“The expansion of all community eye care services is key”

1 The expansion of community eye care services, including MECS, CUES, and glaucoma services

Nazmeen Ahmed, joint venture partner and principal optometrist at Valli Optometry & Audiology Blackburn

“It is of huge importance for the new government to address the expansion of community eye care services, for example the Minor Eye Conditions Service (MECS), the Community Urgent Eye Care Service (CUES), and glaucoma services, to continue to promote this to the general population, and to put measures in place to signpost who to contact when an eye care emergency occurs.”

Professor Nick Rumney, senior independent prescribing (IP) optometrist and director at BBR optometry, a Hakim Group independent practice

“I 100% endorse the calculations moving the bulk of non-surgical eye care into the community, as long as there is no locking down of block contracts to specific groups or companies, and that the AOP and FODO guarantee to spend significant time persuading retail model optometrists to upskill and use those skills, rather than relying on a small number to soak up the work.

“However, please stop using the term MECS. Under CUES and other schemes, like Kent’s Acute Primary Care Ophthalmology Service and Somerset’s Acute Community Eyecare Scheme (ACES), we routinely manage acute anterior uveitis, keratitis (of numerous causes) and cystoid macular oedema, amongst many other things, which are certainly not in any way minor. They are serious. They are acute, though some are chronic and recurrent.

“We urgently need a service that is autonomous and independent prescribing optometrist-led, which is based in primary care. ACES might fit. MECS simply doesn’t.”

Andrew Bridges, director of professional services at Leightons Opticians & Hearing Care

“The expansion of all community eye care services is key, and is an area I fully support. Currently there is a ‘postcode lottery’ on eligibility for this service, dependent on the location of the individuals’ registered GP practice. This is difficult to communicate and to educate patients on, particularly for practices on the boundary of a number of integrated care board areas or on the boundaries of the devolved nations.

“Providing expert care within a patient’s local community is vital to reduce the burden on secondary care of up to one million GP or A&E department appointments per year. Qualified and accredited optometrists and contact lens opticians can assess and provide therapy plans for a wide range of conditions. The key to success is gaining wide adoption in as many optical practices as possible in any given location. Suitable and viable fees are needed to fund this service.

“With the increasing waiting list to access secondary care for glaucoma assessment and follow-up, a growing number of optometrists have additional accreditation and or qualification to refine referrals, and to monitor and/or treat glaucoma. With as many as half of those with glaucoma in the UK not being aware or diagnosed, it’s vital we have these services widely available throughout the nation.”

Giles Edmonds, Specsavers clinical services director

“In England, national commissioning of a community urgent eye care service and community glaucoma services will deliver improved access to care for our patients.

“It will also ease pressure on NHS GPs and hospital services by making better use of our experts in primary care optometry.

“Specsavers welcomes the AOP’s focus on developing these services and is committed to going the extra mile for the nation’s eye health, working with whoever [forms the next government] to achieve that objective.”

Imran Rahman, consultant ophthalmologist and chief executive officer of CHEC

“Our focus has always been on making healthcare services more readily available and accessible in local communities, by offering patients greater choice, flexibility, and reduced waiting times.

“We’ve long been an advocate for bringing community eye care services closer to home. We started life taking patients out of long waiting lists for out-patient consultations and supporting community optometrists in the wider community, providing capacity and accessibility.

“We continue to support community provision through refined pathways, supporting optometry driven CUES, glaucoma refinement and other services, built on the framework of integrated services between consultants and optometrists.

“We are also forging partnerships with established community optometry providers to further improve access to community-based services. In Dorset, for example, CHEC has partnered with several local optometry practices to deliver routine shared care glaucoma monitoring.

“Since April 2023, 21,845 patients have booked appointments in CHEC’s community optometry service, providing much needed capacity and support to the local trust.”

2 Improved IT infrastructure, to improve file sharing between primary and secondary care

Andrew Bridges, director of professional services at Leightons Opticians & Hearing Care

“Digital connection to NHS records is vital to ensure that, in community eye care, we have access to clinical images and can share them to aid continuous patient care – and perhaps reduce unnecessary referrals, if previous images are accessed and no apparent change is found. Limited access is already available to medical records via Opera, and greater access will be vital.”

Nazmeen Ahmed, joint venture partner and principal optometrist at Valli Optometry & Audiology Blackburn

“It would be very valuable to improve IT infrastructure, to improve file sharing between primary and secondary care providers. To be able to utilise current resources, and to make them more effective, will further improve patient care.”

Giles Edmonds, Specsavers clinical services director

“We’re very supportive of this as a huge enabler for more efficient and effective working between primary and secondary care.”

Imran Rahman, consultant ophthalmologist and chief executive Officer of CHEC

“We welcome the call for improved file sharing. CHEC has committed to ensuring our IT systems are not only fit for purpose but are designed for patients to manage their own care, for clinicians to monitor their outcomes, and for CHEC as a provider to measure effectiveness.

“We believe technology drives success. The issue mainly is with integration with acute trusts systems, as there are so many differing platforms and barriers to integration. In the independent sector, the process is smoother and allows for robust information sharing.”

3 Expansion of prescribing powers for optometrists, through an update of the entry level exemptions list of medications

Nazmeen Ahmed, joint venture partner and principal optometrist at Valli Optometry & Audiology Blackburn

“The expansion of prescribing powers for optometrists, through an update to the entry level exemptions list of medications, would allow a more streamlined patient experience and a better level of care.”

Professor Nick Rumney, senior IP optometrist and director at BBR optometry, a Hakim Group independent practice

“I have been on the working party for this for 10 years, advising FODO and AOP, and co-authored the first proposals. The Department of Health has dragged its feet. They have the data and the capability. This request is a bare minimum.”

Andrew Bridges, director of professional services at Leightons Opticians & Hearing Care

“Access to prescribing for core level and those with IP qualifications is essential to support patient care, to provide local and convenient access to care for patients, and to reduce the demands on GPs and ophthalmology and the waiting lists. The approach of ‘optometrist first’, is key alongside ‘pharmacy first.’ With this process, patients have access to eye care professionals using the correct instrumentation and diagnostic techniques to provide expert diagnosis, treatments and advice in their community.”

Access to prescribing for core level and those with higher independent prescribing qualifications is essential to support patient care

Imran Rahman, consultant ophthalmologist and chief executive Officer of CHEC

“We support the call to expand prescribing powers for optometrists. For this to be effective, we must also ensure the industry has access to the right education.

“At CHEC, we’ve long championed the importance of education, and put it at the heart of our development strategy. Only last month we stepped up our skill-building provision with the launch of an independent prescribing course placement. This programme provides access to CHEC’s national footprint of hospitals and clinics, enabling optometrists to complete the compulsory placement required to gain the prescribing qualification.

“As a modern healthcare provider, we have a duty to develop and offer new skills to our valued optometric partners.”

Read the AOP’s three eye care asks in full here.