AOP calls for a “collaborative approach to glaucoma care”

AOP economic modelling on glaucoma care reports annual cost savings of between £37m and £76m from transferring more care to optometry

Man having sight test

The AOP has a published a policy statement detailing the role of optometry in revolutionising glaucoma care.

In the statement, the AOP shares its belief that “utilising the optometric workforce can improve the way in which glaucoma care is delivered to patients in England, and could save the NHS £90 million per year in glaucoma care in 2030.”

The policy statement, which is available to read on the AOP website, details how “glaucoma is costing the NHS over £520m a year to manage,” stating that a national approach to the commissioning of glaucoma care in optometry is required. This, it says, would eliminate the patient care postcode lottery, and ensure maximum efficiency and value for money.

In the statement, the AOP calls for a collaborative approach to glaucoma care that utilises “the existing, extensive, highly skilled optometry workforce alongside secondary care,” which it believes “could immediately reduce the cost burden by £70m.” 

Glaucoma burden

It is estimated that 1.39 million people in the UK are living with ocular hypertension (OHT) and a further 708,000 are living with glaucoma. Furthermore, glaucoma accounts for around 20% of outpatient appointments.

Exploring the existing model for glaucoma care, the policy statement documents that, currently, most patients with glaucoma are seen and reviewed within hospital eye departments, explaining that “this usually involves patients over the age of 70, who are unable to drive as their examination will often involve pupil-dilating drops that blur their vision.” Patients therefore rely on public transport, family or patient transport to get them to and from what can be multiple appointments a year.

The AOP highlights that these hospital visits can occur on different days and times due to the nature of the different appointments required, from a review with an ophthalmologist, to seeing a nurse or technician for visual fields. 

“These visits are expensive, time consuming and in many instances unnecessary for both the patient and the NHS,” the statement highlights. 

Last year a paper published by Fu et al reported that around 70% of patients seen in glaucoma clinics are at low risk of sight loss.

In the paper, the authors explore the cost burden associated to the delivery of glaucoma care within secondary care in the UK. They report that the cost of caring for glaucoma patients is more expensive than the current NHS tariff prices. 

In order to demonstrate how glaucoma care could be delivered in optometry practices, the AOP has constructed an economic model exploring the potential cost savings from delivering care in optometry practices via two parallel, but linked, delivery mechanisms.

The AOP reports that, based upon 2020–21 patient volumes and depending on the volume transferred to optometry, there could be annual cost savings of between £37m and £76m.