“The pandemic has shown us that the optometry and ophthalmology sectors can work together”
Ophthalmologist and medical director of Newmedica, Nigel Kirkpatrick, on how the pandemic has changed the scope of community optometry
20 June 2022
Ophthalmology is the largest outpatient specialty in the NHS, with 7.8 million outpatient appointments annually. Even before the pandemic, our hospital eye services were struggling. Follow-up intervals were extending beyond safe levels and the offer to see more patients in the community was making painfully slow progress.
In response to the pandemic, eye care services in the UK were withdrawn, reduced or restricted. This led to millions of missed eye examinations, delays in treatment and extended waiting times for patients. The current NHS elective care waiting list is the same size as the population of Denmark.
Public dissatisfaction with the NHS is increasing, particularly with the time that it takes to get a GP or hospital appointment. The NHS recovery plan aims to eliminate one year waits by 2025 by recruiting staff from abroad, increasing productivity through digital solutions and using the independent sector to offer more choice to patients. While waiting times are important, the quality of care and providing sufficient capacity are the overriding factors in dealing with the backlog. Making in-roads takes time. Staffing is a big concern, yet current NHS plans do not address this workforce issue.
Even before the pandemic, our hospital eye services were struggling. Follow-up intervals were extending beyond safe levels and the offer to see more patients in the community was making painfully slow progress
Capital equipment in medical facilities also needs long term planning. I strongly support the worthwhile incentive to increase services using the payment by results mechanism.
We also need changes in working practices that sustain improvements in productivity. The switch to day surgery has happened over the last 20 years, but COVID-19 has demonstrated our ability to shift rapidly, for example, to virtual clinics and streamlined pathways that reduce time spent in waiting rooms and enable the management of services using virtual meetings.
The pandemic has shown us that optometry and ophthalmology sectors can work together to support patients with their eye health needs, delivering effective and innovative care pathways in an accessible community-based setting.
There will be a lasting legacy of COVID-19 for some years and there simply are not enough ophthalmologists in the UK to respond. Optometry remains the front line for patients with significant eye disease, working with primary care ophthalmology in the community
The future direction
As an ophthalmologist, I believe it’s vital that I provide personal patient care and build connections with optometrists as we work in partnership on important aspects of patient care, such as having a clear referral route, high-quality patient outcomes, and the management of post-operative issues. With these in mind, as optometrists it’s worth considering how well you know the team or surgeon you refer to and their posterior capsule rupture rate. For example, what kind of access to clinical advice do you have? Is there a 24/7 phone number you can call? And, of course, reflect on what your patients tell you.
There will be a lasting legacy of COVID-19 for some years and there simply are not enough ophthalmologists in the UK to respond. Optometry remains the front line for patients with significant eye disease, working with primary care ophthalmology in the community. We urgently require an integrated workforce, operating closer to patients’ homes with detailed patient knowledge.
I believe ophthalmology and optometry will become fully integrated as we contribute our expertise as highly skilled clinicians.
As optometrists upskill through glaucoma certification and independent prescribing, and engage with local consultants for shared CPD, case-based discussions and clinical advice queries, we will develop teams with an unrivalled skillset to diagnose and treat our patients.
About the author
Nigel Kirkpatrick is a consultant ophthalmologist based in Gloucestershire working in both NHS and private practice. He is also medical director of Newmedica.
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