The College view

The NHS is changing - it has to make better use of its limited resources while at the same time improving patient choice and the accessibility of care. In eye care it can do neither without enhancing the role of the optometrist to allow direct referral, prescribing responsibilities and increased specialisation.
At a recent strategic planning meeting, senior staff and trustees of the College discussed, among other things, the impact on our members of the introduction of integrated eye care services. There was general agreement that, like all change, this could present opportunities as well as threats to the profession, but that the College very much welcomed the potential for its members to utilise and expand their professional skills, especially in the area of decision making.
Integrated eye care services will bring a range of professionals together within communities, so that, wherever possible, patients can be diagnosed, treated and managed outside of a hospital setting. Some of our members are already involved in the schemes being piloted around the country, and where this is the case there is great enthusiasm, especially where the schemes are properly funded.
The introduction of integrated eye care services requires a fundamental re-appraisal of who does what and a breaking down of traditional professional boundaries. In this way, the enhanced role of the optometrist, moving into areas traditionally seen as the purview of ophthalmology, is likely to be matched by enhanced roles for others who may take on roles traditionally performed by optometrists; an upwards skills shift in other words.
One of the College's first tasks is to get the measure of the percentage of its members who are, or who would like to be, involved in integrated care schemes, and also to reassure those who are happy with the status quo that there is a place for everyone in the brave new world of optometry. We also need to ensure that the necessary specialist training and professional support is available.
The College would like to see a much greater level of awareness by the public of what optometrists can do, so that their first port of call when they have a problem with their eyes is the optometrist rather than the GP or another healthcare provider.
Properly funded integrated community schemes will do a great deal to make that dream a reality.