A snapshot of LOC activity across England

Delegates to the National Optical Conference in Birmingham were provided with a snapshot of local optical committee activity across England (18-19 May, Hilton Birmingham Metropole).

LOC representatives from different regions detailed both the opportunities and challenges facing optical professionals in their areas.

While delegates referenced the uncertainty created by funding cuts and changes to commissioning in England, a proactive and unified response formed a common thread among the different presentations.

“Our South East motto is stronger together and in the last year, that has never been more true,” Hampshire LOC chair, Bryony Allen, observed.

Julia Maiden, representing the North West, paid tribute to LOC members, commissioners and provider companies for their “hard work, passion and vision for optometry.”

“Together, we are not just part of the system. We are helping to shape it,” she emphasised.

Progress on connectivity in the Midlands

Optometrist, Charles Barlow, highlighted that the roll out of the Eye Care Electronic Referral Service across the Midlands was an example of successful collaboration.

“The LOC was involved with the project from day one. We implemented the service in every single ICB region in the Midlands,” he said.

He emphasised the value of monthly meetings organised by NHS England with representation from all the LOCs.

“We have the provider present to share updates and we have learned so much from others about navigating challenges and best practice,” Barlow observed.

He added that a sign up rate of around 90% is typical across the region, although Barlow paid particular tribute to Lincolnshire which has achieved a 100% sign up rate.

Barlow said that the next electronic referral project would involve optometry practices receiving a link to GP Connect.

“During phase one practices will be able to access the NHS patient shared care record. Then in phase two, the plan is to receive documentation access,” Barlow explained.

Reflecting on challenges within the region, Barlow pointed to difficulties in referring between areas and making use of further qualifications as a source of frustration.

“We have had so much success in workforce development – with people qualifying in glaucoma and IP – but then we can’t place them anywhere,” he said.

Cardiovascular disease prevention in the north west

Optometrist, Julia Maiden, shared with delegates that in Cheshire and Merseyside a total of 32 optometrists have been supported to complete their IP training.

Cheshire and Merseyside has also secured funding to deliver WOPEC foreign body removal training to 93 optometrists involved in delivering the Community Urgent Eyecare Service.

She highlighted that one of the most exciting areas of LOC innovation within the North West is around public health.

Between November 2024 and March 2025, a cardiovascular disease prevention initiative saw 2254 patients receive blood pressure readings at optometry practices in Greater Manchester.

Maiden highlighted that close to one in four (24%) of patients required onward referral.

She added that one patient had dangerously high blood pressure and was hospitalised for six days.

“These are not just statistics. These are lives that were directly impacted by the vigilance and clinical expertise of primary care optometrists and the wider team,” Maiden emphasised.

These are lives that were directly impacted by the vigilance and clinical expertise of primary care optometrists

Referral challenges in the north east and Yorkshire

Optometrist, Stephanie Cairns, shared that a reoccurring theme across the north east and Yorkshire region has been challenges in referring patients to secondary care.

The need for GP involvement in referrals can create difficulties, Cairns said.

“LOCs from Coledale to North Cumbria have reported referral delays,” she shared.

Cairns emphasised that this has prompted a push for more direct and efficient referral routes within the region.

“The continued resilience of paper-based hospital vouchers has also caused many concerns, particularly in the north eastern Cumbria area, where there's been risks around the delay of payments and lost documentation,” she said.

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Electronic referrals: new data reveals regional disparities in access

While some areas are referring directly to secondary care through an electronic platform, others continue to rely on GP practices for onward referrals

Inclusive eye care pathways and hydroxychloroquine monitoring in London

Chair of North Central London LOC, Prakash Rughani, highlighted that some of the challenges around commissioning in London relate to population density.

“For example, North East London has the population of Newcastle, Glasgow, Edinburgh and Plymouth combined,” he said.

Rughani noted that North West London, with a population equivalent to Bradford, Leicester, Leeds and Sheffield, now has pre and post-cataract checks, glaucoma repeat readings and enhanced case finding.

He shared that South East London has a single point of access which processes all referrals made through the electronic referral system.

