The challenge

OCT for all

OT  speaks to Specsavers as it embarks on the nationwide rollout of OCT devices in its practices across the UK

Nidek OCT screen

In May this year, Specsavers confirmed a multi-million-pound plan to ensure that each of its 740 practices in the UK has an optical coherence tomography (OCT) device installed within the next two years.

Prior to the announcement, just 32 branches of the multiple had the technology available, demonstrating what a large investment and rollout plan would be required to reach this goal.

Yet Specsavers is confident in achieving its aim and it would seem that its partners are embracing the technology and the opportunities that it can bring. “We were very pleasantly surprised at the number of practitioners who expressed an interest in investing in the device – we had around a 65% uptake in the initial phase, which is much higher than we anticipated,” head of enhanced optical services for Specsavers, Mike Horler, told OT.

“Even now that number is growing – partners continue to sign up every day after speaking to fellow optometrists and joint venture partners (JVPs) about the technology,” he added.

OCT practicalities

While Mr Horler, who is also director of Specsavers in Brighton, confirmed that the rollout of the first OCTs to Specsavers stores under this investment is “imminent,” his practice took delivery of its first OCT more than four years ago.

Having invested in the technology in order to participate in a local enhanced age-related macular degeneration scheme, Mr Horler is a strong advocate of the technology. “I believe that it is the way forward for the profession. For lots of conditions it can be a silver bullet when diagnosing a patient,” he said. 

Ahead of the rollout, Specsavers has selected two preferred OCT suppliers, Nidek through Birmingham Optical and Heidelberg Engineering. It is also advising that its JVPs recommend the scan to all patients over the age of 25, and has set a maximum fee of £10 per scan. “It is the local partners’ decision who they recommend scans to and what they charge, up to £10,” Mr Horler emphasised.

Discussing the price point, the optometrist confirmed that the fee was trialled within practices and that as a company: “We believe setting a maximum fee of £10 is a value for money offering that sits comfortably within Specsavers’ mission values and purposes of delivering affordable eye care for all,” he said.

“This is about OCT becoming a part of Specsavers’ core offering. [The price tag] enables practitioners to offer a high level of clinical care, while ensuring that the technology is accessible to a large number of patients,” he added.

"Over the last four years, it's been nothing but a very positive experience that enables us to deliver a high standard of patient care in our community"

Training is key

Classified as an early adopter of OCT within the multiple, Mr Horler has played a pivotal role in the development of Specsavers’ internal OCT staff training programme.

The online programme must be completed by at least two optometrists in each practice before Specsavers will arrange the delivery and installation of an OCT device. However, ideally each and every practitioner will do this, Mr Horler said.

“It makes sense for all optometrists to complete this training if we plan to deliver OCT to a large percentage of the population – it’s essential as many optometrists as possible are trained and comfortable to deliver this high level of clinical care,” he added.

Comprising seven online lectures and associated multiple choice questions, the training has been designed to specifically meet the needs of Specsavers’ optometrists.

Emphasising the importance of this mandatory training, Mr Horler explained: “Optometrists generally, even on the current undergraduate programme, get little exposure to OCTs and interpreting OCT scans. Therefore, we felt that it was vital to offer our practitioners training that met their needs.”

Having explored what OCT training was already available on the market, the multiple opted to design its own bespoke programme, which should take practitioners around six to seven hours to complete.

Training in not limited to the confines of a computer screen as regional training events, refresher training and four CET sessions at PAC in October are already planned for once the rollout is underway.


Early adopter

Optometrist and director of two Specsavers practices in Cambridge, Kam Dhillon, took delivery of an OCT device in late 2016, before the multiple announced its company-wide rollout plan.

Speaking about the reason for his investment in the technology, Mr Dhillon explained: “I had been thinking about purchasing an OCT for a while – it seemed to be a natural next step in terms of the clinical offering of my stores.”

For Mr Dhillon, the decision-tipping point came down to providing better care for patients and ensuring his practitioners have the tools required to do this. “I want my patients to feel like they have received the best possible clinical care when they come to my practices, and I want my optometrists to feel that they are equipped to offer that care – OCT allows us to achieve that,” he said. 

On delivery of the OCT, optometrists at Mr Dhillon’s practices received “in-depth” training from the manufacturer, and consumed “as much OCT-focused CET as possible,” before scans were offered to patients at Specsavers’ recommended £10 fee.

“We spent plenty of time getting to grips with the tool and understanding its capabilities before offering it to patients on a wider scale,” the director confirmed.

Career satisfaction

With the device firmly embedded into Mr Dhillon’s practice offering, he speaks honestly about introducing the device. “My optometrists want to offer the best possible care to their patients so when we took delivery of the device, the reception was very positive – they were very excited and couldn’t wait to have a go,” he said. 

Over 10 months on, Mr Dhillon shared: “After initial nerves, we have found that the more experience you have with the OCT, and the more images you take, the better you become at interpreting them. There’s not a day that goes by when our team of optometrists are not talking to and asking each other about images.”   

Since introducing OCT into their practices, both Mr Horler and Mr Dhillon have witnessed the business benefits in terms of referrals and retention that an OCT brings. They also highlight that the positive impact that it has had on their optometrists is second to none.

“Since having access to an OCT, I know that many of my optometrists would now think long and hard before moving to a practice that didn’t have one. Furthermore, I’ve since had optometrists join us who have said that having access to an OCT was a deciding factor in their move,” Mr Dhillon said.

Similarly, Mr Horler reflected: “From an optometrist’s point of view, if I am giving an interviewee a tour, and they spot the OCT, it sparks up a conversation straightaway. And while it’s a great attraction for new staff, current staff are passionate about its use and are always discussing scans. It’s firmly embedded in our patient care.”

Returning to the multiple’s rollout plans, while reception has been “fantastic,” ultimately it is up to the partners to decide which one to sign up for, Mr Horler highlighted, referring to the 35% of those yet to sign up.

He closed: “Over the last four years, it’s been nothing but a very positive experience that enables us to deliver a high standard of patient care in our community.”