Patient priorities, timely communication and effective collaboration were on the agenda when eye care stakeholders and MPs gathered at the Houses of Parliament on Tuesday 29 October.
Westminster Eye Health Day 2024 focused solely on policy, with members of the eye care community using the afternoon as an opportunity to further reinforce the messages of eye health, prevention and investment to invited MPs.
The afternoon was organised by The Eyes Have It partnership, which is made up of representatives from the AOP, the Royal National Institute of Blind People (RNIB), the Macular Society, Fight for Sight/Vision Foundation, and the Royal College of Ophthalmologists. The group’s activities are funded by Roche.
OT gathered insights from the day – including what practical measures optometrists can take if they want to push the importance of eye health in Parliament.
1
Using your voice
Optometrists who have an interest in elevating eye care are in a good position to make themselves known to their local representatives, attendees told OT.
Adam Sampson, chief executive of the AOP, said that optometrists should understand who their local MP is, and “engage with them as a constituent, as a local business-person, or as a local health professional.”
“What matters is that you make them aware of the importance of eye health to the nation, both socially and economically,” Sampson said.
“As long as MPs understand the importance of the issue and the role that optometrists play in managing and hopefully solving the problem, that’s all we ask.”
Ankur Trivedi, optometrist in Gloucestershire and AOP board member, offered some practical advice.
“I think optometrists should see what they can do on a local basis,” he said. “Invite your local MP on a practice visit, and make them aware of what is working well, if you do have commissioned services. That strengthens the case of those to continue.”
He added: “If you’re in an area that hasn’t commissioned any of these services, show them that the next county or next city along is developing similar services. If you can get an MP behind [eye care] and make them see the benefit and value of it, that’s going to make this a lot easier.”
2
Data sharing as a priority
A key government priority is the move from analogue to digital, Sampson said, and “that is absolutely something that the AOP has been calling for for years.”
Ali Rivett, chief executive at the Royal College of Ophthalmologists, noted investment in IT infrastructure as one of his organisation’s key policy asks.
“Because of the nature of eye care across community settings, secondary care, and the independent sector, the lack of investment in integrating those different systems is ultimately harming patient care,” he said.
Want to host an MP practice visit? Email the AOP for guidance
Dr Peter Hampson, clinical and policy director at the AOP, believes that “at the moment, we’re really good at gathering data, but we’re really poor at sharing data, and that’s in both primary and secondary care.”
“We’ve got information that we capture, for example on the Optomap, which is wonderful,” Hampson said.
“But there is no easy way to get that to a consultant for a second opinion. We need to make that continuity of care exist. Really, it’s joining up those pieces. We’ve got the tech, but we haven’t got the roads or the pathways to join things together so we can work collaboratively.”
3
A national eye care plan remains priority
The passage of the National Eye Health Strategy Bill through Parliament was halted in the summer of 2023, when it was unable to receive its second reading during the then-current parliamentary session.
Key voices in the optical industry emphasised their support for a coordinated national strategy for eye health at the time – and the message remains consistent more than a year on.
Speaking about the purpose of Westminster Eye Health Day, Amy Craddock, research and policy associate at the RNIB, told OT that “the key message is really to push for a national eye care plan for England.”
“We really want to see consistency across England,” Craddock emphasised.
Ellie Southwood, director of impact at Fight for Sight/Vision Foundation, would like to see “an integrated and holistic approach to eye care and eye health.”
“We really need a national plan that addresses some of the disjointed nature of what we have at the moment, and which looks at the whole pathway – everything from people getting diagnosed, including on the High Street, right through to what is available in terms of treatments,” Southwood said.
The UK invests 1.2% of health grants in eye research, she said, “which obviously doesn’t reflect the huge number of people that eye care and eye health issues affect.”
Eye care is an area that needs investment, because investment is going to generate positives and serve society
Ed Holloway, chief executive of the Macular Society, noted the wide benefits that a national eye care plan would have for society.
“The key thing with the national eye plan is that it’s avoiding preventable sight loss and making sure, therefore, that people can stay in the workplace longer,” Holloway said.
“For us, this isn’t about something that’s going to cost money – it’s going to save money, because it’s going to lead to increases in productivity.”
He added: “Eye care is an area that needs investment, because investment is going to generate positives and serve society.”
Ali Rivett, speaking from the ophthalmology perspective, noted that “there is lots more to do.”
“Ophthalmology is the largest outpatient specialty, with nine million appointments a year, but it still lacks that national coordinated plan. So, there is more to campaign on,” he said.
Tori Griffiths, public affairs partner at Roche, emphasised that the number one message of Westminster Eye Health Day, to further highlight the need for a national eye care plan, has “been the case for quite a long time.”
