The NHS Long Term Plan is an ambitious initiative that includes a number of commitments, mainly designed around preventative health measures and based on primary care service delivery.
The College has welcomed the focus on improving services outside hospitals and moving towards more joined-up, preventative and personalised care for patients. Unfortunately, eye health is not addressed sufficiently in the plan, despite the capacity pressures evident in the hospital eye service.
We are pleased that the government has committed to ensuring children with learning disabilities have their eyesight needs met, and we hope it will lead to improved services, both in the community and in special schools. But across England, hospital eye services are struggling to manage rising demand due to an ageing population and more advanced ophthalmic treatments. Delayed follow-up appointments are one of the main causes of avoidable sight loss in patients.
We strongly support the ambition to establish integrated care systems, across England by 2021. It sends the signal that NHS organisations need to work with local authorities and other partners to deliver improvements in the health and care of the local population. Making greater use of primary care resources, including services provided by optometrists, is an essential move towards a joined up and efficient healthcare system that puts patients first. To help realise this, the College has been working with its partners through the Clinical Council for Eye Health Commissioning (www.ccehc.org.uk) to develop and promote sustainable systems of care, and to review the traditional boundaries between primary and secondary care, and between health and social care, to ensure better and more consistent access to care across England.
The College is also working to raise awareness and understanding in the NHS and with other health professionals that optometrists are uniquely well-positioned to play an even wider role in transforming health delivery, both in the community and in hospital settings to create a more flexible eye health provision. As more people live longer, care will be delivered in people’s homes or somewhere convenient, increasingly freeing up space in hospitals for those who need it most. In many parts of England, optometrists are delivering enhanced eye care services in community-based locations, which helps to reduce pressure on hospital eye services. The College of Optometrists’ Enhanced Scheme Evaluation project shows that specific schemes investigated within the project are clinically safe and potentially cost-effective, so the failure to recognise the extended role optometrists could play through these enhanced schemes is a missed opportunity. The College will continue to press commissioners to include these schemes in their delivery plans.
The plan also highlights the need for improved use of technology in the health and social care service. Good IT connections between optical practices and other parts of the NHS are key in realising the full potential of community optometry. The current lack of interoperability between IT systems in different parts of the NHS is a major challenge and a key issue for optometrists. There is an urgent need to act on this. Digital connectivity between optical practices and the rest of the NHS would help to provide better and more efficient care for patients and would ease the transfer of referral feedback to optometrists, which is important for patient outcomes. We hope NHS England will quickly move forward with its IT connectivity programme to establish this much-needed two-way communication between optical practices and other parts of the NHS.
At a time of great challenges and opportunities for the NHS, it is essential to make sure we deliver efficient and cost effective quality care to patients, with quicker access for those patients who need hospital services and treatment. While this plan is a significant step forward, the scale of the challenge and change required to meet it is clear. The College will continue to engage with policy-makers to ensure that optometrists are seen as a key part of the health workforce, fulfilling their potential to play an even greater role to the benefit of patients.
Olivier Denève is head of policy and public affairs at the College of Optometrists.