10 February 2022

Optometry First – Call to action

The national optical bodies (ABDO, AOP, The College of Optometrists, FODO, LOCSU) have worked with NHS England to develop the Optometry First model and are urging commissioners to take advantage of the full range of clinical expertise and infrastructure primary eye care has to offer.

Primary eye care has long been able to deliver a wide range of NHS care outside hospitals, including diagnosis, treatment, follow-up to surgery, and the co-management of long-term conditions.  

Through NHS England’s National Eye Care Recovery and Transformation Programme, commissioners are being encouraged to take advantage of the full range of clinical expertise and infrastructure primary eye care has to offer, recognising it as the equivalent of general practice.  

This is driven by the need to tackle outpatient waits, eliminate the risks of avoidable sight loss and address hospital capacity pressures which existed prior to COVID, and have increased significantly during the pandemic. The expansion of care outside hospitals is also key to outpatient transformation and bringing the benefits of integrated care closer to home for an ageing population.  

To help the NHS achieve this vital service transformation, the national optical bodies have worked with NHS England to develop an Optometry First model to be commissioned at scale utilising a consistent service specification.  

Optometry First describes a comprehensive primary eye care service. It builds on the principles of CUES and reflects the vision of The College of Optometrists, Royal College of Ophthalmologists and wider optical representative bodies for a joint vision for safe and sustainable patient eye care services. 

It will improve efficiency and accuracy of case-finding, extend the scope of care available within primary eye care and improve patient experience and opportunities for self-care. The model employs the core competencies of optometrists, dispensing opticians and their practice team, supported by higher qualified primary care practitioners and the multidisciplinary hospital ophthalmology team, where necessary, across a network of local optometric practices and the hospital eye service.

The service will ensure that primary care practitioners can offer first contact care through to resolution, whilst also providing continuity of care for people with a long-term condition closer to home.

NHS England now wish to test this model by working intensively with a small number of systems, as well as continuing to work more widely, with a view to strengthening the evidence base and demonstrating a route to scaling up across England. This is an approach supported by all optical bodies.    

The willingness of primary eyecare to participate is a key criterion for ICS selection. Therefore, we are urging practices and their whole practice teams to demonstrate their willingness by getting involved if their area is selected to test this new model of care. In the first instance, please contact your LOC for further information. They will link directly with the ICS, LOCSU and other representative organisations.  

If you would like to learn more about Optometry First, please contact your LOC, LOCSU or your representative body. You can also apply for an account on the FutureNHS Collaboration Platform and view the Optometry First Toolkit online.  

Related further reading

Clinical Adviser for the College Daniel Hardiman-McCartney FCOptom on how to ensure a sustainable optometry workforce.

Clinical case studies can make a small but important contribution to the sum of clinical knowledge. Why do we need them, asks Kim Thomas, and how do you write one?

The College’s Clinical Editor, Jane Veys MCOptom, on rabbits in the headlights and royally good handovers