”We see 2023 being a very big year for Optometry First”

What are the key priorities for LOCSU in 2023?

Janice Foster (JF): There have been so many changes within the Local Optical Committee Support Unit (LOCSU), and so many changes in terms of NHS and NHS commissioning. Next year will be a transition year for LOCSU. We have got strategy planning days on January 24 and 25, where we will be looking to set our key priorities for the year ahead, to make sure we answer all the needs of local optical committees (LOCs) as well as of the sector as a whole.

One of the key priorities is looking at supporting LOCs is as they start to pick up more of the regional commissioning and the regional variances within the new NHS world, as commissioning shifts to Integrated Care Systems (ICSs) for optometry.

Also, building on all the work that has happened with Optometry First, and looking at those pathways. There is a critical part that LOCs have to play, as the sector pulls together, in being stronger and amplifying, regionally, the messages that we’re giving nationally. There is a lot of work to be done on that. It’s a year of transition and change – but a year of opportunity for the sector, for LOCs, and for LOCSU.

There is a critical part that LOCs have to play, as the sector pulls together, in being stronger and amplifying, regionally, the messages that we’re giving nationally

Richard Knight (RK): We are driving Optometry First. The early adopters are progressing well and there is buy-in from everyone involved. The priority for next year is converting those early adopters into as many clinicians throughout the country and throughout the ICSs as possible, ideally all of them.

The other priority is encouraging and driving LOC engagement with the new health bodies. We recently developed some template letters for LOCs that haven't had any contact – this is something that came out at the National Optical Conference (NOC). We’ve developed icebreaker letters, and a priority for us both now, and into the future, is to make sure we coach LOCs to use the language and rhetoric that the NHS uses, because the best way of getting results is to work with them in the right terminology.

How has the change from clinical commissioning groups to ICSs gone for LOCSU and for LOCs so far?

JF: It is challenging for LOCs, because there is so much work to be done and so many messages to get out. It is about ensuring that we’re giving everybody the right tools to be able to sit at the table and have the correct conversations. That is a big part of what we’re doing. We run the regional forums, and many of the LOCs are working together, in making sure that there is a representative for primary eye care on each of the integrated care board (ICB) meetings, wherever possible.

One of the big things that all of the LOCs have done, together with the optical leads at LOCSU, is attend the NHS England ICS roadshows that were held up and down the country. The feedback from them was that the primary eye care voice was there, in great strength, and that it has been picked up by many that this is a sector that needs to be listened to.

Optometry is the next good news sector. There is a lot of work happening. There’s a lot of opportunity, and a lot to build on. I think the conversations have started, although there’s still a lot of work to do: a lot of evidence and case studies to pull together to demonstrate the good work that can take place. I think 2023 is going to be very much building on that.

Where do you see Optometry First going in 2023? Are there any major developments that you think will come through next year?

JF: We’re working on a strategy, together with the whole sector. Optometry First is very much a sector-owned initiative. We see 2023 being a very big year for Optometry First. We want people to be getting their best eye care possible within primary care at the first opportunity, as opposed to going anywhere else. It’s very much centred around the patient, and making sure we get the pathways in place for patients.

Optometry First is our biggest ticket item for 2023. No matter what comes out of the planning days, Optometry First will be front and centre in that. It is one of the things that really pulls the whole sector together, and is something where we can make a big difference. We’ve already been doing a lot of work. We have got a strategy in development and we have steering groups set up that pull everybody together to contribute to it. We’re collecting the case studies, and we’ve done a lot of work with the transformation team at NHS England, sowing the seeds for Optometry First with the early adopters in 2022. We’re building on that next year.

A lot of transformation has happened over the last few years, including the inclusion of eye care in NHS England's planning guidance. What do you see transformation looking like in 2023?

JF: We have pockets of excellence all over the country in terms of the transformation that’s taking place at a very local level, with different pathways, be it through practices, through LOCs, or through Primary Eyecare Services. We need to go from pockets to a whole nation, where that becomes mainstream practice. For me, a big part of the transformation as is getting that picked up across the whole country, rather than just in small areas.

