Eye care provision in England needs to move away from the current ‘fractured way of working’ and should be structured on a national level, according to a new manifesto for eye health.
A post-Covid-19 manifesto that proposes ‘radical change’ to how eye care is delivered has been launched by the Association for Independent Optometrists and Dispensing Opticians (AIO).
The optical body said that the NHS would be left ‘stretched, exhausted and ill-equipped’ to deal with a backlog of patient cases after the pandemic and that optometrists were well-placed to help relieve pressure.
It said that the current arrangement between NHS England and primary care optometry was ‘broken,’ which it explained was evidenced by ‘an anachronistic, inappropriate and unrealistic’ General Ophthalmic Services contract (GOS) and fee.
The manifesto stated that the NHS has ‘minimal understanding’ of optometrists’ work and how utilising the skills of the profession could save the NHS money.
Dr Christian French, chair of the AIO, said: ‘The awful Covid-19 epidemic and the disparate NHS England handling of emergency eye care provision by optometrists, who are being asked to offer emergency care in regions where they have been campaigning to establish such schemes for years, has been a catalyst for AIO to consider a radical new approach to eye care provision.
‘The NHS will emerge from the current pandemic stretched, exhausted, and ill-equipped to deal with a significant backlog of patient cases in hospital eye services. Primary care optometry can play a full and active role in helping to relieve this pressure and is something already within their clinical capabilities. The time for all parties to come together to make change happen is now.’
The AIO highlighted that optometry should be structured on a national level in line with other primary care professions such as dentistry and pharmacy.
French added that the current way of working with clinical commissioning groups (CCGs) in England is fractured, which has resulted in a postcode lottery and unnecessary sight loss.
‘It is well known that the provision of eye health care in Scotland and Wales is far better developed and more efficient than it is in England and it is time that patients in England are treated on a similar footing,’ he said.
In its manifesto, the AIO described primary care optometry as an under-utilised resource with extensive clinical capabilities and a workforce that was eager to assist in ophthalmic co-management. The AIO set out that the solution is for primary care optometry to establish virtual clinics to examine routine patients and feed data back to hospital eye services, as well as co-managing stable patients in order to build a stronger and more supportive relationship with colleagues in secondary care.
The AIO added that GOS was an impractical tool for eye care and offered poor financial reimbursement for practitioners. It said the system should be organised on a national level and redesigned to pay for individual components of examinations, such as a basic vision check, ocular health check and minor eye conditions services.
With hospital eye services running at maximum capacity, there would be a backlog of patients once Covid-19 restrictions were lifted, the AIO highlighted. It said that a focus needed to put on managing newly diagnosed, progressive and surgical cases, as well as a review of data collected in virtual clinics and co-managing with primary care optometry would result in better allocations of costs and more targeted referrals.
Stressing the urgency of action, the AIO said optometrists and dispensing opticians were in turmoil and wanted to utilise their full clinical skillset to help patients but did not feel adequately funded by the NHS for the services they currently provide. It added that there was a growing movement among practitioners in primary care optometry who are considering abandoning the NHS contract.
The AIO has called for other optical bodies to support the manifesto, stating that it can play an important role in helping the NHS recover from the effects of the pandemic.
- Read the manifesto on the AIO’s website www.aiovision.org.