Rughani added that newly commissioned services in South East London include hydroxychloroquine and ocular imaging pathways – used, for example, for nevus monitoring and the Easy Eye Care Pathway for people with learning disabilities and autism.

A new contract in South East London with the Integrated Care Board has extended these services through to 2029.

“South East London is perhaps the jewel in the crown of London’s eye care commissioning,” he said.

Forging links with secondary care in Cambridgeshire and Peterborough

Reflecting on LOC activity within the east of England, optometrist, Alison Lask, highlighted that Norfolk and Waveney LOC have created guidance on securing an NHSmail account with the assistance of an ICB commissioner.

“This guidance has very kindly been shared with all the LOCs in the east of England,” she said.

“Norfolk and Waveney have had some real success in reigniting local glaucoma services and expanding them to another trust, which is quite an achievement at the current time,” she emphasised.

The optometrist shared that there are strong links between primary care optometry and secondary care within Cambridgeshire and Peterborough ICB.

“We can use our Cinapsis referral system to request advice and guidance from the hospital and receive it directly from the consultants,” she said.

She added that the Cinapsis system is working well across the region and is funded by the hospital trusts because of its effect in easing pressure on secondary care.

In Hertfordshire, a blood pressure screening pilot is proving to be successful.

“They have been able to support the commissioning of pathways with an evidence-based audit of Minor Eye Conditions Services and are in discussion for a paediatric service and glaucoma,” she said.

The owner of A & I Lask Opticians in Cambridge shared that Suffolk and Essex have been working together to build relationships with other primary care disciplines and build the profile of optometry within their patch.

“Commissioning has been challenging across the borders as they are working across a varied footprint,” she said.

The optometrist highlighted that workforce changes and restructuring within the NHS could mean that LOCs will lose long-established relationships.

“The biggest thing that we’ve got coming up across the east of England is the changes in the ICB footprints,” she said.

“Nobody really knows where those boundaries will fall. But one thing is for sure – across the east of England, we will all make it work, no matter what happens,” she emphasised.

This has revolutionised the quality and speed of referrals, delivering care close to home and improving outcomes. It’s a shining example of what technology really can do

Sharing images between High Street and hospital in Gloucestershire

Optometrist, Charles Bill, highlighted that the south west of England covers Wiltshire, Dorset, Avon, Gloucester, Somerset, Cornwall and Devon.

“Unlike London, it has a large coverage area with very few people,” he said.

Bill observed that while the region has experienced challenges, particularly in Devon, a strong focus on education has provided opportunities over the past year.

“First and foremost, our region has made a real investment in education across all areas. We committed time and resources to developing and delivering CPD, ensuring that no matter where a registrant is located in the region, they have access to high quality training opportunities,” he said.

He shared that as well as in-person study days, LOCs have organised innovative online events, including a peer review.

Bill noted that Gloucestershire LOC has piloted a low vision service. The Community Ophthalmic Link project, enabling the transfer of images between optometry practices and secondary care, received an HSJ Partnership Award for the most impactful use of technology on clinical practice.

“This shows that there is a solution out there for rapid file sharing between primary and secondary care,” he emphasised.

“You can actually see an OCT, a visual field or a photograph. This has revolutionised the quality and speed of referrals, delivering care close to home and improving outcomes. It’s a shining example of what technology really can do,” Bill highlighted.

A unified approach in the wake of funding cuts in the south east

Optometrist, Bryony Allen, shared with delegates that ICBs in the south east of England have experienced funding cuts.

“Sadly, a number of services have been lost in connection to this,” she said.

Allen highlighted the open, honest and supportive communication has helped to foster collaboration between LOCs in the south east.

“This has been fundamental to our efficacy, ensuring appropriate pushback where there has been any misunderstanding of the role and remit of community optometry, and providing a single, united voice,” Allen said.

She added that this united approach has supported progress in newly commissioned services within Kent and Medway, as well as a service boundary extension within Frimley.

Allen noted that regular regional calls have served as an opportunity to share LOC highs and lows.

“No comment or question is unwelcome and every single member is valued as their authentic self,” she said.