A workforce vision: Background
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
1. Utilising the full skills and competences of optometrists
1. Utilising the full skills and competences of optometrists
Our vision:
- Increased recognition of optometrists and their competences and skills among other healthcare professionals and among commissioners of eye care services.
- Optometry-led eye care services are commissioned, funded and promoted to patients and the public; and optometrists are established as first contact healthcare practitioners in all four UK nations.
We will achieve this by:
- Working with governments, health services, commissioners and employers to ensure that the competences and skills of optometrists are recognised and used to their full potential across the UK.
- Championing a UK-wide first contact practitioner scheme for optometrists to manage and treat more patients in primary care, as well as developing and promoting more enhanced and shared eye care services.
Optometrists working in primary care are well-placed to provide routine, enhanced and shared eye care services closer to home, and to reduce the backlog of delayed outpatient appointments, without additional training. With further training, they can offer an even wider range of specialist eye care services and treatments for managing patients with more complex needs without referral to secondary care. Likewise, those working in secondary care can provide specialised eye care and treatments that increase the capacity of outpatient clinics.
In many parts of the UK, optometrists already play an essential role in taking the pressure off hospital eye care services, and make a significant contribution to reducing sight loss by:
- Providing first contact care for eye conditions, and routine eye examinations and sight tests.
- Delivering urgent eye care in the community.
- Making full use of their core competences, as well as independent prescribing and higher qualifications, to safely and effectively treat and manage more eye conditions in primary and secondary care settings.
- Making use of existing and new technologies to reach patients and deliver joined-up care.
- Reducing the burden on the other strands of primary care (such as GP practices) and reducing pressures on ophthalmology departments within secondary care.
- Maintaining access to quality eye care services for local populations.
In order to improve eye care services and patient outcomes, we believe that health services must utilise the full core skills and competences of optometrists (both in primary and secondary care). Services must also be commissioned and funded which make full use of the higher and independent prescribing qualifications that many optometrists hold, which in many cases are not being deployed to their full potential.
Establishing optometrists as first contact practitioners
The COVID-19 crisis has showcased the role of primary care optometrists as ‘first contact’ healthcare providers for eye health, and accelerated the role of advanced optometric practice. We have a unique opportunity to build on these achievements to address the backlog, and build a cost-effective, clinically safe and sustainable eye care service for the benefits of patients.
These schemes broaden the scope of care delivered in primary care beyond sight testing, and make optimal use of the existing primary eye care workforce to reduce unnecessary referrals to secondary care, and increase capacity to manage low risk patients with long-term eye conditions. This will reduce pressure on secondary eye care services and benefit patients, and the wider NHS.
2. Supporting and inspiring optometrists to develop new skills
2. Supporting and inspiring optometrists to develop new skills
Our vision:
- Optometrists are able to broaden their scope of practice through training and education, and have opportunities to use their skills in all eye care pathways.
We will achieve this by:
- Working with the GOC and other stakeholders to ensure that the future of pre-registration optometry education supports the future requirements of the profession.
- Offering high quality and relevant post-registration higher qualifications in specialised areas of practice, as well as training and CPD, all of which align with evolving models of care.
- Encouraging and supporting optometrists to contribute to the education of the next generation.
- Championing and encouraging the role of optometrists in taking the lead in clinical research.
We will continue to lead and collaborate on future-focused optometric education, training and development. We will maintain our position as the leader in post-registration professional education and development, by both direct delivery of CPD and training, and through accreditation of higher qualifications. We will also establish clear pathways for the development of new skills in both clinical and non-clinical domains.
We will collaborate with higher education providers to ensure that high quality work-based learning and assessment is delivered consistently across the UK for both initial and specialist registration qualifications, to enable the sector to capitalise fully on the outcomes of the GOC’s Education Strategic Review (ESR).
We will also be encouraging optometrists to broaden their scope of practice, including managing uncertainty and risk, and making best use of their skills. Members will be supported throughout their career with online training, events, podcasts, publications and higher qualifications.
Developing optometrists for the future
As optometry’s scope of practice continues to evolve, we will ensure that our pre- and post-registration education offer supports optometrists to meet the changing needs of patients, new technologies and treatments, new service models and the evolving workforce. As well as providing high-quality clinical CPD and higher qualifications, there will be a renewed focus on non-clinical domains such as leadership and risk management, and supporting optometrists to contribute to the education of the next generation.
We will encourage optometrists to consider mentoring, especially through the College’s supervision programme for work placements, both for initial registration and Independent Prescribing (IP); and we will be exploring new ways to recognise members who fulfil these roles.
3. Ensuring that optometrists are at the heart of new models of eye care
3. Ensuring that optometrists are at the heart of new models of eye care
Our vision:
- Enhanced and equal collaboration between primary and secondary eye care to develop patient-centred pathways that make full use of optometrists’ skills and experience.
- Every person in the UK has access to an optometrist.
We will achieve this by:
- Defining and upholding the role of optometry across all patient pathways.
- Developing models for current and future workforce needs, aligned with new clinical practice and patient outcomes.
Effective collaboration with partners across the UK will be central to understanding and developing new models of primary and secondary eye care that make best use of optometrists’ core skills, higher qualifications and specialisms. The College of Optometrists and The Royal College of Ophthalmologists have already developed a joint vision for safe and sustainable patient eye care services to support our workforce, and the commissioning of safe and sustainable eye care services that meet the needs of all patients, improving patient care and outcomes during and beyond the pandemic.
Over the next ten years we will build on our partnership with health services and other organisations across the eye care sector to ensure that the skills and competences of optometrists are fully recognised and utilised, and that optometrists are placed at the centre of new models of care, ultimately ensuring that future patient needs are met. At the heart of this will be ensuring that we fully understand changing patient expectations, the role of new technology, and how the College can support members to upskill and deliver new services.
Understanding the workforce: current and future needs
A data driven, multi-professional approach to understanding eye care workforce supply and demand is needed to inform health service decisions relating to workforce planning, investment, training, and deployment.
We will be working with partners across the eye health professions to commission the development of a multidisciplinary eye care workforce data model, and a comprehensive analysis of current and future population eye care need.
Ultimately, an improved understanding of the eye care workforce will help commissioners and service designers to:
- Improve access to eye care services and reduce inequalities in access, including geographical disparities.
- Improve eye health outcomes and patient experience across the full range of patient pathways.
- Facilitate multi-professional collaboration between primary and secondary eye care.
- Identify gaps in existing data capture methods and improve future workforce data models.
To support this work, we will continue to conduct our member surveys to capture and analyse data on workforce and clinical practice.
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.
- 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.
- 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.
- 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.
- 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.
- Direct patient contact should take place with a clinician capable of making appropriate management decisions, and make full use of the optometric profession.
- 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.
- 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.
- Eye care services need to be appropriately and equitably funded to meet growing patient needs across primary and secondary eye care.
- 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.