A workforce vision for the UK

We believe optometrists should be at the heart of patient-centred eye care in the UK, making full use of their skills, being given opportunities to develop new skills, and playing a central role in leading and delivering new models of care to improve patient outcomes. 

As the provision of eye care in the UK is rapidly changing, our vision sets out how we will ensure that optometrists remain at the forefront of eye care provision, and continue to be valued and recognised as a key healthcare profession. 

We have set out the three core aims of our vision, with an explanation of how we will work towards achieving them.

Our three aims

Taking our vision forward

The provision of eye care services in the UK is rapidly changing. An ageing population, capacity pressures on hospital eye services (exacerbated by the COVID-19 pandemic), and a growing risk of sight loss due to long secondary care waiting times, have resulted in new models of eye care being introduced across the UK.  In addition, there is the rapid acceleration of new technologies, and changing demographics within the optometry workforce, including a general move towards part-time and locum work.

Even before the COVID-19 pandemic began, demand for eye care services in the UK had exceeded capacity; a 40% increase in demand is predicted over the next 20 years. There is an urgent need to address not only the pre-existing backlog of patients, but also the additional backlog due to the pandemic, and the expected demand for NHS services in the future. 

Patient expectations are also changing, and technology is pushing eye care services towards possibilities such as greater automation, online consultations and telehealth. The pandemic has accelerated these changes, and they are likely to impact how optometrists will deliver eye care in the future. There is a growing number of optometrists with independent prescribing and higher qualifications, as well as a trend in the profession towards optometrists working at the ‘top of their licence’ to provide a wider range of care.

There is also a growing need to ensure that there are sufficient optometrists to meet patient need, optimise services and improve patient outcomes in the future. An evolving optometry profession is one that can fully utilise its core skills to meet the needs of patients, embrace new models of care that address new and emerging needs, and has opportunities to upskill to deliver advanced and enhanced services, as well as lead the development of future eye care.

The optometry workforce across both primary and secondary care will need to adapt and change to meet new challenges. As eye care services, modes of delivery and patient expectations change, the development and training available to optometrists will also need to evolve. The College of Optometrists will ensure that the optometry profession remains at the forefront of eye care provision, and continues to be valued and recognised as a key healthcare profession. 

Our recommendations

We believe optometrists should be making full use of their skills, have opportunities to develop new skills, and play a central role in delivering new models of care to improve patient outcomes. Our vision sets out how we will ensure that the optometry profession remains at the forefront of eye care provision in the UK, and how the College will be working to support members.

To support the aims of our vision, we will be working with all four UK governments and each nation’s health service, and will be making the following recommendations to policy makers and commissioners in the eye care sector.

  1. Eye care services need to incorporate innovative, integrated models of care to improve patient care and outcomes in a way that is sustainable and within the limited resources of each health service.
  2. We have an opportunity to build on the new clinical pathways and innovations introduced at pace during the COVID-19 pandemic, making full use of the skills and competences of optometrists in primary and secondary care.
  3. We need to develop more integrated eye care between all relevant organisations across the hospital eye service, the independent sector, community settings and primary eye care.
  4. Patients in all four UK nations should be able to access all eye care services via their primary care optometrist in the first instance, with optometrists established as first contact practitioners.
  5. Direct patient contact should take place with a clinician capable of making appropriate management decisions, and make full use of the optometric profession.
  6. There should be better utilisation of optometrists with appropriate independent prescribing and higher qualifications. Optometrists who have completed higher qualifications can work with a greater degree of autonomy and provide a wider range of care.
  7. Pathways and services should be integrated at geographies larger than single hospital level, where possible, and long-term improvement plans put in place; with a joint lead optometrist and lead ophthalmologist for the pathways. There should be equity of access to enhanced services developed on the basis of population need, rather than on a historical basis.
  8. Eye care services need to be appropriately and equitably funded to meet growing patient needs across primary and secondary eye care.
  9. Referral and patient record systems should be electronic, and support shared patient care across primary and secondary providers.

Further information

For more information please contact policy@college-optometrists.org.

More on advancing optometry

The College of Optometrists has launched a new vision which sets out its ambitions for the future of the profession, and its plans to put the optometric workforce at the forefront of eye care provision, education and research.