We are living in momentous times as can clearly be seen from recent events in the UK parliament. The same can be said for our own profession. While there may be confusion and uncertainty in UK politics the same can not be said for optometry. There are, amidst all the uncertainty, two certainties currently for optometry in my opinion.
Firstly, given the announcements in the last spending round, there has not in recent years ever been more money available to the NHS than currently. Second, the inevitable use of online technology allowing people to self-refract and obtain a spectacle prescription without the services of an optometrist.
Both of these create massive opportunities for optometry provided we have the people in place to take those opportunities forward. My greatest fear is that currently we simply do not have the visionaries needed to lead the profession at this time. The recent articles in the journals surrounding the use of smartphone technology serve to prove this point. The recent article in Acuity makes the point that smartphone and tablet vision tests are widely used by optometrists and patients in the US but currently are banned in the UK. Further, the link between online testing and online spectacle purchase is also available thereby potentially sidestepping optometry all together.
Legal moves in the US may try and stop the current activity but it is clear that this will only be a temporary stop. Paul Morris at Specsavers seems to get it right when he states, despite the risk of GOC fines: ‘I think it is never a question of if, it’s just when.’ The College and the Optical Confederation commissioned a report in 2016 which concluded by saying: ‘The place of the sight test does not have to remain within traditional optical practice.’ Sadly, Daniel Hardiman-McCartney, clinical adviser for the College takes the more typical approach to the future when he makes the comment that any attempt at deregulation must be resisted, as it could result in a significant rise in preventable sight loss. Such comments show that the traditional approach to change at the College is alive and well.
This profession has a long history of doing nothing in the face of change until that change has happened and then moaning about the change. We have never in our history grasped the nettle when it comes to major change. We have never looked at the future and decided to take charge of that future and plan for it ourselves. Typically, we have tried to defend what we have now because, to be blunt, it’s so easy to make money this way – so why change? This time we need to see the inevitable, grasp the nettle and take the lead in carving out a new role for optometry. There have been visionaries in this profession who have been calling for deregulation for many years. Deregulation into a system designed by this profession, not imposed on us by outside business interests with their own profit margins as the reason for change.
With the announcement by government of a massive injection of funds into the NHS surely the time has come to look at the General Ophthalmic Services and abandon them entirely. It is a sad joke that we have continued with GOS for so long. It is not fit for a modern healthcare system. It is probably responsible for more avoidable sight loss than deregulating refraction ever would be, provided a new system is designed effectively.
For years we have spoken about the clash between retail optical shops and clinical optometry. I have always believed that clinical optometry is the way forward for those who train as optometrists. The modern optometrist has clinical skills that mean they are ready to take on vast swathes of what is currently undertaken in overworked hospital eye clinics. Daily we see and hear reports of patients’ overdue glaucoma follow-ups in eye departments, some of who will unnecessarily suffer vision loss as a result. This profession has the capacity and the skills to undertake this work.
What must happen now is that we must stop concerning ourselves with the threat of smartphone technology and look towards creating a modern eye healthcare service within the NHS. A service that is not centred around what we were capable of doing in 1958 but that centres around our modern clinical skills.
We need to grasp the opportunities that the spending round and smartphone technology give us and design a new service that truly reflects our skills. The question is whether we have the leaders and the visionaries to do this. Do we have the strength as a profession to determine our own destiny? Or do we do what we have always done and sit back and wait for the inevitable demise of our profession?
Now is the time for the younger visionaries to step up. It’s your future going forward. Dare to create a future that is not based on 1958 but rather on 20-20. The future is very bright if we get it right now.