Specsavers publishes Access to care report

Specsavers calls on policymakers to act to increase access to health care, highlighting the existing skills in primary care optometry and audiology

A young man is having his eyes tested with a slit lamp. His eyes are lit blue as his face rests on the chin support. The optometrist is positioned in front of eye pieces and is using a joystick to control the instrument
Specsavers has formed a new report, Access to care, calling on policy makers to act to increase access to eye health services in the community.

The Access to care report highlights the vital role of primary care in access to healthcare and identifies areas of opportunity for the Government to reduce pressure on the waiting lists, by making more effective use of existing services, resources, and skills in community optometry and audiology.

The report outlines the use of technology in optometry on the High Street, how commissioning in Scotland and Wales is helping to reduce pressure on GPs and reduce irreversible sight loss, and illustrates the administrative barriers that prevent vulnerable groups accessing services.

Opening the report, Lord Low of Dalston CBE, pointed to the associations between poor sight and hearing with issues such as social isolation and loneliness, and emphasised that, as the population ages, demand for health services will increase, adding pressure on “already challenged” systems.

“Achieving the best outcomes and quality of life for patients must be the focus for all decision makers. Those seeking to build coalitions to improve population health must consider how to provide equitable access to health care for all people, particularly vulnerable groups,” he said.

Low suggested that, by integrating existing resources in the healthcare system and voluntary sector, policymakers can release capacity and improve access to care, adding: “Primary care optometry, and community audiology and eye health services, help people manage their own care better and prevent avoidable hearing and sight loss.”

The report highlighted data that shows patients with eye related conditions account for five million GP consultations per year, while more than one million A&E attendances last year were for eye related conditions.

Calling commissioning “patchy, especially in England,” the report notes that “only 23 out of 42 integrated care boards consistently commission Community Urgent Eyecare services.”

Giles Edmonds, Specsavers clinical services director (optics), described community optometry and audiology as “integral yet often overlooked” within primary and community care, adding: “Using this highly qualified workforce to its fullest extent will free up capacity within the health service in return for very little cost to the taxpayer and an overwhelming improvement in patient health outcomes and quality of life.”

Edmonds argued that the resources, facilities and governance mechanisms are already in place to deliver community-based urgent eye care services to NHS patients in England, emphasising: “This is a commissioning policy decision for each Integrated Commissioning Board to make.”

Doug Perkins, chairman and founder of Specsavers, highlighted the examples of services making a positive difference for patients and supporting the health service, but added: “The stark reality is that, unless we take co-ordinated action now, we will see more people in our communities put at risk and suffer irreversible vision and hearing loss.”

Inside the manifesto

Glaucoma services

The report emphasises the “huge pressure” on glaucoma services, sharing a case study from Hampshire where services are enabling optometrists to manage low-risk patients in the community.

Chair of Hampshire Local Optical Committee, Bryony Allen, explained: “Glaucoma services in Hampshire are delivered by expert optometrists providing excellent care. Those at-risk of progression are now supported by a friendly expert in the community, who will continue to monitor them if they remain stable or triage them back into secondary care if needed.”

Jag Singh, Specsavers head of new clinical services pathway development, is quoted in the report: “Between 75% and 92% of patients seen in glaucoma monitoring services throughout England are kept in the community for ongoing review. A nationally commissioned eye care pathway would allow more patients to be seen in the community and help alleviate the increasing pressure on ophthalmology services.”

Eye care for all

Specsavers has been working to improve access to eye and hearing care for people experiencing homelessness, working in partnership with Crisis, The Big Issue, Vision Care for Homeless People (VCHP), Simon Community NI and Focus Ireland.

Highlighting “unnecessary barriers” to NHS eye care due to “administrative obstacles” in the GOS contract, the group shared insight from VCHP that found, in 20 years of operating, less than half of clients seen by the charity had been eligible for an NHS-funded eye test.

Steve Pratt, director of Specsavers Crayford, shared his personal experience of homelessness as part of the report, and how a chance conversation while working in a coffee shop led to a career with Specsavers.

“I know that by making eye care easy to access we can help give people dignity and self-worth. This is a first step to accessing other services and a more stable future,” he shared.

AOP chief executive, Adam Sampson, joined the launch event for the report and answered questions as part of a panel discussion.

He said: “We’re delighted to be supporting the Specsavers initiative – it’s a really important piece of work.”

“As providers of these services, we’ve not always got it right – some of those barriers come from government, but some are from the sector,” Sampson suggested. “Today, we’re quite rightly looking at people from a homelessness lens, but patients who are coming into practice have a whole range of needs that we should be aware of in designing services or them.”

Administrative barriers

In the last 12 months, Specsavers Home Visits in the UK has visited almost 175,000 people to provide sight tests in their own homes, including nearly 20,000 people living in care homes.

The multiple has also expanded its Home Visits audiology service, which aims to cover half of the UK by February 2024, and reach the remainder within the next 12 months.

Specsavers emphasised the link between vision and the risk of falls, sharing data that suggests three quarters of severe falls that result in hospital admission through A&E are directly attributable to sight loss.

In domiciliary services, Specsavers identified concerns around the pre-visit notification (PVN).

Dawn Roberts Specsavers clinical director of home visits, suggested it is: “a barrier to care and discriminates against those who need it most.”

Hearing care demands

Specsavers has also highlighted the growing demand for hearing care, quoting research published in The Lancet which found that those with hearing loss had a 42% higher risk of dementia, and that the use of hearing aids removes this additional risk.

The audiology backlog for hospital-based hearing loss services exceeds 14 months in some areas, the Group shared.

Sonam Sehemby, Specsavers head of clinical services (audiology), described how the group has piloted a new audiology practitioner role.

“A modular approach to training allows colleagues to gain qualifications quickly, in wax removal, triage and repair, and fitting and rehabilitation, then immediately contribute to our wider clinical teams, delivering the best healthcare possible,” she said.