Optometry’s big questions: views from new AOP Councillors

Challenges and successes, professional progression and crystal ball-gazing predictions, OT puts three of the AOP’s newest designated Council members in the hot seat. Here Erica Campbell-Walker (representing Scotland), Ankur Trivedi (representing Independent prescribing optometrists), and Priya Tanda (representing pre-reg optometrists), share their views on the direction of the profession.

The here and now

What issue in optometry is most important to you right now – and why?

For Scottish optometrist of 20 years, Campbell-Walker, the upskilling of professionals is the most important issue for optometry right now in order to ensure the profession is well-positioned to adapt to the evolving healthcare landscape.

Getting this right will ensure that “optometrists and dispensing opticians have the resources, skills and support necessary to provide high-quality, patient-centred care so that patients have access to local enhanced healthcare services that meet their current and future needs,” she told OT.

Representing IP optometrists, Trivedi is an optometrist of more than two decades who has already embraced upskilling, gaining his IP qualification in 2014. For him, the most important thing for the profession right now is for professionals to be able to “fully utilise the training and experience they have in order to deliver care to the best of their ability.”

This is really important he said because “the skills that you develop during training can be easily lost if they are not utilised.”

Relatively new to the profession as she embarks on the final stepping stone to qualification is pre-reg optometrist, Tanda, who feels that pivotal right now is the education and development of future optometrists.

“With the regular changes in technology, ocular interventions and policy,” she highlighted, “all optometrists need to be up to date with this for them to be fully informed for their patients.”

I know that’s a big ask and there is not a quick win, but if I could wave a magic wand and get good IT everywhere with great interoperability and connectivity it would make many things easier for all

Challenge and reward

What do you feel the profession’s biggest challenge has been over the last 12 months and why?

For Campbell-Walker, the profession’s biggest challenge over the last 12 months also remains its current challenge: the disparity of recognition for optometrists in the four nations.

“Scotland, Northern Ireland and Wales have forged ahead to embrace and extend the scope of optometrists, recognising the service benefits and vital role that optometrists play in delivering high-quality enhanced healthcare services and how we form an equitable and accessible network to support secondary care,” she enthused, while highlighting that “this is not the case in all areas of England, with many IP optometrists still unable to access FP10 prescription pads.”

While changes in pace and position expand across the nations, pre-reg optometrist, Tanda is all too aware of the impact of the pandemic on patients and access to care.

“Since the pandemic, wait lists in hospital eye services have been increasingly longer, with patients not having access to regular follow-up appointments,” she highlighted. This has put strain on services being delivered in both hospital and High Street environments, “with the transition period we are in now being slowly navigated,” she said.

“Going forward, it will be key to tackle the hospital outpatient backlog in eye care, which may be through increasing community optometry services or more investment in primary eye care services,” she added.

Trivedi agreed, explaining: “We are still recovering and adjusting,” reiterating that “the delays that have been caused by COVID-19 are still being felt, in both the hospital and High Steet settings.”

With his partner working in the High Street setting, he is aware that every day she sees patients with a delayed follow-up, presenting in order to see someone and escalate things if needed.

In Gloucestershire, where Trivedi is based, a relatively new IT connectivity project called Blueworks offers optometrists on the High Street in this situation some relief, explaining that they are able to “dial in with secure access to see the patient’s journey, details and where they are in the process.”

“It saves time as she doesn’t refer due to the unknown, but there is much more to achieve,” he added.

What do you feel the profession’s greatest success has been over the last 12 months and why?

In navigating difficult and unknown pathways also emerges success, identifies Tanda when referring to the development of the profession in a post-pandemic era.

Reflecting on 12 months ago compared to today, Tanda stated: “We have been able to transition out of the pandemic brilliantly. Face-to-face CPD and conferences have been brought back, and we are able to practise optometry safely and adaptively. Optometrists are taking on more in the healthcare profession - with developments in areas like COVID-19 Urgent Eyecare Services highlighting these changes.”

“As optometrists, we have acquired a broader skill set from working through COVID-19 and have been able to use learnings to elevate the profession today,” she highlighted.

