Why local optical committees are vital in influencing optometry’s place in primary care

At NHS Confed Expo 2026, clinical director at Primary Eyecare Services, Lisa Gibson, spoke on a panel alongside pharmacy colleagues about how the respective professions could influence service change from the edges.

After the panel, Gibson and Primary Eyecare Services chief executive, Dharmesh Patel, spoke to OT about the key way that optometrists can get involved in influencing change – even if they don’t have lots of spare time to do so.

What is the importance of primary care in influencing service change, and why is it important for primary care to be involved?

Dharmesh Patel (DP): I think at the heart [of this] are future models of care, whether that’s the neighbourhood model and its wider impact, or more generally for the needs of the population at source.

For us, recognising that optometry is a core part of the four pillars of primary care is why it’s critical. Ensuring that we can influence that, in a system that has its unique power dynamics, is really important. It’s important that we do that as a voice together, because alone, we are a smaller voice. Together, we’re much more powerful.

Lisa Gibson (LG): We aren’t there everywhere at the moment, but in the pockets where we are, in these primary care systems, you can really see it is making a difference in educating our partners on what we can do and finding out what everybody’s needs are in those systems.

In the past two or three years, we’ve seen this real shift. We’ve always had systems where there has been some good partnership working, but actually that is becoming more of a known, and more of a standardised approach.

DP: Where we can get the four primary care groups working together, and from our perspective in optometry, where we’ve got the local optical committee (LOC) and the provider arm really going in together, we’re much better aligned and we’re much more effective. It’s capitalising on that opportunity as a strong voice in the system.

Why is it important to work specifically with pharmacy colleagues, as you have on today’s panel?

DP: The idea was to be a panel on primary care, focusing on those who are at the edge of the system: optometry, pharmacy, and dentistry. The idea was that community primary care tends to mean general practice. We have to find that greater voice. We have a double job: we have to influence the system, and we also have to influence general practice to include us.

LG: We’re all at the edge. Primary care has traditionally been GPs, but actually, there’s so much benefit by bringing all the [primary care] professions into it. That’s what the session is really about.

Have you got any practical tips for eye care practitioners who are interested in this work? Where should they direct their energies?

DP: I always say two things: you should be engaging with your LOC. They are your representative committee locally, they will help you engage in the local system, and you will be able to align into what’s going on locally. The LOC is your first port of call. Are you getting their information? Are you engaging with them to design what the future looks like?

Secondly, you should deliver the local enhanced services that are commissioned. That’s where Primary Eyecare Services comes in, or the other provider arms. That really starts to embed you into your local system. It’s what this panel was about: building trusts and relationships in your local area.

LG: Put your hands up, and get involved. Even if you don’t have the capacity to do a fuller role, go to some meetings, and get speaking to some partners within the systems. It’s quite interesting: it takes you out of a test room and gives you a totally different dynamic.

DP: You can get involved as much or as little as you want. You could just be that voice that is supporting the LOC. They want to know what’s going on on the ground – that then feeds everything. It’s genuinely a bottom-up approach.

If you are really busy in your day-to-day practice, but you want to influence, you can do that through your LOC. The LOC can identify the people with the most capacity, who really want to get involved, and can really help drive that, alongside ourselves and others. It’s really up to you, but LOCs are your roots, and they are the clear route for everywhere in the country.

LG: Especially as the neighbourhood agenda comes more and more into the forefront, we do need people. You might be an optometrist who doesn’t want a wider LOC role, but taking on something within that neighbourhood you’re working in, working with the local GPs and pharmacies, you can feed intelligence into the LOC and help to build a wider offering. You could be that spokesperson within the neighbourhood that you work in, and that’s what the true neighbourhood agenda is about.

What would you say to eye care practitioners to bolster their confidence in influencing if they are not there already?

LG: If you don't have the confidence to do it, the LOC is a really good forum. They are the statutory body, and they are the lever into lots of these conversations.

Also, if there are enhanced services delivered by Primary Eyecare Services in the area, we are very much in these local systems as partners. Speak to Primary Eyecare Services – speak to your local clinical leads, speak to our team, and we can help feed in some inputs.

DP: It does come down to the thing that was talked about on the panel: trust and relationships. Confidence and the skills are very much [developed] through LOCs: being able to say, ‘these are the challenges we have in practice. How do we translate that into what we know about what patients need, and how do we deliver that, and then how do we connect and go forward?’

It is hard to do, because of capacity, but it is to the point that Lisa made earlier on perseverance: do it again and again and again. NHS commissioning is a quagmire of detail and complexity, so actually, LOCs and everyone involved have to read, learn, network, and speak out to learn more. It is complex, and it has taken some of us 10 years plus to understand it.

You could be that spokesperson within the neighbourhood that you work in, and that’s what the true neighbourhood agenda is about

What is the overarching message that you want people to take away from the panel?

DP: We have made so much progress for our profession, as part of primary care, and it has been a long journey. If we continue to do what Lisa said, we’ll make further strides. It’s not going to happen overnight. It’s going to take the steps that we were talking about. It’s going to take everybody, because there’s a lot to do, and it’s about capacity, as well as skills and energies.

There is something about how we, as a sector, ought to support developing people as well, which is definitely something we need to consider.

LG: Get involved. The more people who are out there supporting that optometry narrative, getting optometry into local systems, and local neighbourhoods, the better. We can offer so much, as a profession for patients. We can support our colleagues in primary care; we can support our colleagues in secondary care. We’re here; we’ve got a skill set. We need to use it, and we need to make sure others know that we are available to do so.

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Influencing system change for optometry

Lisa Gibson, clinical director at Primary Eyecare Services, was joined by pharmacy colleagues to discuss influencing change ‘from the edges’ at NHS Confed Expo 2026