Optometry’s pre-election policy wish-list

1 Eye care for everyone, wherever they live

Ross Campbell, ophthalmic partner and professional advancement consultant at Specsavers: “There is such a postcode lottery in services that exist”

What would you like to say to policymakers around eye care and patient pathways, specifically for vulnerable patients?

I’d like people to be able to access eye health services on the High Street without having to be registered with a GP. I know that’s unlikely, but it’s a barrier. There is such a postcode lottery in services that exist. What I’d really like, England-wise, for eye health services, is for it not to matter where you live or which GP you are registered with – you can access eye health services. That would be my number one.

What would you say around the role and importance of the optometry profession?

Optometrists are medical professionals. Help us to reduce the strain on the NHS, conveniently, in High Street locations. We can make access to care easier, increasing capacity in secondary care and allowing people who really need treatment from an ophthalmologist to get it without having to wait.

2 Digital connectivity, a better workforce plan, and improved research

Christiana Dinah, consultant ophthalmologist in north west London: “Optometrists need to be able to refer to us with images that we can, in real time, assess and respond to”

If you could have the ear of policymakers, what would you say to them around eye care and patient pathways?

Three things, I think, would make a big difference. One would be digital connectivity. Optometrists need to be able to refer to us with images that we can, in real time, assess and respond to. They get feedback immediately and we are referral refining, so we’re only seeing patients who need seeing. That is potential capacity that we could create, if we could just have digital connectivity. 

The other piece is a workforce plan that incorporates eye care professionals: from ophthalmologists to ophthalmic nurses. I think that's really important. Elsewhere, there are physician associates. We don’t need those. We have optometrists, who are adjacent to us, who understand eye anatomy. Upskilling them is far easier. So, we need to focus on and incorporate that. 

The third thing is research. We’ve already started, with community research optometry. We need to support community optometrists to embed themselves in the communities. It will help us significantly. It will help life sciences in the UK, and help place ophthalmology in the UK as a global leader.

What would you tell policymakers about the role and importance of the optometry profession?

Optometrists are an integral part of eye care and eye health in the UK. They are our GPs, in essence. GPs are the gatekeepers to secondary care for general health; optometrists are the gatekeepers to ophthalmology. But they are more than gatekeepers. They can be harnessed, to be part of secondary care delivery as well. They’re a hidden gem, a tool, and a resource that we need to support to upskill and integrate into what eye care looks like.

Optometrists are an integral part of eye care and eye health in the UK. They are our GPs, in essence

3 Long-term commitment to the Special Schools Eye Care Service

Andrew Bridges, director of professional services at Leightons Opticians & Hearing Care: “Optometry and dispensing optician eye care professionals are trained and registered to provide vital services”

If you could have the ear of policymakers, what would you like to say around eye care and patient pathways specifically for vulnerable patients?

I would like to ensure the Special Schools Eye Care Service gains the required status and correct funding for a national roll-out, which may be at risk or under threat due to potential funding cuts. A high proportion of this group requires eye care, and spectacles play an important part in their daily activities and quality of life.

What would you say, if you were speaking to policymakers, around the role and importance of the optometry profession?

Optometry and dispensing optician eye care professionals are trained and registered to provide vital services in local, familiar surroundings to support the patients and their families in what can be challenging times.

4 A national glaucoma pathway

Professor Anthony King, ophthalmologist and Glaucoma UK chair: “Unify the delivery of glaucoma care”

If you could have the ear of policymakers, what would you say to them around eye care and patient pathways?

From a glaucoma perspective, it would be nice to have a unified patient care pathway for glaucoma, which is consistent throughout the UK. It would eliminate inequalities that currently exist in the delivery of glaucoma care.

If you had one ask for policymakers around eye care, what would that be?

Unify the delivery of glaucoma care, to make it consistent and to eliminate the differences that exist.

What would you say to those policymakers about the role and importance of optometry?

That it is underutilised at the moment. We have a massive shortage in terms of appropriately trained people to manage glaucoma. 

Glaucoma monitoring is something that could be moved out of the hospital and into the community. What’s the most important message to relay on that?

There is a lot of glaucoma care that is undertaken within the community. I think, though, that the quality is very variable in terms of how it’s delivered. We need consistency in how we’re doing things. If we have consistency at a high level, we will have very good quality care.

5 A national eye care strategy for England

Giles Edmonds, clinical services director at Specsavers: “We have the capacity to be able to see more outpatients in the community”

If you could have the ear of policymakers, what would you say to them around eye care and patient pathways?

