In focus

Looking forward to 2024

OT  asked attendees at this autumn’s party conferences what eye care can expect from the coming year

Side view of Steve Barclay, the former health secretary, who is looking into a white OCT machine. In the background is lime green Specsavers signage
Dominic Lipinski CCHQ / Parsons Media

Key stakeholders in the eye care sector had different, yet still complementary, aims when attending this autumn’s party conferences.

For Specsavers, the main objective was to highlight to decision makers how community optometry can help to reduce GP waiting times and relieve pressure on busy hospitals.

“We wanted to show MPs that we can do even more to contribute to public health and the prevention agenda,” Giles Edmonds, Specsavers clinical services director, told OT. “We also wanted to make a clear ask of the Government to make access to care more equitable and show exactly how this can be done at very low cost.”

Edmonds called the engagement from MPs “tremendous,” noting that Specsavers had in-depth conversations with more than 100 MPs, party peers and commissioners across the Conservative and Labour conferences.

“They were genuinely interested in discussing the wider social benefits of optometry services for people in their constituencies and the variations in services available throughout the UK,” he said.


The numbers of eyes checked across seven days on Specsavers’ Labour and Conservative party conference stands

The Royal National Institute of Blind People (RNIB) attended the three main conferences – Liberal Democrat, Conservative and Labour – with a focus on vision rehabilitation in mind.

Cate Vallis, interim campaigns and public affairs manager at RNIB, emphasised that vision rehabilitation is a service that people should receive when they are first registered as blind or partially sighted.

The aim is to develop key skills so that people “can continue to live independently and do things that they did before they lost their sight,” she said.

Emphasising the importance of accessible voting for blind and partially sighted people ahead of a general election was also key for RNIB, as was developing conversations with candidates – “people who are likely to be tomorrow's politicians” – and party members who might hold sway in future policy.

Like Specsavers, Vallis also noted that reducing waiting lists is priority across all parties.

“Ophthalmology has one of the longest outpatient waiting lists of all medical specialisms,” she said. “Clearly, key to any strategy to reducing waiting lists has to be co-signed with ophthalmology. From an RNIB perspective, we’ve got a whole strategy around that that we’re keen to engage with the Government on.”

She added: “We attended quite a few fringe events on eye care across the conferences. There were interesting messages from the Government, and also from the opposition parties, on the different challenges that are facing the NHS and the different potential solutions to that.”

AOP priorities

AOP policy director, Carolyn Ruston, noted a ‘buzz’ across the Labour conference specifically, adding that many healthcare-focused fringe events were standing room only.

AOP policy director, Carolyn Ruston
“There was a common thread of the need to develop a long-term plan to address the challenges currently facing the UK, with a strong ‘fit for the future’ narrative,” she said.

For the AOP, that different conversations have to be had when speaking to MPs from across different parties was front of mind.

“Health is obviously a key political battleground,” Adam Sampson, AOP chief executive, told OT. “For Conservatives, the fact that the NHS is one of the five pledges matters and gives healthcare some leverage at this point in the election cycle. Labour knows that healthcare is vitally important, but the emphasis is different.”

Sampson noted that the Conservative Party appeared to be most focused on secondary care waiting lists, whilst Labour had a greater emphasis on taking pressure off GPs.

“The key distinction is between short-term and medium-term thinking,” Sampson said, adding, “you have different conversations. With the Conservatives, you say, ‘if you make this change now, if you give us an extended services contract, if you give us IT connectivity, if you give us more work in glaucoma or cataract, we can make a dent in waiting lists immediately.’

“With Labour, the conversations are more about a strategy for eye care, or changes in regulation, or the way the private sector is involved in the NHS generally. So, it’s a broader structural conversation.”

Eyes on 2024

OT is interested in whether attendees gained any insight on what the near future might hold for eye health in the UK, and whether party conference season was able to shed any light on this.

Alongside the obvious conversation around waiting lists – an issue that Edmonds said was highlighted at the Conservative conference via banners hanging from the ceiling – prevention was also a key topic of conversation.

“Prevention was a big theme this year, in terms of addressing the growing public health need, but also linked to addressing avoidable health issues caused by NHS backlog and waiting times,” the AOP’s Ruston said.

She added: “Mental health and wellbeing was also another big theme, along with the need to utilise new and emerging technologies and address long standing IT connectivity issues to improve care delivery.”

Specsavers’ Edmonds also noted the importance of technology, highlighting that he believes the use of analytics in patient care will be a focus for primary care and prevention.

A call was made for evidence-based policy and data driven services that would replace the current situation, where separate groups of health professionals are asking for different things, he said.

Edmonds also spoke about increased equity in healthcare, which Specsavers will continue focusing on in 2024.

Conservative Minister for Homelessness, Felicity Buchan, and Preet Gill, Shadow Minister for Primary Care and Public Health, spoke at a Specsavers fringe event on improving equitable access to care, Edmonds shared.

The event included people with lived experience of homelessness, who “gave powerful examples of the range of unnecessary administrative obstacles disadvantaged people face in accessing healthcare,” he said.

He added that Specsavers will “continue to advocate for changes to the GOS contract for homeless people and ending care home pre-visit voluntary notifications” in 2024.

Edmonds also emphasised that Specsavers is pushing more broadly for changes to eye health services in England in 2024.

Eye health commissioning in England is a ‘postcode lottery,’ Edmonds believes.

He highlighted that variation in the involvement of optometrists in community-based treatment, “caused by regionalised financing arrangements, is resulting in poor standards of care with a few pockets of excellence.”

Better utilisation of the optometry workforce “will free up capacity within the health service and deliver an overwhelming improvement in patient health outcomes and quality of life,” he said.

