There often seems to be a flurry of contemporaneous events that indicate the need for change. Over these past few weeks this seems to be the case. Simon Jones’ editor’s comment, A new digital divide, in Optician highlighted the increasing purchase of spectacles via online suppliers. He also highlighted the issue of online refraction potentially becoming commonplace and how providers of such services are already gearing up for this. Regular readers of this column will know this is something that has concerned Moneo for years. We may well be fast approaching the time when optometry must accept that it will no longer be the first port of call for people to find out what their spectacle prescription is or indeed purchase optical products to fill that prescription.
In the same issue, we saw the thoughts of the ophthalmologist Nigel Kirkpatrick. His column highlighted the parlous state of ophthalmology outpatient departments, glaucoma clinics in particular. With the number of overdue ophthalmology follow-up appointments now reaching more than two million NHS patients, it is inevitable that some of these people will, through no fault of their own, lose their sight. This is, and always has been, unacceptable. There are many who have decried this situation for decades but both the government, who have been aware of this situation, and our professions, who have been slow to consider modernisation, must share the blame for this. How much money will be lost from the NHS ophthalmology services in coming years as patients seek compensation for avoidable sight loss? Money that is desperately needed to counter such sight loss.
Then, thirdly, we have the publication of The State of the UK’s Eye Health 2022, a publication sponsored by Specsavers. The report highlights the terrible state of eye care in the UK in graphic detail. While it points to several regions of the NHS where innovative, collaborative schemes between ophthalmology and optometry have been set up to attempt to tackle the problems, the overall picture is one of desperate times that must be tackled urgently.
While, as I have highlighted on many occasions, optometry stands ready to play its part, my fear is that what Nigel Kirkpatrick refers to as ‘the Cinderellas of the medical world’ will again be ignored and side-lined.
So, how do these three portents of gloom interact with each other? As we move forward and wait for the clinical pathways to develop, optometry must be seen to be fit for the purpose of detecting these people in the community, who either have yet to be diagnosed or who have fallen through the follow-up net. For this to happen, the first thing that is needed is the attendance of the individual to seek eye care. This is something that we currently know does not always happen for many people.
Simon Jones’ comment shines a light on the reason behind this. For many people, the fear of having to pay massive sums of money for spectacles they cannot afford clearly acts as a deterrent to having regular eye tests. Previous research from recent decades has shown this to be the case, so we should not be surprised. We should also not be surprised to learn that people are turning to online refraction and spectacle purchases to fulfil this need.
The parallel to this is people seeking their own remedies for toothache, such as pulling their own teeth out because they cannot afford to visit the dentist. It is noticeable that, reading the Specsavers report, no mention is made of the costs to patients. The elephant in the room is totally ignored, but it is one of the most fundamental reasons why we currently have a problem.
It is not sufficient to tell people that coming to an optometrist is, first and foremost, a clinical event to ensure their eye health. Those people must be able to recognise and trust this as fact. For years, the role of optometrists as retailers has been championed by many. This means that the public see us as shopkeepers, not healthcare specialists. This required change of understanding will not be easy to achieve, such is the domination of the retail message. We desperately need to change the message if we are to truly provide a service that will save people’s sight. Turning a tanker round is never quick or easy. If optometry is to be the first port of call for people seeking eye care, we rapidly need to change people’s perceptions. That change will only come about by promoting our healthcare role and not our retail role.
Clinical excellence must now be the message and it needs to be broadcasted by all sectors in unison.
We cannot rely on our retail income forever. We have made hay while the sun shone, but now the storm clouds are gathering. Do we really have what it takes to stop being shopkeepers?