Optometry Scotland releases recommendations for enhancing community eye care

Optometry Scotland has presented recommendations for enhancing and future-proofing community eye care to the Scottish Government.

The new policy report, The Expert Working Group for Primary Eyecare Services Report, aimed to assess the suitability of the universal policy of NHS-funded eye care in Scotland, review service performance and how this could be maintained, and explore opportunities to enhance service delivery beyond the pandemic, also setting out a series of recommendations to support these areas. 

The working group, which was made up of a range of healthcare and academic professionals, spent three months examining the performance of community optometry before and during the COVID-19 crisis.

Based on its research, the working group concluded that the country should maintain its universal NHS-funded eye care moving forward “on the basis of health equality, early detection and monitoring of health conditions, and improved service efficiencies within primary and secondary care.”

The group also highlighted a need for improved infrastructure of eye care in home and remote settings, and enhanced support and consistency in technological innovation and training.

The Expert Working Group’s key recommendation is for the Scottish Government to agree to a rolling three-year funding settlement with a minimum budget increase of 3% annually in real terms on fees.

The organisation suggests this would “protect the integrity of the workforce and current service delivery” across the country, with Julie Mosgrove, chair of the working group and vice chair of Optometry Scotland, sharing: “Ophthalmic services require regular funding reviews which acknowledge the rising costs of the ongoing training and technology investment needed for the workforce.”

As the only part of the UK with universally-funded NHS eye examinations, Mosgrove said: “It is clear we have a real opportunity to now build on this and establish a service that is truly world class.” 

“The positive impact of optometry was highlighted during the peak of the pandemic and demonstrated how intrinsic community eye care is to other primary and community services,” Mosgrove continued. She added that, with more than two million free eye examinations provided each year, “optometry plays a crucial role in the preventative health agenda” both through the early detection of conditions, and reducing pressure on areas of the NHS.

Recommendations for future-proofing and enhancing community eye care

As well as assessing and confirming the suitability of the policy of NHS-funded eye care, the group set out a series of recommendations to “take community optometry provision to the next level.”

The working group recognised a need for an improved infrastructure for equality of eye care in home settings and remote and rural communities, as well as a need for improved co-ordination and co-operation within the third sector and social and community care providers.

The report highlighted a “sizeable number” of eligible individuals who are not accessing the services they are entitled to, such as more vulnerable patients, the elderly, those with other health issues, or susceptible to isolation, falls or issues relating to sensory impairment.

The report has called for better service consistency across Scotland, which would help to address concerns of disparity between different areas of the country in accessing eye care services, and for those living in rural or remote areas who may be close to a practice, but not a hospital.

Recommendations encourage a widening of the provision of eye care in a home setting. The report highlights the additional benefits of addressing visual impairment for fall prevention, dementia and other mental illnesses and adding, “finding more effective routes to care must be found to provide the quality of provision that is expected of the service.”

“At the heart of the enhancement recommendations are a series of measures to improve equity and to reach the most vulnerable groups,” Mosgrove said.

Considering services in the future, the report suggests technological innovation and greater consistency in equipment standards are key to developing the provision of optometry services in primary care, along with enhanced training.

Looking at training and the ways to maximise core competencies, the group recommended encouraging investment in the programme of continued professional development.

Optometry Scotland also highlighted that it would like to see greater support for the uptake of technology such as optical coherence tomography (OCT). The report recommends the Government works with Optometry Scotland and the primary care alliance to establish a supplementary GOS payment for technology such as OCT.

“A universality of OCT scans could even pave the way to establishing a Scottish database of imagery from the scans,” Mosgrove continued.

The expert working group was made up of representatives from Optometry Scotland, Royal National Institute of Blind People, the Scottish Dental Practice Committee, Macular Scotland, Community Pharmacy Scotland, the Vision Research Group at Glasgow Caledonian University, the University of Aberdeen’s head of economics, and a consultant ophthalmologist from Greater Glasgow and Clyde NHS. The group also heard from a range of additional experts.

The full report can be read online.