LOCSU reports success of local services model

LOCSU chairman Alan Tinger

I am most grateful to the president and the executive committee for the opportunity to make a presentation to the ECOO general assembly on a subject that is very close to my heart – the future of the UK optical market.

I would say at the outset that as the president has mentioned, I am neither an optometrist nor an optician and rather a chartered accountant. You may ask  what right have I to comment on, let alone be involved in forecasting, the future of the UK optical market?

My response is that I was involved in corporate opticians for many years, latterly as managing director and part owner of the company that Tesco Plc outsources to, the majority of the operations of Tesco Opticians, now a nationwide UK chain.

I now no longer have any direct involvement in any opticians business and I am involved in non-executive roles in several optical sector bodies in the UK and I think I can take an informed but objective view of the UK sector.

The Foresight Project is a twelve month project that commenced in January 2015. It is a project that I initiated and arranged the £100,000 funding for, on behalf of the Optical Confederation,  which comprises the five main Representative Bodies in the UK optical sector, and the College of Optometrists.

60 per cent of the funding came from the Central (LOC) Fund and 40 per cent from the Optical Confederation members and the College of Optometrists. It is a subject I could present on at length but I will be brief and hopefully time will allow for some discussion on the subject. Historically the “sector” in the UK has spent a lot of time looking backwards whilst sector disrupters were looking forward.

A classic example is the internet. The UK optical sector woke up to it when it was too late and online contact lens providers from overseas were well established selling into the UK with impunity from UK optical regulation. In an attempt to level the playing field new regulatory legislation was introduced but ended up fettering registered practitioners playing by the rules rather than creating a level playing field.

Why the Foresight Project and why now? Well picture the scene. You are at home relaxing and there is a ring on the door bell. You open the door and outside are paramedics. 'Good evening, we are here because you are about to have a heart attack. Don’t be alarmed, we can help you.'

Far-fetched? – Not at all. Sensors in clothing that can transmit data to a monitoring centre are a reality and no longer science fiction. Technology starts off as disruptive and can then become destructive. If your business in the past was developing and printing films from cameras, for example, it will no longer exist. On the other hand some of the largest businesses in the world now did not exist 25 years ago. Foresight is split into four phases of research.

We have contracted with 2020 Health, a small UK think tank that specialises in the future of healthcare technology, to undertake the research. Its chief executive formerly trained and practised as an optometrist and so has a good understanding of the sector.

The research is commercial research. It is not academic research with peer review and publication in medical or scientific journals.

The four phases of research are:

1)     Worldwide technology and UK demographics.

2)     The effect of phase one on business models.

We, that is our project Steering Group, will then have a pause period whilst we reflect on the outputs from the first two phases and ensure that they cover all we intended.

The project will then move on to consider:

3)     The effect of the first two phases on education and training.

4)     The effect of the first two phases on regulation.

The project will culminate in a final report that will inform the sector of what is likely to happen in the future.

What are the known future challenges for the sector?

  • Online and mobile refraction are now realities.
  • OCT developments are taking away the need to see all patients face to face as ophthalmologists now recognise.
  • Generations are now growing up used to non-face to face communication. Youngsters even play football on line with their friends.
  • Contact lens and lens technology including implant surgery is developing at a high rate.
  • It is most unlikely that a new large scale bricks and mortar optical business will move into the UK.
  • The real threat to the status quo is if new non-bricks and mortar businesses are waiting to pounce.

As other sectors have found, the only way to deal with disruptive and then destructive technology is to upskill. Whilst we live in an uncertain world, what is a certainty in the UK,  and other countries, is that we are currently training optometrists and opticians for jobs that will simply not exist in the same way in the not too distant future.

In the UK there are two worlds of Healthcare:

I)                 The political world, looking for votes, that talks of pumping in more and more money, more doctors, more nurses and more hospital buildings. This is a world divorced from practical or financial reality.

II)               The real world, a global world with technology and specialisation at the forefront.

Despite the problems they face in many other respects, India is now the world leader in very high quality, low cost cataract surgery, Mexico is the world leader in tele-health.

I rest my case.

Alan Tinger is a chartered accountant and a companion of the chartered management institute