Two things. One would be better connectivity between primary care and secondary care, to be able to share images, especially around visual field loss. The second one is that we are here to help. We have the capacity to be able to see more outpatients in the community. Optometrists have the skills to be able to do that. We would like to work closely with ophthalmology.

If you had one ask for policymakers around eye care, what would that be?

A clear eye care strategy for England, as we have in Wales and Scotland, that addresses the issues that we all know are there.

What would you say to those policymakers about the role and importance of optometry?

We have about two million appointments available within optometry that are currently not being utilised, that we could utilise to help improve outcomes for eye care patients in England.

Glaucoma monitoring is something that could be moved out of the hospital and into the community. What's the most important message to relay on that?

We’ve got a lot to learn from Scotland, which is doing pioneering work around the NESGAT scheme. I think it’s coming in Wales, with the new General Ophthalmic Services contract. But I think we lack the strategy that means it is consistent.

Paul Morris, director of professional advancement at Specsavers: “Take the opportunity to see the problems that are coming”

If you could have the ear of policymakers, what would you say to them around eye care and patient pathways?

Take the opportunity to see the problems that are coming, and to ensure that there is a joined-up approach. There has to be a unified strategy. Without that, it doesn’t work. Wales does a decent job; I think Scotland does a good job. Northern Ireland is getting there. England is in disarray, and it needs to be brought into some sort of order.

If you had one ask for policymakers around eye care, what would that be?

It is a clear, single message that all of England can rally behind and deliver better outcomes for patients. That’s all that matters. At the moment, they’re not being served well.

What would you say to policymakers about the role and importance of optometry?

With a tsunami of disease that we know is coming in, they really do have very few other options. It’s time for us to all work together to ensure we get the best for patients. It won’t be as expensive as people think, when you look at other health care budgets, and ultimately, it’d be worth it. The cost to someone who has lost their sight is absolutely astronomical, and we should be preventing it at scale.

Glaucoma monitoring is something that could be moved out of the hospital and into the community. What's the most important thing to say on that?

It already exists. It's really clear how it can be done.  It's not as if it's not out there. We just need the will to do it.

The cost to someone who has lost their sight is absolutely astronomical, and we should be preventing it at scale

6 A focus on technology

Peter Bloomfield, director of research at the Macular Society: “It’s the sense that people least want to lose”

If you could have the ear of policymakers, what would you say around eye care and patient pathways?

That there are so many exciting new opportunities, new treatments and new technologies. We need to be a lot more proactive around developing new pathways and having really clear entry points for new technologies.

If you had one ask for policymakers around eye care, what would that be?

To acknowledge that ophthalmology is the largest secondary care specialty. Attention and funding for it is really necessary. It’s the sense that people least want to lose. Sight loss diagnosis is devastating. We need to be able to intervene and treat.

7 End the cataract post code lottery

 

Christine Purslow, clinical director of outpatients at SpaMedica: “Put an end to the postcode lottery around eligibility criteria for cataract surgery”

If you could have the ear of policymakers, what would you say around eye care and patient pathways?

I’d like them to make their priority the development of effective channels for communication between primary and secondary care, that includes the exchange of photographs.

If you had one ask for policymakers around eye care what would that be?

Put an end to the postcode lottery around eligibility criteria for cataract surgery, and make NICE guidance national.

What would you tell them about the role and importance of the optometry profession?

We are still the first point of contact for the eye care of the nation.

8 Reform the NHS voucher system

Simon Berry, optometrist and owner at Simon Berry Optometrists: “We’re such an important primary care network”

If you could have the ear of policymakers, what would you like to say around eye care and patient pathways?

The NHS voucher system really is antiquated, and it’s starting to show that the UK is lagging behind other countries.

If it’s very basic and you've got a general problem, the NHS is very good. But anything slightly specialist, and if you have a more serious problem, it’s not funded.

What would you tell them about the role and importance of the optometry profession?

We’re such an important primary care network. You tend to read quite a lot in the news about dentists and GPs, and you hear very little about optometrists. If you look at what’s going on with the dentists, exactly the same thing is happening in our industry, but you don’t hear very much about it.

Through COVID-19 we were providing MECS care when eye hospitals couldn’t. They need to recognise how needed the primary care network is.

If you had one ask for policymakers around eye care, what would that be?

Come and shadow me in clinic and see what’s needed.