Online video conferencing is something we all came to rely on in 2020 and the ebb and flow of Covid-19 restrictions meant the technology was used for Alcon’s annual Alconversation panel discussion event, which looked to reflect on an extraordinary year for the eye care sector and how it might look in the future.
The event was chaired by Richard Edwards, professional adviser to the Optical Consumer Complaints Service (OCCS) and featured a panel comprising: Lesley Longstone, chief executive and registrar at the General Optical Council; Daniel Hardiman-McCartney, clinical adviser for the College of Optometrists, Max Halford, clinical lead for the Association of British Dispensing Opticians and Association of Optometrists clinical director, Dr Peter Hampson.
Edwards, back as chair for the fourth year in succession, opened the discussion by saying the chaos and disruption caused by the pandemic had made the evening’s event more important than ever. ‘Inevitably, things can never go back to being the way they were. Our profession, like many parts of life, is simply going to have to change and we’re going to have to forge ahead and work out what our future is going to look like,’ he said.
Lasting legacies
Panelists took on a series of questions from industry media and professionals from the sector. Opening the discussion, Optician asked: ‘What were likely to be the lasting legacies of the pandemic on both optometry and optometric retail?’
Longstone began by recognising that 2020 had been a really difficult year for the sector, with some groups, such as locums, disproportionately affected. She said that while the bounce back seen post-lockdown had been positive and strong, the GOC recognised that some practitioners and businesses would not see the same response. ‘The future of the professions is still really strong,’ said Longstone.
‘If you strip the industry down to its basics, we have an ageing population with increasing eye health needs and there are pressures in secondary care that can be met by primary care. So I think one of the legacies will be some structuring of the eye care services, but I don’t think any of us (on the panel) know yet how things will settle.
‘From a regulatory perspective, the nature of the pandemic in its early stages meant we had to “fall back” on the advice of using professional judgement when practitioners were asking us questions that, at the time, we didn’t know the answers to. I hope this refocusing on professional judgement continues into the future.’
Hardiman-McCartney echoed Longstone’s thoughts on what a difficult year 2020 had been for the sector, both personally and professionally, and said he was proud to be an optometrist and proud of the way the profession had stepped up at a difficult time. ‘I think this will form the foundation of the lasting legacy of the pandemic for the profession,’ said Hardiman-McCartney.
‘Clinically, practitioners have really been challenged, using professional judgement instead of adopting blanket approaches. The sight test has transformed over the past 10 months, with more needs-led consultations and thinking about best-serving the needs of the patient with the resources to hand.
‘The way we communicate with our patients has also changed significantly,’ said Hardiman-McCartney. ‘The adoption of remote and virtual consultations has been widespread and while there shouldn’t be a complete migration, there are aspects that can be locked into the future that will allow us to triage more effectively and deliver care more conveniently.’
Dr Hampson felt much of the lasting change would come in the optometric retail sector: ‘Whether you think it’s good or bad, optometry has had a business model for the past 50 or so years that has been heavily-linked to the sale of spectacles and contact lenses and we think that may potentially break going forwards as more people migrate to buying products online.’
Contact lenses
The theme of professional judgement and discretion during the pandemic continued when the panel began to consider how contact lenses were dispensed during lockdown. Additional leeway for supplying contacts to patients who were overdue check-ups was granted by the GOC during the initial lockdown period, but the concern among professionals was that this could lead to less regulation in future.
Halford said it had been empowering to hear the GOC stress the importance of exercising clinical judgement to care for contact lens patients, but felt there was a time and place for any easing of regulation and highlighted variance in how practices were dealing with contact lens patients and the associated backlogs. ‘We’re doing telephone appointments for some patients, but nearby practices aren’t doing the same, preferring to see patients on a face-to-face basis. Each approach has different merits, but there does need to come a time when we have to move back to our routine ways of working in practice.
‘I would be concerned that if we carried on the way we are, there’s a risk to the hard work eye care professionals have done over the years emphasising the benefits of coming to us for routine eye care.’
Dr Hampson felt the situation brought about by the pandemic could allow for a different sort of framework for contact lens supply. ‘There could be a much more risk-balanced approach that’s patient-centred,’ he said. ‘Not all contact lens patients are the same – with some who use a daily maybe, once a week, and others in extended wear lenses. So, an extension for one patient isn’t the same as another. We could have a framework that states you need to have a face-to-face appointment at some point, but you know for certain patients, it’s not going to hurt if it goes over by a couple of months.’
From a regulatory perspective, Longstone suggested much of the capacity to be able to exercise professional judgement was already in place.
Looking to the future, she said: ‘We are open to a conversation about where that framework should be set, how tightly and loosely. I think in all things, we feel that generally the more discretion for the professional the better, because it is a profession, and we want you to be able to exercise your judgement.’
A profession united
All the panelists said there was the need for optometry professionals and bodies to work and speak in unison on the key issues surrounding funding and collaboration between primary and secondary care. They also opined how optical bodies and associations had collaborated throughout the year over the key issues surrounding the pandemic, including funding and PPE.
Hardiman-McCartney said to support change in the future, the whole profession was needed to make a ‘loud, unified approach in order for the health systems to hear us. To make the case for optometrists, dispensing opticians, contact lens opticians, practice teams, to all be part of the concerted effort to help deliver in this challenge of “how do we square this circle of an ageing population, huge backlog and very little extra resource available?”’
In closing, chair Edwards noted: ‘I feel heartened about increased collaboration and recognition that we need a unified voice, and it feels like there is a direction of travel to really get it.’ •
- The full discussion can be found on Alcon’s YouTube channel https://bit.ly/3rQV1UF