Back in 2017, I wrote an article on the theme that change was coming and ‘the past was not going to be the future.’ Our profession was in a relatively steady state but there were unstoppable external forces – nationally and internationally – that we ignored at our peril. To bring them to life I used the proven economics Pest (political, economic, social, technology) model, which for me demonstrated that industry change is inevitable.

The way you could apply this model to optometry at the time was:

  • Political (including regulatory bodies and the NHS)

It was risky that our full scope of optometry services (particularly in England) was not fully accepted as joined up with key NHS services. Our NHS arrangements were fragile, even though we have been contracted since 1948.

Linked to ever tightening NHS budgets and the factors mentioned above, we had had no significant fee increases for a decade, despite evidence that our services were increasingly valued by GPs and ophthalmologists alike.

People were becoming more aware of internet optical services in 2017, although at the time they were not high quality across the entire range.

Internet technology was the key driver of major threats to regulated practices, particularly from international operators, who have more freedom in unregulated markets to develop their products. New technology was also enabling UK optometrists to perform significantly better primary eye health care and facilitating hospital procedures.

My overall message in 2017, as the threats were predominantly external, was that all stakeholders should work together to protect our profession, including our professional bodies.

So, where are we now, four years later?

It is broadly acknowledged that the Covid-19 pandemic has significantly altered most things in business. My view is that optics is no exception – it has altered everything. Again, it’s Pest, but at much greater speed – Super Pest. We now have to consider that change is inevitable and will be attributable to a combination of threats, the main ones being social and

Social and technology
Covid-19 has caused major change in people’s habits – working from home, using IT throughout the day for work and personal needs. Restricted travel has greatly reduced footfall and optometry demand in most metropolitan areas. New technology has also improved the internet offer available, as well as accuracy. These are likely to be further improved very quickly. Offers for online digital sight tests will be here within five years.

Political, economic and social
Despite government promises of levelling up the economy, social divides have become, and will become, greater. As a profession we must make sure the NHS is on our side in these changes and use our efforts, with their assistance, to accommodate this need. As we head for certain recession this will become a major priority for all stakeholders.

We need also to note that Covid-19 should be a catalyst for all our professional bodies to work together and to become more transparent. They all have a major part to play in the industry survival programme. It is unfortunate that the Optical Confederation has lost its momentum. If a crisis was what was needed to galvanise bodies and associations, surely this is it?

I firmly believe the public will want the full scope of optometry services to be available on the high street, using ever improving technology, better personal communication and yes, some remote digital eye care. This political journey will not be easy and, once again, success will come from all colleagues working together.

What next?

I am aware that there is stress and fatigue in our practices and that colleague and patient safety is a priority for all organisations in the NHS. As with all our NHS colleagues, we need to be open for care, providing a full scope of services to ensure eye health needs are met.

In this Pest war we will never survive by staying at home. Patients will start to work around us on the internet and those habits will be impossible to break. Please remember if patients lose faith with their local practitioners, the government and NHS will surely follow. Communications from the GOC, AOP, the College and FODO, must fully demonstrate that optometrists make a big difference to clinical outcomes.

The object of the Pest analysis is to facilitate a plan for the future. Repeated lockdowns have necessitated a rapid change to all businesses. There is more focus on full-scope optometry than there ever has been and demand is higher than ever. Increased media and political attention on patient eye health and wellbeing will be a reason why we all have a future.

I am convinced that patients want optometrists to be there for them and provide the full scope of professional services. Let’s work together to beat this Super Pest threat.