Policy briefing: Change NHS: help to build a health service fit for the future

What has been announced?

The UK Government has announced a ‘10 Year Health Plan’ to build a health service fit for the future. This follows on from the report by Lord Darzi about the challenges facing the health service. The plan will set out how the government will deliver an NHS that can cope with the changing population, one that is older and where expanding treatment options create growing capacity and financial pressures. This work will be led by the Department of Health and Social Care in conjunction with NHS England and is seeking a wide range of views, from patients, staff, professionals and organisations.

The Government has set out that the 10-year health plan will focus on three shifts:

Shift 1: moving care from hospitals to communities 
Shift 2: making better use of technology in health and care 
Shift 3: focusing on preventing sickness not just treating it  

What do we say?

For many years we have championed how our members can help to tackle the growing pressures on the NHS, particularly in ophthalmology, but also pressures on our GP and pharmacy colleagues. There are some key areas that have prevented this from already happening; a lack of funding, overly complex, short term contracting arrangements for enhanced services and a reluctance to move patients from traditional secondary care settings. But we argue that a few simple steps could remedy these challenges for the benefit of patients, health outcomes and the NHS.

Our members are ready and able to take on additional activity that has historically been delivered in a hospital setting; glaucoma care alongside minor and urgent eye care services are the obvious examples, but it is not the limit of where they can help to release secondary care capacity, and more importantly deliver care for predominantly elderly patients closer to home.

In terms of making better use of technology, optometry is a data rich, technology driven profession with OCT scanners and other equipment that are equivalent, and in some cases better than those found in a hospital setting. We have argued for many years that we should ‘move data, not patients’, but our ambitions have been hamstrung by a lack of digital connectivity. If the connectivity challenge between primary eye care and secondary care is tackled then our members can utilise the existing technology at their disposal, potentially saving the NHS millions and providing a better service for patients.

If we turn to prevention, our members are well placed to provide opportunistic interventions to patients who are currently well, detecting diseases such as high blood pressure before the patient is aware that there is a problem.

While this is an emerging area that can, and should be explored, we should not underestimate the value of the early detection of glaucoma. While in the majority of cases this isn’t a disease that can be ‘prevented’, early detection and treatment leads to irrefutably better outcomes for patients – preventing sight loss and reducing  social care costs. Primary eye care already detects nearly all cases of symptomless glaucoma, but it could do more still.

We are calling for a significant shift in current ophthalmology appointments from secondary care into primary eye care. Alongside this it is important that primary eye care is seen as the gatekeeper to ophthalmology, only when our members can do no more, should the patient move on to the next level of specialist care.