A new Strategy for Optometry document created by the Association of Optometrists (AOP) aimed at MPs, NHS commissioners and other healthcare decision makers has set out the organisation’s vision for how optometry may look in the future and how it can play a bigger part in the delivery of NHS care in the medium-to-long term.
The AOP said the strategy laid out where optometrists were qualified and equipped to deliver more NHS work and how doing so could relieve pressure on overstretched hospital eye and emergency departments. Against the backdrop of the coronavirus pandemic, the AOP added eye care in the UK had gone through fundamental change as optical practices provided crucial eye care to patients when hospitals and GPs could not.
‘The coronavirus pandemic prompted commissioners and clinicians to innovate. But NHS primary eye care beyond the sight test remains particularly patchy in England, creating a postcode lottery that is confusing and unfair for patients,’ AOP council chair Dr Julie-Anne Little told Optician.
She added: ‘Our strategy has been developed with the AOP Council and sets out a vision for key decision makers – showing how optometry can work better and smarter for the NHS and ensuring the skills of eye care professionals are used to their full potential. But it also highlights the reforms needed in eye care funding to make sure patients in every community retain access to the care they need.’
Fragmentation
In its strategy document, the AOP highlighted the disparate nature of eye care provision in Scotland, Wales, Northern Ireland and England, with the latter described as having an ‘even more fragmented’ patient experience.
Expanded systems of NHS care in practices in Scotland and Wales were being used to treat a wider range of patients in the community, said the AOP, but the system in England meant optometrists and the growing number of independent prescribing (IP) optometrists could not work to their fullest potential.
The system in England ‘lags behind’ other UK nations because extended primary care services were being commissioned locally with little central direction. ‘New NHS Planning Guidance will see this change, but until that starts to have an effect there remains a lack of consistency between areas, which results in what amounts to a postcode lottery for patients,’ said the report.
The fragmentation between nations was further exposed by the effects of the pandemic, said the AOP, with existing systems in Wales and Scotland allowing their respective governments to use optometry in their pandemic response plans. Meanwhile, in England, many parts of the country were left without provision of NHS minor eye conditions at the start of the pandemic, meaning patients would have to visit emergency departments or GPs, which had limited access. Although the situation improved with the creation of Covid-19 Urgent Eyecare Service (Cues), there was over a fifth of clinical commissioning groups that have yet to commission the services and only 78% of the population in England would be covered.
Changes
In response to fragmented pathways across the home nations, the AOP has called on MPs, NHS commissioners and other healthcare decision makers to introduce a fairly remunerated and consistent model of comprehensive eye care. The benefits, said the AOP, would be that patients would receive high quality, cost-effective care and hospital eye departments would be able to concentrate on the patients that really needed the attention of an ophthalmologist and clearing a backlog of patients waiting for cataract surgery along with other treatments that have been delayed as a result of the Covid-19
pandemic.
For optometrists and other practitioners, however, the AOP said these changes would result in care systems that saw their skills used to the fullest.