16 December 2025
A meeting of the AOP Council on 12 November discussed commercial pressures and practices, IT connectivity, and the NHS England medium term planning framework.
The meeting began with an introduction from chief executive, Adam Sampson, who referenced the AOP’s recent activity at political party conferences and work in influencing and public positioning.
The AOP is also in a process of strategic planning as the association comes to the end of its previous strategy and plans for the future.
Looking forward, Sampson said: “We want to push Government to see whether we can get a certain basket of optometry services mandated across England, in the way they are available in Scotland and Wales.”
Understanding commercial pressures
The General Optical Council (GOC) has launched a thematic review on commercial practices, to understand the effects on registrants and their delivery of patient care.
The launch of the review came about as a result of the GOC’s 2025 Workforce and Perceptions Survey, which found a significant proportion of respondents felt they had sometimes or frequently experienced time and commercial pressures in their role within the past 12 months.
Of the more than 3700 responses, the survey found 30% of respondents felt under pressure to meet commercial targets at the expense of patient care sometimes or frequently.
The review is considering how to address overbooking (or ‘ghost clinics’), short sight testing times, commercial targets and incentives, a lack of transparency around costs and eligibility for NHS financial support, and refusal to treat young children – in part for commercial reasons.
Councillors were asked for their views on potential interventions that could be taken to mitigate against the issues, with Paul Alexander, policy and governance manager at the AOP, telling Council: “We want to take a temperature check.”
Councillors expressed broad consensus that certain commercial practices were something that needed to be addressed and represented challenges faced by employees. Some noted that this has long been a concern.
The general ophthalmic services fee was felt to be a factor in these commercial pressures, though it was identified that there is the potential for such pressures regardless of the GOS fee levels.
On the practice of overbooking clinics, Councillors acknowledged the issues presented by patients not attending appointment bookings, and shared examples across the sector of where overbooking is used, often to combat patient DNAs – such as in hospital clinics.
Rebecca Donnelly, AOP Councillor representing franchisee and joint venture partner optometrists, emphasised the importance of using data, such as average cancellation rates, to inform booking the practice diary, particularly in large practices with rolling clinics.
She suggested: “Is there a way for the GOC to include a statement within the standards that protects practitioners when they raise concerns? How can we build a framework that gives businesses the flexibility they need, while ensuring clinicians feel confident and supported in speaking up?”
A further consideration for recommendations could be to ensure that clinicians are part of the decision-making of internal practice frameworks, Donnelly suggested.
The potential for future business regulation, and whether this would help ensure accountability, was raised.
Councillors agreed that setting a strict number of patients that could be seen per day would not be an appropriate measure.
Councillors also discussed the need for the AOP’s response to the review to be informed by evidence and examples centred around patient safety.
It was highlighted that it can be particularly difficult for optometrists who are in the first few years of their career to be able to say ‘no’ to an employer or manager.
Connectivity in healthcare
The Government’s 10-Year Health Plan offered some insight into how the shift ‘from analogue to digital’ might look in the reimagined NHS – with plans including utilising data for a digitally accessible healthcare system and forming a single patient record.
The AOP is seeking to strengthen its call to prioritise the delivery of effective digital systems – improving connectivity between primary care optometry, general practice, and secondary care ophthalmology.
The AOP has previously called for all practitioners to have access to NHS mail and for the national roll-out of the electronic referral system to ensure a robust and secure mechanism of communication between primary and secondary care.
The policy team at the AOP sought to gain feedback from Councillors on the development of IT connectivity and what solutions the association should be pursuing.
Councillors were asked to consider how existing IT systems could be adapted or improved through achievable changes that could be supported on a national basis.
Areas for prioritisation in improving IT connectivity between optometry and ophthalmology were also discussed, as well as what an optimally-connected digital infrastructure for eye care would entail.
Councillors discussed centralised patient records, the potential data protection considerations for this, and how much information optometrists would be able to – or wish to – access, with many agreeing that a summary record of diagnoses, medications, and letters to the GP, would be useful.
The flow of information was identified as being particularly important, such as when contacting different specialities and the inconsistencies in approach between them.
Councillors noted, however, that in some areas patients are required to download a separate app to receive their hospital letters.
Emma Spofforth, AOP chair, noted: “Integrated care boards are each introducing their own solutions to shared records within their locality. They are trying to join up various IT systems which costs huge sums of money with some IT systems simply not connecting to others.”
It was also acknowledged that some patients may have difficulties accessing digital tools such as the NHS app.
Policy briefing: 10-Year Health Plan for England
The AOP’s summary – and what it means for optometry
Discussing the NHS England medium term planning framework
The Department for Health and Social Care and NHS England produced a framework in October which provides more detail on the longer-term transformation plans for the NHS.
The framework describes a new operating model for areas of the NHS including primary care. Despite this, there are still unknowns and the AOP is calling on the Government to include optometry in the planning.
Councillors were invited to discuss whether the AOP should continue to push for the widespread coverage of enhanced services.
Spofforth highlighted to Council: “This is a huge opportunity for our profession.”
The AOP has said that commissioning should be based on three principles: central mandate that services must be present in every integrated care board, along with clear nationally-agreed clinical service specifications with reporting and administrative functions around them, and dedicated funding provided to pay for the services as a nationally-agreed price point.
Councillors were encouraged to consider what would be needed to implement a framework around these principles.
The majority consensus from Councillors was that the AOP should continue to push for enhanced services to be widely available to patients.
Considering what would be needed to enable the implementation of a framework for commissioning enhanced services, Councillors suggested funding, training and ensuring appropriate equipment for particular pathways, was important.
Political goodwill, taking lessons from other nations, and avoiding competitive tendering was also raised.
Councillors were encouraged to highlight areas to push for inclusion in a nationally-agreed specification.
Glaucoma monitoring was highlighted, as well as pre-and post-op cataracts, minor and urgent eye care services, macular and dry eye, with paediatrics also presented as an area of focus.
Simon Raw, AOP Councillor for North East England, highlighted the large numbers of patients in need of glaucoma monitoring services, emphasising that this is a service optometrists can provide. He also urged: “Don’t forget domiciliary.”
Councillors agreed that the ambitious approach taken in the AOP’s asks was necessary to create change.
Celebrating Andrew Tompkin
The AOP chair concluded the meeting by sharing an official thanks to Andrew Tompkin, consultant optometrist, who was recognised with an honorary life membership of the AOP at the Hospital and Specialty Optometrists Conference.
Tompkin has served as secretary of the AOP Hospital Optometrists Committee since 1991.
Spofforth recognised the time and contributions given by Tompkin.
Six insights from HSOC
OT presents a selection of takeaways from the AOP’s Hospital and Specialty Optometrists Conference
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