An OCT in every store
Clinical services director at Specsavers, Giles Edmonds, discusses the rollout of OCT devices in all UK Specsavers stores 18 months since it began
01 In 2017 Specsavers announced its aim to have an optical coherence tomography (OCT) device installed in all of its UK practices. The rollout officially began around 18 months ago.
At Specsavers we always look ahead and plan a five-year view, so OCT has been on our road map for a number of years now. The technology has been available in the hospital setting for quite some time, and has become increasingly present in independent opticians, while a small number of our stores already had it available. Therefore, when we looked ahead to what the next development in our transforming eye health strategy would be, the natural evolution was to have an OCT in every store. We already have hospital grade fundus cameras and hospital grade field screeners in all our stores after all.
We try to ensure the delivery of a similar level of service across every store and we believe that OCT is an important tool for all of our customers to have access to, so when it came down to where to install it, it was vital that all of our stores have one installed. We are about offering a inconsistent service.
02 When we announced the multi-million-pound rollout, 20 or so of our stores had already had an OCT installed for a number of years.
As part of the portfolio-wide rollout, the first OCT was installed around the end of last year and today we are installing the device in around 35 stores per month – this is happening at an increased pace and is already up from the 25 per month that we were achieving when the project began.
It took us a little longer for installation to initially begin as there were two routes that we could take, a standalone or an integrated approach. We opted to ensure that a fully integrated system was in place for all stores before we began. Currently, 212 OCTs have been installed and we expect to complete the rollout in early 2020 – it’s progressing really well.
When we looked to ahead to what the next development in our transforming eye health strategy would be, the natural evolution was to have an OCT in every store
03 We do not install an OCT in a store until staff have completed our mandatory training, which we have created for both clinical and non-clinical staff.
Training is very important to us and we want to make sure it is completed before installation to ensure that the customer receives the right journey – that non-clinical staff are comfortable explaining what an OCT is and its benefits, and clinical staff can interpret scans appropriately. OCT is not an easy thing to understand properly, but our online modules and workshops demystify it.
From a clinician’s point of view, doing a test that you don’t fully understand may not provide the right outcome for the customer and could increase referral rates into ophthalmology. This is something that we are keen to make sure does not happen. We are able to track referral rates after the installation of an OCT and what we have found is that while in the first week or two referral rates go up slightly, overall referral rates for customers post-OCT are lower. This demonstrates that our clinicians are referring less and managing more in the community, which is great for customers and ophthalmology.
04 When the rollout was announced, the response from our practitioners was extremely positive. Having seen many of them at Specsavers’ PAC conference in October, it is fair to say that it is still incredibly high.
Similarly, customer feedback has also been strong – the feedback we receive from customers who have had OCT is higher in terms of customer service than when they have not.
The value of OCT was recognised when a 50-year-old gentleman attended our Derby store with sudden temporary sight loss in one eye. An OCT scan detected something behind the eye and an emergency referral was made. At the hospital the patient had an MRI scan, which showed he had suffered two mini strokes that he was not aware of. A heart scan then found benign papillary fibroelastomas growths on the valves, atrium and aorta, meaning the patient was at risk of further strokes. Successful open-heart surgery followed, and the patient is now back at work full-time.
The sector has a workforce of highly-skilled optometrists with hospital grade equipment in the convenience of a community location, so we need to continue to champion getting more involved in community ophthalmology work. It is a very exciting time for optometry
05 Once rollout is completed, I’m sure we will be looking to communicate it widely in terms of a national marketing campaign.
We are also already in talks with commissioners about how we can better integrate optometry and ophthalmology services, including how we can get more involved in glaucoma monitoring schemes and macular services. There are lots of areas where the hospital eye service is struggling and there is opportunity for optometrists to support. The sector has a workforce of highly-skilled optometrists with hospital grade equipment in the convenience of a community location, so we need to continue to champion getting more involved in community ophthalmology work. It is a very exciting time for optometry.