When I read Verum’s viewpoint column in the January 27 issue of Optician I half expected to find a Mr Denbigh cartoon on the one of the subsequent pages. I guess what goes around comes around and so perhaps I should not be so surprised to see a viewpoint popular in the 1970s recycled today.
But today’s optometrists work in a very different world to the ophthalmic environment that existed back then. The NHS fee while never exactly generous was in real terms somewhat better than the pittance it is today. So it is hardly surprising that today’s optometrists struggle to go the extra mile to give secondary care the level of detail they would prefer when the reality is that the GOS is so poorly remunerated. And of course litigation was hardly an issue in days gone by. It is quite different today and it is difficult not to be sympathetic to a colleague who plays it safe.
Who would potentially sacrifice their career and reputation just to save the NHS a bit of cash?
Verum proposes that optometrists should raise their game, presumably to a level that secondary care and the CCGs find convenient. I think these days we call this community eye health services and it is pretty much what Locsu has been all about for the past 10 years or so. But despite the sterling efforts of LOCs locally and Locsu nationally, and the audited benefits that community eye health services bring, uptake of these across the country has been bafflingly patchy. Sometimes the reason for this has been a failure to engage by the CCGs, sometimes negative input from secondary care, who then ironically go on to complain about the quality of referrals.
But Verum’s comments are not entirely without substance. Locally some years ago optometrists did indeed encounter some criticism about the quality of optometric referrals. So an audit was conducted. Which found the complaint unfounded, the referrals in the audit period were all excellent. Except one, which was dreadful. Illegible, incomplete, and clinically dubious. Turns out it was from a doctor from a local eye unit working as an OMP. Funny old world.