“There is strong support for community optometrists to be part of the solution”

For those who don’t know Healthwatch, our role is to find out what people think about health and care services and tell policymakers what is working and what could be better. And we recently did just this on the issue of eye care.

Over 2000 people shared their stories as part of our research, which spanned High Street and specialist services. From what people told us, there were three clear messages.

One in four people who responded to our survey reported waiting more than a year before being seen

Urgent action is needed to improve access to specialist care

Individuals currently awaiting specialist NHS eye care, or those who have recently received it, shared their frustrations about getting referred in the first place. Almost a quarter of people had to attend multiple appointments before this happened.

Even when referred, one in four people who responded to our survey reported waiting more than a year before being seen. Many also shared how this prolonged wait deeply affected them.

The majority (70%) noticed their vision getting worse while waiting for specialist eye care, which in turn often affected every aspect of their lives, from being able to work and perform daily tasks to their mental health.

What was even worse is that the vast majority of those we spoke to said they had received little or no support or advice to help them cope while waiting. Just 4% said they had been given information and advice to help with day-to-day activities like working.

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Utilise High Street optometry to cut NHS waiting times, Healthwatch says

Research saw 85% of those waiting for secondary eye care express support for optometrists

The public backs High Street opticians as part of the solution

If the first message is that people face real problems accessing specialist eye care, the second is that there is strong support for community optometrists to be part of the solution.

The statistics speak for themselves. An overwhelming 85% of people support getting specialist care referrals directly from optometrists, and over 65% trust High Street opticians to manage and treat eye conditions without having to visit a GP first.

This is why we have called on the Government to use optometrists more extensively to help cut waiting times and provide more treatment and aftercare closer to home.

A good starting point would be updating eye care treatment guidance to empower you to take a more active role in people’s care, including delivering more services directly.

A second, more transformative step would involve harnessing the power and skills of optometrists in the community more fully, for example, through models such as Optometry First, where optometrists and their teams support patients before and after hospital care.

Expanding the use of optometrists could achieve multiple benefits: improving the efficiency and accuracy of diagnosis, reducing the need for hospital attendance, improving patient outcomes by reducing overall waiting times, and improving people’s experience of waiting.

If the first message is that people face real problems accessing specialist eye care, the second is that there is strong support for community optometrists to be part of the solution

Tackling health inequalities is everyone’s business

The third takeaway from our research is that the actual or perceived cost of eye care remains a real barrier to access.

We asked those waiting for specialist eye care why they had not gone private. Although some were against doing so out of principle, many just did not have the money. The cost issue also arose when we spoke to people about their use of High Street opticians.

Regular eye tests are key to identifying and preventing many cases of sight loss. However, one in seven people who responded to our survey had avoided eye care due to cost in the last two years. The figure amongst people who described themselves as ‘not at all comfortable financially’ was almost three times higher.

Unpacking the reasons for this, when many of our respondents were eligible for free eye tests, is not clear-cut. However, there was a strong correlation between whether someone had been offered additional services at a cost and whether they then avoided going to the optician.

There is a strong case for reviewing the existing eye care voucher scheme to ensure that people who need financial support meet eligibility criteria

Calling for change

So, what can be done? There is a strong case for reviewing the existing eye care voucher scheme to ensure that people who need financial support meet eligibility criteria.

Given the inflation we have seen in recent years, this review should also establish whether current financial for support and NHS voucher values are at the correct levels. The Government also needs to do more to make the public aware of the financial support that is available.

However, the eye care sector can also take practical steps. For those on the lowest incomes, the fear of being asked to pay for additional services, regardless of whether they are essential, is affecting people’s confidence in seeking eye care.

Opticians need to pay the bills, but there is a balance to strike. Can High Street opticians do more to be mindful of their patients’ potential financial sensitivities? For example, by not making people feel pressured to buy additional services or not discussing costs in front of other customers.

In short, expanding your role and giving you more scope and flexibility to deliver services would improve people's overall experiences, cut waiting lists, and help you to make more accessible eye care a reality. But there are changes you can make too that will help people to feel even more confident about coming to you for help.

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More support required to help with eye test costs, Healthwatch says

Patients deterred from visiting optometry practices