“Ideally, it would be amazing to see that somehow wrapped up in the NHS consultation on the 10-year plan,” she said.
4
Learnings from the devolved nations
Trivedi told OT how he had spoken to an MP from Scotland during the afternoon. The conversation was an opportunity to “make the differences between England, Scotland and Wales really clear,” he said.
“Obviously, in Scotland it is very different,” Trivedi said. “Eye care is across the whole nation. It was an opportunity to say, ‘I think it is important.’
In England, there are “questions around the geography, and every patch doing their own thing. Different areas have their own, often different, priorities,” Trivedi said.
He added: “Where our neighbors are doing things slightly better, we should learn from it, and see what we can do better and differently.”
5
The wide-ranging role of optometry in healthcare
“If people have poor eye health, or poor vision, it can affect their mental health, and their access to other health interventions,” Trivedi told OT.
He emphasised the importance of “being aware of that cascading effect we can have on the holistic aspects of patient care.”
It is important to grasp the opportunity to have conversations around this, he said.
Hampson also noted the far-reaching impact that eye health can have on healthcare.
“We are aiming to raise awareness of eye health to some of the MPs who are less familiar with it, to explain the benefit that we can bring in terms of the 10-year plans, and how primary care optometry can really solve some of the challenges that we’ve got with backlogs, with care close to the community,” Hampson said.
He added that his aim is to “raise that awareness with members of Parliament, so they understand how it all starts to fit together.”
Hampson believes that there is untapped potential within optometry, which could be utilised extensively in the future.
“We ought to really focus on what we would do in prevention,” he said, noting cardiovascular checks in practice and increased interventions for people who think they are well, “to catch them before they become unwell,” as potential growth areas.
“Going forward, some of the enhanced diagnostics that we know are coming will allow us to look at the retina, and maybe predict dementia, and maybe other risk factors that we’re not aware of,” Hampson said.
“That’s just on the cusp at the moment, but leaning into it, so as it does come on board we can make use of it, would be amazing.”
6
MPs are not as aware of eye care as they should be
OT asked Shockat Adam, optometrist and newly elected Independent MP for Leicester South, how he feels being on the other side – now thinking about eye care as an MP rather than as a primary care provider.
“It has confirmed everything that I felt on the other side, which was that we are not on the agenda as much as we should be,” Adam said.
“Possibly, there is a lack of understanding about what we [optometrists] actually do. That has been a real confirmation of my feeling. But being able to bring up optometry, eye care, and eye health, as many times as I can, has been really positive.”
Trivedi empathised with MPs’ busy schedules, and acknowledged that Westminster Eye Health Day provided those within the eye health sector the opportunity to engage with them in a focused way.
“MPs have so many different things on their agenda and so many things to be thinking about,” he said.
He added that the day allowed “the chance to have a bit of their head space and make them aware, because I don’t think they are.”
7
Healthcare could be used to revitalise High Streets
Cat Eccles, MP for Stourbridge in the West Midlands, has a background in ophthalmics and worked for the NHS for 20 years, as well as for private providers.
Eccles noted that a recent focus on audiology and optical coherence tomography scanning by Specsavers has meant more opportunity for both of these services on the High Street.
She also told OT that in her constituency, a phlebotomist has recently taken up a vacant High Street unit.
These examples highlight “that shift to healthcare services on the High Street and in towns” and have the potential to “basically regenerate how we think of our local communities,” Eccles said.
“It’s drawing people in,” she added. “If we’re giving them a reason to come into towns, hopefully they go and spend some time or money and visit businesses while they’re there as well.”
Eccles noted: “In the West Midlands especially, there has been a lot of centralisation of services. I think having services right there on the doorstep is only going to be beneficial.”
8
A workforce plan is needed
Jess Brown Fuller, MP for Chichester, attended Westminster Eye Health Day with her colleague, Liberal Democrat health spokesperson Helen Morgan.
“At some point we all worry about our eyesight,” Brown Fuller told OT. “It’s really important to come along to events like this, to understand what all those people working within primary and secondary care are asking for.
“The thing that I’ve learned, which I was already really aware of but has really been shown here, is that [level of] miscommunication between primary care and secondary care, and the importance of having really clear pathways so that the information can be passed on really easily.”
Brown Fuller, a Liberal Democrat, noted that an NHS workforce plan was included in the Labour manifesto.
“Groups like this need to actually see that being delivered,” she said. “[We need] more places for training, and more opportunities to train up people with specialisms in eye care.”
Jordan Marshall, policy manager at the Royal College of Ophthalmologists, agreed on the need for a workforce plan.
“One of the problems we have is a lack of ophthalmologists,” Marshall said. “We have workforce shortages all across the country.”
