Throughout the years I have been involved in the optical industry there have been frequent times when the future for both optical professionals and optical practices as we know them did not look prosperous.
I can just about remember back to the early eighties when the dispensing of spectacles was deregulated, followed not long afterwards by the end of the NHS sight test being free to all. Fast forward to the nineties and noughties and we saw the advent of the internet that brought about selling of contact lenses and spectacles direct to the customer.
The numbers of registered optometrists has steadily increased and compared to 20 years ago we now have well over double the number of graduates each year. Most recently, new technology has emerged that potentially deskills the professional role as it is able to produce a prescription and check the health of the eye without human intervention.
All of these significant changes to the structure of the market were seen by many to herald the demise of the traditional model, where a patient had a sight test and purchased spectacles from that practice. There was conjecture that practices would close and there would be unemployment in the professional ranks.
The reality of course has been somewhat different. We still have ‘optometric deserts’ where practices are unable to recruit, a very thriving locum sector but rather than the optometric role being devalued there are opportunities for optometrists to further their skills and get involved in more aspects of clinical care. Optical practices may have experienced a short-term downturn in patient numbers, but never as great a reduction as some predicted, and the traditional optical practice model has survived.
What does this tell us for the future? Will the model as we know it continue and will there be a future for optical professionals, both optometric and dispensing? On all counts, I would say the answer is yes – we can be confident looking forward. Clearly there are the multiple groups that are very successful at targeting the mass middle market and there are independents who offer a local community service. Also, recently in a number of places I have visited I have been struck by the number of upmarket independent practices, many new, that are offering a bespoke service featuring luxury brands.
It seems that enough members of the public value the style of practice they choose, want to be able to see well, and to know their eyes are healthy. They also know they are making a bespoke purchase, often with a designer tag and associated cost, and so want to try the frame on before they purchase and know they are able to return to the practice for whatever reason if they need to. All this means there are huge numbers who want the reassurance of dealing with an individual, rather than a machine, or a remote entity through the internet.
More good news for the future is that it seems inevitable that there will be a greater need for optical professionals to provide eye care that is currently in GP surgeries and hospitals. Although this has been slow to happen there has to be a tipping point where numbers of new patients plus existing patients with eye health related issues means that the secondary care system just cannot cope. My view is that we are already there, but the realisation of this and the work involved in changing the system is lagging behind. The theme of change within the NHS is to provide more treatment away from secondary care and there is huge opportunity in eye health to do this, close to where the patient lives. Many practices, however, are largely well equipped to deal with new workstreams and many have invested in technology such as fundus cameras and OCTs to enable this.
Practitioners are undertaking additional qualifications so they have the required competencies and I can foresee university optometry courses producing students who have increasingly relevant skills to be able to undertake a wider range of eye care straight from qualification.
We are told that history repeats itself and if that is the case, we can be confident of the future. The optical practice that offers what their target sector of the market wants will continue to do well. There will be a gradual evolution, but it would be advisable to remember that the basic job remains the same. We must communicate well with patients, establish trust, make sure they can see as well as possible, reassure them that their eyes are healthy, and produce suitable correction that looks good and works for the individual.