He added that, although the responsibility for commissioning decisions lay with individual Integrated Care Boards currently, if using the optometry workforce was made a requirement up to a million A&E attendances each year could be diverted to accessible local NHS Primary Care services.

“The resources, facilities and governance mechanisms are already in place in primary care optometry to deliver Community Urgent Eyecare Services to all NHS patients in England, with no additional investment from the NHS,” Edmonds said.

A change of pace?

At the time of writing, there has been no confirmation on which month of 2024 might see the country heading to the polling booths. We only know that a general election will be coming, and with it, potentially, a new government. So, what changes do those in the industry foresee if that does end up being the case?

Ruston told OT: “Given the discussions at conference, I would expect to see a new focus on investment in healthcare, including those areas where there is current underinvestment, such as eye care.

“I would also expect to see a focus on public health and reducing health inequalities, a strategy for a consistent roll out of new healthcare technologies, a real focus and narrative around individual driven care, and a plan to tackle the growing mental health crisis in the UK.”

“There is a lot to be hopeful about,” Edmonds said, citing examples of cooperation between community optometrists and healthcare services in hospitals that are making a positive difference for patients, as mentioned in Specsavers’ Access to Care report.

The report “set out clear policy changes that would deliver large scale and lasting change for the nation’s eye health because the stark reality is that, unless we take co-ordinated action now, we will see more people in our communities put at risk and suffer irreversible vision loss,” Edmonds said.

Specsavers has identified key areas of opportunity for the current or a future government to pursue in the coming months: reducing pressure on GPs, A&E and other NHS hospital services, making more effective use of existing primary care services in the community, preventing avoidable vision loss, and increasing access to care for vulnerable groups.

Eleanor Thompson, RNIB director of campaigns, with Keir Starmer

Vallis emphasised the importance of not assuming what the outcome of a general election will be, and that “RNIB continues to engage with all political parties on an equal footing.”

“It is within the interests of blind and partially sighted people to make sure we have good relationships across all political parties,” she said. “We would be hopeful, whatever the result of an election, to continue good relationships with government. We’ve always had the relationships to be able to have good, open conversations with them.”

She added: “We were really pleased recently when they listened to our campaign about the importance of keeping ticket offices open. That’s down to the wealth of campaigners that we’ve got behind RNIB, and also the wealth of public affairs expertise that we use to try and influence decision makers as much as possible.”

Sampson emphasised that, with their eyes on 10 Downing Street and a belief that they could be there for more than one election cycle, Labour has “the space to think about longer-term returns.”

“Conversations with Labour politicians are much more about structural solutions rather than short-term fixes,” he said.

Sampson explained that a narrow focus on eye care is unlikely to be helpful for those working to influence policy in the sector.

Instead, “You have got to develop an ability to be engaged in a wider range of policy healthcare issues, and issues beyond healthcare if necessary, and find ways of bringing those back to your core asks,” he said.

He used the example of the AOP’s Sight Won't Wait campaign, which focuses on NHS waiting lists and the way that eye care plays into this, plus recent work around the cost of living, as examples of key ways to emphasise a message that policymakers can engage with.

“You’re looking at ways of talking about issues that are out there politically and seen as politically important, and saying that eye care has a role in that issue,” Sampson said.

A strategy for eye health

OT is interested in how a national eye health strategy, which looks likely to be reintroduced to Parliament in 2024, plays into potential progress in the coming year.

Edmonds believes that “whichever party is in power, it is vital that we maintain momentum around the call for a national eye health strategy.”

After speaking at the Labour conference to Marsha de Cordova, the architect of the National Eye Health Strategy Bill, Edmonds emphasised that “it is clear she is considering the next steps for her campaign.”

“She needs the support of a united sector to secure the highest level of engagement,” Edmonds said.

“Optometry bodies have worked hard to forge strong links over the last 12 months with joint work on shared language and key messages. This provides a strong basis for us to work together on a national eye health strategy.”

Vallis also emphasised that RNIB is “fully supportive” of de Cordova’s work on bringing forward a coordinated strategy, adding that the charity is “keen to try every avenue we can to make sure that there is a proper eye health strategy for the NHS.”

Sampson emphasised that “the point is not just what a national eye care strategy says, but how you start selling the strategy.”

“Whoever comes into government next year is going to be facing a very significant economic crisis,” he said. “We know tax levels are very high. We know the economy is likely to be going into recession; interest rates are very high. We know public spending is under a huge amount of pressure. It is foolish to imagine that you can go into a new government and say, ‘here’s a national eye care strategy, it’s only going to cost £600 million.’ Every sector interest group will be banging on the door of the next government. Even if your solutions are the right solutions, you’ve got to be able to demonstrate that they are a priority for funding.”

Sampson continued: “There’s got to be a cost benefit analysis as to why this is the right space to spend money. It has to be an economic case or an unarguable human case, preferably both. It’s not enough for us to develop the right suite of policies. We’ve got to develop the right suite of arguments to justify those policies being prioritised.

“In order to engage politicians, you have to talk about the way that our issues fit into a broader spectrum of issues that they’re interested in. You can’t engage simply by saying, ‘we just want to talk about eye care.’ You have to say, ‘we want to talk about primary care, and the process of eye care in primary care.’

“The pharmacists have been very good in saying that they can take pressure off GPs. They don’t go in and say, ‘pharmacy is important.’ They say, ‘we understand you’re worried about GPs. We can do this, and take pressure off.’ We have to find simple language and say, ‘we understand the problems of healthcare generally, we can be part of the solution.’”

Lead image: Former health secretary, Steve Barclay, visiting the Specsavers stand at the Conservative Party Conference