In six weeks time we will all be voting for our preferred choice to form a new government. For many this may be an unwelcome election given the number of times we have been to the polls recently plus there is mixed opinion as to why we are having an election; opportunism on the part of Mrs May given her standing in the opinion polls or a genuine desire to achieve a Brexit mandate. However, like it or not, the election will be with us on June 8.
Unfortunately none of the parties will be campaigning to address issues within the world of eye care in order to attract votes. To say we are not high on any parties political agenda is an underestimation – optics probably comes lower on political agendas than the price of beer in the House of Commons bar. Simply we do too good a job and there will be no letters landing on MPs doormats complaining about a lack of access to optical services. As with all previous elections for as long as I can remember there has been little or no effect on the world of optics. The only ‘election effect’ I perceive is during the period leading up to the election when practices are slightly quieter as the prospect of any change reduces consumer confidence.
However, let’s think about an imaginary world where optics has a relevance for members of the public and as a result those who are writing the parties election manifestos need to include vote catching initiatives. What would you want to see? Here is my top four.
Number one must be funding. If an optical practice was purely run on NHS fees, more likely that not it would go bankrupt. Hence, we would like to see a recalibration of the funding, fundamentally meaning an increase in NHS fees. This should realistically cover the cost of what we do, that is providing a first class eye examination and a tailor-made pair of spectacles and would end the inequity of the cross subsidy where those who wear spectacles subsidise the cost of everyone else’s eye examination. For once, the Westminster politicians should look north of the border to see what is done there, where realistic fees enable a high standard of eye care in optical practice together with easing the burden on GPs and secondary care.
Second on my list would be to have a truly national NHS optical service. We have a uniform eye examination, however with more than 200 clinical commissioning groups, there is little uniformity across the nation with regard to additional services that are commissioned. In one area a patient may visit their local optical practice for glaucoma monitoring, while in the next town the same investigation requires a visit to hospital supported by ambulance transport. Surely we need to have one national pathway with local implementation?
Next, an issue which is not high profile, but very relevant. Eye clinic liaison officers, ECLOs, are one of the most effective ways of supporting patients in an eye clinic. The ECLOs help patients understand the impact of their diagnosis and provide them with emotional and practical support for their next steps. Research that has looked at the positive impact on value for money of ECLO’s in adult hospital eye departments has shown that an ECLO service can deliver financial returns to health and social care budgets of over £10 for every one pound spent. Seems a bit of a ‘no-brainer’ doesn’t it?
Saving money, reducing the time taken by more expensive clinical staff with patients and families and enabling people to be more independent – all of which are long term NHS aims. And yet the ECLO role is not in every hospital and where there is one the post is often only funded by the voluntary sector. I’d like to see a political party pledging to put more ECLOs in place.
Finally, sustainability and transformation plans, STPs, of which there are around 44, are designed to accelerate local implementation of the NHS five-year forward view and to bring together CCGs and other local organisations. So much so that ‘plans’ are being replaced by ‘partnerships’. Out of the 44 STPs, I understand less that 10% have any mention of eye health and I suspect there has been little or no partnership with any of the local groups who represent optics. This should be on STP’s agendas.
Manifestos should be inspirational, build on what is already evidenced and look forward to provide better future services, which all these issues enable. There will be other issues that could be addressed; manpower, children’s vision screening, eye examinations for those with learning disability, but what would be your required election manifesto issues?