail role and, as a result, have fashioned an industry that is viewed in the same arena as stores such as JD Sports and Sainsbury’s. Bluntly, to most people in this country, we are shopkeepers selling commodities. This is where the problem lies. Those I have spoken to invariably say that they would not consider going to a retailer if they had a medical problem. Medical problems require medical expertise and medical solutions in a clinical setting, not a trip to a shop or a store.
Current adverts on television or radio often invite people to visit ‘stores’ or ‘shops’. It is this insistence by so many in our field that we are actually a retail trade that will, I have no doubt, prove to be one of the biggest obstacles this year in achieving what we aim to do. There are many optometrists seeking higher qualifications to meet these higher needs. This is laudable, but it is not ourselves that we must seek to convince of our capabilities. It is those we will negotiate with and, most importantly, those who we will desire to use our services. Currently, in the view of many potential service users, we are miles from the credibility we seek.
Sadly, the retail penetration into our profession over the years has been so complete that this ingrained view, now held by so many of the public, will be hard to change. The damage to our clinical reputation is profound. At the same time, while some of the retailers may now wish to paint a different picture, so successful have their efforts been in commercialising optometry over the decades that the task is akin to turning an oil tanker around in a canal channel.
If we truly desire to see optometry perceived as a medical first point of contact, as Optometry First would aim for, we urgently need to start to dismantle this retail facade. Hospitals are not supermarkets, doctors surgeries are not stores, and dental surgeries are not shops. As long as we continue to refer to optometric outlets as stores and shops, the public will continue to see us as shopkeepers.
Damage to our clinical reputation has been relentless over decades and repairing that damage will not happen overnight. I wish Locsu and its allies every good wish for their efforts in 2023. I believe Janice Foster when she says: ‘Optometry First is our biggest ticket item in 2023.’ I have no doubt that Locsu will throw everything at it. The question is whether large swathes of our profession truly want to be the first port of call for ophthalmic medical issues or whether they really want to plough on relentlessly with their shopkeeper bent.
Locsu may have great success negotiating with transformation teams at NHS England. I hope they do, but the true transformation must be at street level where the public should see us as an eye healthcare profession first and not a bunch of shopkeepers out to sell them goods. Those who have been successful in transforming the public view of a clinical profession into a retail one, have made millions by so doing. Now is the time to put back some of those millions into a campaign aimed at restoring our clinical reputation in the eyes of our potential service users.