For Campbell-Walker, it is developments within the education sphere where she identifies success, and is impressed at how stakeholders and higher education institutes have adopted the Education and Training Requirements (ETR).

Originally, Campbell-Walker confesses she had “significant concerns for the future direction of optometry as proposals around the optometry degree apprenticeship were troubling,” but feels that the ETR is a success that cannot be overlooked because of the future potential it holds, providing the opportunity to incorporate higher qualifications into the qualification process “will result in an upskilled profession,” she highlighted.

Remaining on education, Trivedi shared that he has observed “lots of my colleagues really grasp the nettle” recently. “They have been looking at what’s going in the profession and are using the opportunity to really grow and develop and push themselves with the recovery of the pandemic going on in the background,” he shared.

Trivedi emphasised: “There are lots more opportunities in the sector compared to when I first qualified in 2002. I have seen people locally and nationally get involved – it is great to see how we have approached and made the most of it.”

Going forward, it will be key to tackle the hospital outpatient backlog in eye care, which may be through increasing community optometry services or more investment in primary eye care services

Driving the profession forward

What three changes would you like to see to help optometry move forward?

For Tanda, the top three changes that he would like to see to support the forward trajectory of the profession are: greater communication and service pathways between hospital and High Street eye services; for healthcare professions and the general public to better understand the expertise of optometrists and dispensing opticians; and for the next generation of optometrists to have increased access to be able to share their perspectives.

This would ultimately allow “greater cohesion within different areas of the profession,” she shared, adding: “More collaboration and teamwork within our profession is vital.”

Campbell-Walker is keen to see: increased support and incentives for optometrists to upskill “with more businesses using the apprenticeship levy to upskill postgraduate ophthalmic professionals and more local/national initiatives to fund higher qualifications and IP.”

She would also like greater recognition and support from the public and policymakers of the vital role the profession can play in accessible and high-quality healthcare, as well as a shift from the reliance on spectacle sales to subsidise enhanced professional services “in order to ensure future sustainability of a healthcare focused model.”

For Trivedi it is all about increasing relationships between fellow professionals in the wider sector ¬– working towards what is best for patients. He would also like to see more IP optometrists who have done the training but have struggled to secure a placement succeed in this. “I think it’s really sad when you look at the conversion rate between those who do the training versus those who complete the placements and become qualified,” he said.

Finally, but aware of the scale of the ask, Trivedi would call for better IT infrastructure that allows the sharing of clinical information between eye care professionals

“I know that’s a big ask and there is no quick win, but if I could wave a magic wand and get good IT everywhere with great interoperability and connectivity it would make many things easier for all,” he said.

Crystal ball gazing

What is your prediction for optometry in the next five years: what will the biggest difference be between then and now and why?

When it comes to predictions, Trivedi believes the path being trodden will continue and flourish: “There will be a great involvement of community optometry using well utilised and developed shared care services to allow patients to be seen and managed closer to home.”

In order to achieve this, however, Trivedi emphasised, “we all need to be working in partnership and working smarter.”

Campbell-Walker’s prediction for optometry in the next five years differs by nation, but, similar to Trivedi, “it will be overwhelmingly driven by the need to effectively use all available resources to support secondary care as the population ages and healthcare demand increases,” she said, adding: “The more the profession shows its worth, the more opportunities will become available.”

In Scotland, Northern Ireland and Wales, she predicts that all optometry students will begin graduating as IP optometrists and there will be significant work underway to support existing optometrists begin their journey to become IP. However, for England she finds a prediction harder because it is at a crossroads. While “certain areas of England are already on the same path as the other nations, in other areas policymakers have not yet recognised the unique opportunities proffered by optometrists,” she said.

“I hope in five years that all areas in England will be at least where Scotland, Northern Ireland and Wales are now and policymakers will have recognised the positive impact optometrists have had on healthcare in the other nations and the early adopting areas within England,” she added.

Remaining on services and scope, Tanda believes that the current GOS fees paired with many practices making the move to private in recent years brings an interesting change to the profession moving forward. “Whether GOS fees will remain static, or whether practices will be able to have more sustainable sight test fees also bears a question about access to NHS services – will these changes affect the way the public has access to NHS services?,” she questioned.