Community optometry is the answer to patient delays

The Optical Confederation (OC) and the LOC Support Unit (LOCSU) have reiterated the call for a “standardised system” to enhanced eye services, in response to an attack on delays in eye care services published in the Daily Mail this week.

In a letter to the newspaper, which was signed by all the leaders of the OC, of which the AOP is a founding member, and LOCSU, it highlighted that “conveniently located community opticians’ practices really should be the first port of call for anyone with an eye problem.”

The Daily Mail exposé reports on the story of Malcolm Johnson, who faced a long and potentially eye health-threatening wait for treatment of macular degeneration from the NHS, and elected to ‘go private’ in order to receive prompt treatment.

The article also highlights recent comments made by the Royal College of Ophthalmologists’ president, Professor Carrie MacEwen, where she identified a “perfect storm” of understaffing and overwork, coupled with NHS appointment targets that were“distorting” clinical priorities.

In its letter to the newspaper, the OC endorses the concern that hospital eye departments are “overworked.” Recognising the importance of the Daily Mail article in “bringing to readers’ attention the scandal of people going blind while waiting for hospital ophthalmology appointments”, the letter highlights: “Demand has increased over 30% in five years – and with an ageing population and expected new treatments for previously untreatable disease the number of patients is set to rise even more quickly in the near future."

The OC letter adds: “It should not be lost on readers that Mr Johnson went to his GP first who was unable to help, and it was the optometrist at Mr Johnson’s opticians that made the initial diagnosis. A recent survey by the General Optical Council shows that over half of patients would visit their GP if they woke up with an eye problem, yet optometrists (at your local opticians) are better equipped to make an accurate diagnosis and referral, and in many cases will be able to treat minor conditions with the help of the pharmacist. It was suggested that orthoptists could retrain to take up the slack in the hospital. This, however, misses the point, as there are less than 2,000 orthoptists and a smaller number of ophthalmologists.

The letter concludes: “There are 20,000 practitioners – 14,000 optometrists and 6000 dispensing opticians – operating out of over 6000 conveniently located community opticians’ practices who really should be the first port of call for anyone with an eye problem. Increasingly opticians are being commissioned by the NHS to conduct many of the follow up appointments previously provided by hospitals at greater convenience to patients and reduced cost to the taxpayer. Currently there are 200 Clinical Commissioning Groups in England; with nearly 20 enhanced eye services that is over 4000 contracts to be negotiated – it is no wonder that eye care like so many other aspects of NHS care remains a postcode lottery – and the sooner we move to a more standardised system as has happened in Scotland the better.”