AOP Council: Workforce planning and future technology

Workforce planning, artificial intelligence in optometry, and degree apprenticeships, formed key discussions in the latest AOP Council meeting on 12 March.

During the meeting, the Council elected Karen Gennard, Councillor representing the South West of England, to the AOP Board.

Council discussions explored factors affecting the future of optometry, from the spread of the profession, to new technologies. OT summarises the discourse.

Workforce planning

The AOP Council discussed the distribution of optometrists across the UK and what might encourage optometrists to relocate to areas of undersupply.

Modelling conducted by the AOP in 2022 suggested areas of the UK with significant oversupply, and areas with significant undersupply, such as Portsmouth, Liverpool, Nottingham, and Sheffield.

The AOP highlighted that in order to support the delivery of enhanced services, it will be important to ensure a sufficiently sized workforce in all regions.

Dr Peter Hampson, clinical and policy director at the AOP, said: “There have never been as many optometrists as there are today,” but noted that workforce distribution remains an issue.

The reasons that optometrists might be reluctant to relocate to different areas of the UK were first considered, with societal, cultural, and familial influences identified as strong reasons it can be difficult for people to relocate.

Feeding back from a group discussion, Sarah Lowry, AOP Councillor for the North West of England, pointed to the challenges a graduate might face in relocating to a rural area.

“If you move into those areas you could have less clinical support and mentorship if it is a single clinic practice,” she suggested. In areas with an older population, the practice could also see higher levels of pathology.

While wages in underserved areas of the UK could be higher, Lowry pointed out: “Your life might be more expensive if you haven’t got family close by to help with childcare, or if you have to rent an entire house rather than an apartment or share accommodation. Are you actually coming out with more money?”

As university fees and cost of living has risen, students could be choosing to study at higher education institutions closer to home, Councillors noted.

Councillors considered factors that might support practitioners to relocate.

Frances Jamieson, AOP Councillor for Scotland, gave an example from the Scottish Highlands, which she described as “A notoriously difficult place to hire across all of healthcare and social care.”

This is primarily because of issues with accommodation, but also because it can be perceived as a “career ender.”

To support professionals in the Highlands, a new national treatment centre was built, with new equipment, training opportunities and support for practitioners to specialise.

Jamieson highlighted the importance of presenting the opportunity as “not a career ender, but a progressor.”

Creating different types of employment contracts with built in flexibility and a view to career progression were considered by Councillors as a possible way to support practitioners to relocate.

The importance of contracts that work around family life were also identified as important, however, it was acknowledged that the practicalities of offering these contracts while managing clinics can be challenging for independent practices.

Nicholas Hagan, AOP Councillor for the East of England, pointed out that a relocation does not have to be for a practitioner’s whole career, but can form part of a colleague succession planning, to ensure a practice always has enough high calibre clinicians.

He explained: “We had 30 pre-registration optometrists in 17 years and that was the way we were able to produce the resource and have a continuity of employment and succession planning. They would stay for five or six years and then move on.”

Councillors also highlighted the need to raise awareness of optometry as a career path, such as to children in secondary school, while the benefits of experiencing different placements around the country should be highlighted to optometrists early in university.

Adopting and adapting: artificial intelligence in optics

The AOP formed an AI and IT Innovations Task Group in summer 2024, which has since met twice to hear from experts in the field of optical technology.

The group is planning to produce practical resources to support AOP members to be prepared for the changes in how eye health services will be delivered in the future, and the ways AI can be a tool for the profession.

Paul Alexander, policy and governance manager at the AOP, said: “We’re looking to provide as much practical resource to members as possible, to help understand AI, embrace it, adopt and adapt.”

He emphasised that AI technology “is always going to be a tool, rather than a machine making your clinical decisions for you.”

Council explored the areas of daily practice where AI could be beneficial, with ideas primarily focused on administrative tasks such as notetaking and diary management, stock management and ordering glasses and contact lenses.

Generation of patient satisfaction surveys, translation services, and handover support, were also suggested.

Illustrating the patient journey, calculating waiting times in secondary eye care services, or supporting referral pathways, were also suggested as areas where AI tools could be beneficial.

Councillors also identified potential concerns regarding the limitations and reliability of AI, data protection, legal protections, and the lines of responsibility where AI technology is used.

Will Holmes, AOP Councillor for university lecturers, noted the potential risks of practitioners using AI tools in tasks they have not been designed for.

Councillors discussed ideas for resources on AI that could be useful for AOP members, along with guidance and reassurances for practitioners.

Holmes suggested that guidance on AI should illustrate that: “You shouldn’t be worried about AI to the point where you should be concerned about your livelihood. But you should be alert to the fact things will change and think about professional development in the future.”

Degree apprenticeships

The NHS Long Term Workforce Plan identified increasing education and training as a priority, including apprenticeships and alternative routes into professional roles. This includes introducing medical degree apprenticeships with a goal of training 2000 medical students in this way by 2031/32. With this in mind, degree apprenticeships appear to be a direction of travel within healthcare.

Proposals for the creation of an optometry degree apprenticeship were put on hold in 2021, following “significant concerns” raised amongst the profession. The AOP highlighted the concerns of members regarding the proposals at the time.

Introducing the topic to the Council meeting, the AOP emphasised that it would continue to be guided by members and that the concerns raised in 2019 would need to be addressed.

Councillors were asked to consider – if degree apprenticeships are to be introduced – how apprentices could be guaranteed to receive a range of clinical exposure, what processes should be in place to track progress, and what safeguards should be established.

Councillors considered whether the requirements of offering a degree apprenticeship could include ensuring experience in different clinical settings. This could be through the practice itself, or by forming an agreement with other local practices.

Apprentices should have protected time for learning, and there should be a requirement for the apprenticeship to be completed in a certain amount of time to ensure progression through the programme, Councillors suggested.

Hagan shared that following the ETR and the subsequent launch of new optometry courses, students are already on placements earlier in their learning.

“They don’t have the same journey that people have traditionally gone on,” he said.

Councillors discussed the role of a supervisor and the training they would require, while concerns were raised regarding the influence that supervisors might have as the only perspective guiding a trainee.

Regulations are already well established for many degree apprenticeship frameworks, including tri-partisan meetings and accreditation processes, Councillors noted.

Lowry questioned the length of time that a degree apprenticeship might take and where the funding would come from. She said: “How many years could it take to qualify this way, and if a practice is funding it, how long are apprentices going to be tied into their employer afterwards? Are they going to be able to keep the same supervisor for the time it will take?”

Jamieson reflected that the framework for degree apprenticeship models is understandable in a large organisation such as the NHS where a breadth of experience could be provided, but questioned the delivery of this in contracted services outside of the NHS.