He added: “We would like to see a reiterated commitment around the long-term workforce plan and the need to double medicine places and increase specialty training places along with that.”
9
The importance of sector unity
Holloway emphasised that Westminster Eye Health Day “is a really important day to have the sector all speaking together about the importance of eye health, and how we need to see a national plan that brings together care and support to make sure people have access to the early diagnosis and the treatments that they need.”
Adam told OT that it is vital that fellow optometrists feel they can clearly articulate “what we can deliver to the whole healthcare system, as an integrated partner, not just individually.”
He added: “Once that awareness is amongst parliamentarians and lawmakers, it makes perfect sense to be on the same footing as dentistry and pharmacy, to relieve the pressure on our primary care services and also save money in the long run.”
Rivett added that the Royal College of Ophthalmologists “is supportive of the entire multidisciplinary team working to the highest level of their capability, and also moving care closer to patients – so from the hospital setting and ophthalmology to optometry in other areas.”
10
Patient priorities for the new government
Holloway highlighted the importance of diagnostic pathways for those who are supported by the Macular Society.
“The key thing for them is having a really smooth diagnostic pathway, so that as soon as they get something picked up in their High Street optician, they’re able to get access to specialist secondary care, and then they’re able to get the follow-up treatments that they need,” he said.
“We’re really worried about the delays people are seeing with getting those follow-up appointments and getting regular treatment,” Holloway added.
Marshall told OT: “We know that treating and diagnosing patients as early as possible is going to lead to the best outcomes, so that’s where I think optometry and ophthalmology have to work really closely together, screening patients as early as possible.”
He added that for the Royal College of Ophthalmologists, “making sure that they’re diagnosed and can be treated as early as possible is absolutely what we want to prioritise.”
11
A policy of prevention
Sampson noted that a key priority for the new government is moving from cure to prevention, and that General Ophthalmic Services sight tests “are a critical offer that we have” as optometrists.
Holloway agreed that sight testing is important for the Macular Society.
“We completely agree that prevention is better than treatment,” he said. “We want to see people having those regular eye checks, and having symptoms picked up early, so that we can intervene and treat early, before people’s condition gets worse and before people lose their sight.”
Hampson used glaucoma as an example that highlights prevention best practice in optometry.
“In terms of glaucoma prevention, we don’t stop glaucoma occurring, but if it wasn’t for optometry, most glaucoma would only be detected at end stage,” he said.
“All the glaucoma that is detected early, which is really prevention, comes about because of optometry already.”
12
Investment in ophthalmology
Speaking ahead of the autumn Budget, Marshall emphasised that any investment in the NHS estate must benefit secondary care eye services.
“There are a lot of issues that ophthalmology departments face,” Marshall said, noting the 600,000 patient-strong waiting list for eye care in England.
“There are a number of things that can help address that,” Marshall believes.
“We need more clinic and theatre space. There has been talk about investment in the NHS estate, so it would be really, really helpful if ophthalmology was able to benefit from that,” he added.
The day after Westminster Eye Health Day, Chancellor Rachel Reeves announced a £22.6 billion investment in the day-to-day running of the NHS, which she emphasised should be seen as a ‘down-payment’ ahead of the publication of results of the 10-year consultation in the spring.
13
Timing is everything
Fight for Sight/Vision Foundation’s Southwood told OT that “the timing is absolutely right, while the government is thinking about the future of health and social care, particularly around a 10-year plan for health, to really make sure that we get eye care and eye health right up the agenda.”
Now is the time for conversations about the infrastructure of the healthcare system, about accessibility, and about the ways that primary and secondary care interact, Southwood believes.
“In all of those conversations, the challenging state of eye care and eye health is absolutely essential,” she said.
In all of those conversations, the challenging state of eye care and eye health is absolutely essential
“We know eye care has one of the longest waiting lists, and there are people losing their sight unnecessarily in the UK, which we obviously want to focus on.”
Southwood added: “The answers, we believe, are not that complicated, but do require quite a lot of political will. The timing is now.”
Hampson noted that, in terms of surgical hubs and diagnostic tools that the NHS might feel it needs to invest in, optometry is already prepared.
“In optometry, we don’t need that [investment],” Hampson said. “We’ve already got lots of kit, and lots of equipment.
“We will be trying to make the case that they don’t need to spend that money again, because we have already invested.”
14
A new level of energy from government
“The change of government has had a huge impact, not least because we’ve met many people today for whom this is a new issue and who we really hope will become our ambassadors for the future,” Southwood told OT.
“It feels like there’s a real energy to it, which has been really refreshed by a new incoming government.”
A strong will for change exists amongst policymakers, Sampson believes.
“I feel confident that the government is committed to the idea,” he said.
“The challenge for the new set of ministers is turning their ideas into reality.”
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