The College of Optometrists welcomes the new community-based approach to health care in England

Dr Gillian Rudduck MCOptom, President of The College of Optometrists, commented: “The College of Optometrists is pleased to see the 10 Year Health Plan for England has a commitment to preventative, community-based care to improve patients’ outcomes and cut waiting times. Many proposals in the plan align with our profession’s established approach and our priorities to improve eye health.

“Ophthalmology is currently the largest outpatient speciality in the NHS, with almost 9 million appointments in England a year and long wait lists that lead to avoidable sight loss.  We therefore support the Plan’s ambition to bring more care closer to home. Optometrists and primary eye care services already play a vital role in delivering high-quality, accessible eye care within local neighbourhoods, providing accessible, timely diagnosis and management of eye conditions. Most optical practices already lead the way in neighbourhood accessibility, offering extended hours and weekend appointments. Rather than reinvent the wheel, we hope that Neighbourhood Health Services will look to local eye care services to understand how to improve accessibility, and will partner with them to provide seamless care with the appropriate eye health professional without needing to see a GP first.”

Primary care optometrists are embedded in communities, making them ideally placed to deliver further improved outcomes within this new model of care. Optometry, as one of the four core pillars of primary care, is integral to reducing hospital pressures and optometrists possess the necessary clinical skills to provide far more community-based NHS services than most are currently commissioned to deliver.

To realise this shift successfully, it is crucial that funded pathways are rapidly and universally commissioned in primary eye care. Optometrists are well placed to deliver the aims of the 10 Year Health Plan by providing a wider range of enhanced eye care services in the community, supporting earlier intervention and avoiding unnecessary GP and hospital appointments.

These include community urgent eye care, pre- and post-cataract care, and glaucoma referral refinement services. 70% of patients who attend emergency departments for ocular problems could be managed in primary care. Where local urgent and emergency eye care schemes are commissioned, between 75% and 97% of acute eye cases can be fully managed in primary care, without need for onward referral. Local optometrists can also work in partnership with colleagues in hospital eye services to manage more patients in the community, freeing up hospital capacity for more complex and urgent patients.  All these impactful services should be rolled out across England.

The 10 Year Health Plan focus on prevention is an approach we champion in primary eye care, where regular eye tests are vital for maintaining not only good vision and eye health, but also can spot wider health problems. We need to see more public awareness campaigns to promote the importance of regular eye tests, from an early age, to detect and treat eye conditions early and prevent avoidable sight loss. The digitising of the “red book” is a clear opportunity to embed eye health from birth, and we look forward to working with the government to achieve this.