Supply and demand

That politicians see a negative view of what is happening is scarcely a surprise. Spending time at party conferences, I often find myself on panels with other healthcare professionals, all of whom are only too ready to articulate the problems as they see them. They know the truth about political influencing: crises get attention; good news gets ignored. And there is no greater crisis in healthcare than workforce supply.

Complaints about the shortage of doctors and nurses in secondary care are commonplace: in ophthalmology, for example, the Royal College of Ophthalmologists estimates that more than three quarters of eye clinics are struggling to recruit.

The position in primary care, generally, is little better. The British Medical Association (BMA) estimates a fall of 1700 GPs over the past decade. Yet this number is eclipsed by the fall in the number of NHS dentists by over 25,000 during the same period. Staffing shortages have been a key argument those groups have made for pay increases.

On the face of it, the position in optometry is different. Overall, the number of optometrists on the General Optical Council register has increased year on year, with student intakes remaining high and leaver numbers not seeing the sort of increase which has bedevilled the GP sector, for example.

The increasing use of technology within optometry has had the effect of streamlining some processes and systems, while enabling optometrists to provide a wider range of eye care services. The enthusiasm for innovation in the sector may well help to avoid the sorts of acute staffing shortages which have so hampered the work of other parts of healthcare.

But, as this edition explores, we cannot take for granted that we will avoid the sort of workforce crises which have hit other sectors. For a start, while there is no overall issue of workforce capacity, there is certainly an issue around workforce distribution.

There is no shortage of optometrists in, say, Bradford or Birmingham, but the picture in Bodmin and Berwick looks very different. It is not for nothing that some large employers sponsor overseas optometrists to work in such locations while they complete the qualification process to work permanently in the UK.

Moreover, the changing nature of the optometric workforce raises questions about how and where the next generation of optometrists will want to pursue their careers. In recent years, we have seen a significant number of optometrists opting for locum and/or part-time work. Will that trend continue? As opportunities to own your own business decline, how will that affect the aspirations of an ambitious optometrist? How many optometrists will want to pivot towards an increasingly clinical practice, including potentially moving to work within the mainstream NHS, and how many will want to remain in a largely retail environment? What will this mean for the wages and the flexibility that many crave?

At the AOP, we have been exploring these issues with our Council, and doing what we can to take the temperature of our members. That has given us some information. In truth, the answers will only become clear over time. We will be ready to respond and, as we are here to do, to support our members in whatever choices they make.