“Time is the biggest factor”

When you first qualify as an optometrist, I don’t believe you observe or consider the public’s perception of optometry too much as you are so focused on getting up to speed – or I certainly was. But, thinking back to what I recall about the public’s perception of optometry when I first qualified, practising in Scotland, it has always been relatively positive. Within my family and culture, people look up at optometrists: if my gran told her friends that I was an optometrist, they would be like ‘oh, that is very, very good.’

Although I have witnessed the public’s perception of optometry change over time, these experiences have been post the general ophthalmic services (GOS) contract changes in Scotland when, in 2006, a sight test became free for everyone (and the profession is remunerated appropriately). Having a single message for the public that, regardless of where they live or what they earn, an eye test is free has allowed the public’s perception of optometry to change at a nation level. There is no confusion about entitlement, or a postcode lottery to access, the public are all entitled to the same service.

I have observed positive change and evolution with the contract over the years as it hasn’t stood still. In the last couple of years, it’s evolved further, without a doubt. During the pandemic, it felt, more so than ever before, that the profession was being looked at as the first port of call for everything related to eye care. Patients increasingly presented to their optometrist with an eye problem, as well as for treatment for a range of eye-related enhanced services.

The community has started to present themselves – they have learnt to come and see the optometrist first

In my experience, all of the health boards that I have practised under in Scotland have pushed for optometry to be the first port of call for anything eye-related, which is important. For example, early in my career I recall schemes and campaigns run by different health boards, which saw leaflets made and posters ran in practice.

This work combined has culminated in support for the profession from across healthcare sector. For instance, nowadays, in most areas in Scotland, when a patient calls their GP with anything to do with their eyes, they are told to visit their optometrist.

This has been drilled into GP practices and their staff over the last few years in particular and, because of this, it has started to filter out to the rest of society. If you call your GP once and are told to present at your local optometrist with an eye-related problem, when you have an issue in the future, you will visit your optometrist first.

It has become rare now for me to speak to someone who says they spoke to their GP that morning and was told to call their optometrist. The community has started to present themselves – they have learnt to come and see the optometrist first.

However, these types of messages take a long time to filter through to the public, and it’s very hard to get the funding, as well as the drive required, to push through these changes without facing challenges – the amount of effort that is required to push the right messages in the right places at the right time is a lot.

For change to happen and drive to be effective it must involve cross-sectoring working, pharmacists, GP and optometrists operating in cohesion. We need to encourage and demonstrate more cross-sector working with the boundaries removed to enable us to work better together.

Personally, I feel that the eye care journeys in each of the four nations are too far apart now for a nationalised service to be introduced, but a nation view is important. But, when it comes to progress to other nations, we must remember that Scotland is very small in size and population compared to England – we’re talking 55 million versus five million people.

10 years ago it was enough to put up posters up and give out leaflets, but now we need to look at other ways to connect with and capture the next generation

Heighten positivity

Continuing to improve the public’s perception of optometry takes time. It is almost like a pyramid scheme: you have a message at the top and as it goes down it gets diluted. At the bottom of the pyramid are optometry professionals, and we need to continue working hard to keep the message strong.

We can do this by establishing and building relationships with our local GP practices and pharmacists. It can be as simple as picking up the phone to GP practices or visiting pharmacists close to your practice to speak to them about what you can do.

This is something I did with my local pharmacist when I took over my Boots franchise practice a decade ago and it helped us build a bond straightaway. Having their email address to hand and being approachable makes a big difference. These simple foundations help to create the big building blocks that are required for improvement.

The next step for Scotland to increase the public’s perception of optometry further is related to the independent prescribing (IP) optometrists coming through now. Scotland has the highest number of IP registered optometrists when compared to other nations. What this is doing is allowing patients to be treated in the community for a wider number of conditions which they would have previously been referred into the hospital service for. This gives patients an immediate and positive experience, avoiding waiting times in the hospital.

In terms of the future, I would like to see optometrists considered to be the GPs of the eyes. I believe we will get there, but time is the biggest factor. Time and keeping the message strong, trying not to dilute it, and adapting to how we continue to share that message with the public. 10 years ago it was enough to put posters up and give out leaflets, but now we need to look at other ways to connect with and capture the next generation.

About the author

Adnaan Ahmed is an optometrist and franchise owner of Boots Opticians in Irvine. He is also an AOP Councillor representing franchisee/joint venture partner optometrists.