The other big part of the transformation is around communications and digital connectivity. That is going to need to take some huge leaps forward.

The other element has got to be the workforce, and workforce confidence. By that I mean not just building on capacity, but on the confidence of all the professionals who we work alongside, so they know that there is there is the trust, the capability and the capacity within primary eye care. For me, it’s workforce, it’s digital connectivity, and it’s building on those pockets of excellence that we have already.

The eye health bill that has been presented to Parliament in recent weeks is something that the AOP is supportive of. What do you think the value of that would be?

JF: It is something we’ve got to absolutely capitalise on. It was tremendous when Marsha (de Cordova, the MP for Battersea and co-chair of the All Party Parliamentary Group on Eye Health and Visual Impairment) got the first reading and the first reading was passed, and to take that through to the second reading. We’ve got a real opportunity, for the first time, to have eye care discussed at such a high level. It is transition but it’s also opportunity, and it is about seizing it and driving it forward, to have it on a cross-parliamentary agenda where we have key MPs talking about it across the country.

What we need to do now is back it up with demonstrated evidence, from a patient’s perspective. It opens the door for us to be able to do that, to really bring the patient voice through. That links very nicely in terms of looking at what MPs will want. It is critical that we add the weight behind the intentions that Marsha has expressed. I think, as a sector, we’ll pull together to do that.

RK: It’s a good thing; it will fill a gap. It hits a lot of the national objectives of the NHS and the Government. England is the only country in the UK without one of these things, and it’s something we support. It has the potential to improve access and mitigate health inequalities, and there are also potentially wider boons in terms of public health.

What are the biggest challenges that you anticipate in 2023?

JF: The biggest challenge is going to be the pace that we’re going to need to bring about the changes. If you’d asked me a few months ago, I probably would have said the biggest challenge was going to be getting the whole sector behind what it is that we’re doing. But I think the whole sector is rallying. It’s how we get that pace to be able to meet the needs of our practices and teams on the ground, of patients, and of the NHS, particularly at a time of pressure. Pace is going to be a big challenge.

The other thing is demonstrating the evidence. We know and understand what we can do, but sharing that evidence with others in a format that speaks to them is going to be a challenge. But I think it’s something that we absolutely can overcome, in working together.

One of the most heartening things that I heard at the end of NOC came from an optometrist on the ground, who said ‘the future of primary eye care looks to be in good hands, judging by the youthful enthusiasm of the NOC audience.’ When I think of the challenges, I then think, hold on a second – we’ve got all the people we need to deliver and meet those challenges. The future is in good hands. The challenges can be overcome. Actually, they are opportunities.

RK: In terms of Optometry First, the biggest challenge we anticipate is ensuring that, having tested the waters, it’s then expanded upon and commissioned widely, ideally on a national level, but at least in as many systems as possible.

What we’re slightly worried about, having got this momentum and having set up these areas, is recalcitrant people or bodies who may not necessarily see primary eye care in the way we do – as a way of allocating existing resources to current problems. In that case, the risk is that it all stays in the trusts, which would be a retrograde step: bad for patients, but also contradicting the NHS Long Term Plan and the Health and Social Care Act. So, that’s our biggest challenge.

Adjoining that is the frenetic pace that we work at. LOCSU is a small unit, but from our point of view we cover a lot of ground. It is about making sure that pace is maintained to the extent that we require on a larger regional, and hopefully national, level.

It is so heartening and empowering when you talk to practitioners on the ground and see them with the patients and experience that patient journey through a practice

Any final thoughts on transformation or 2023 plans that we haven’t already discussed?

JF: We are agile, and I don’t think we’ve been in a better or stronger position to face the challenges that we have ahead, and really make a difference for patients. Having patients at the heart of what we do – I think we often lose sight of that. We get caught up in the politics and IT and reporting and all those things, and we forget that there is a patient at the heart of everything.

It is so heartening and empowering when you talk to practitioners on the ground and see them with the patients and experience that patient journey through a practice. For me, it’s an exciting time. It’s filled with opportunity. I think 2023 is going to be a fantastic year.