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A qualitative study of stakeholder views regarding participation in locally commissioned enhanced optometric services

E Konstantakopoulou, R A Harper, D F Edgar, J G Lawrenson

A qualitative study was designed to determine the views and attitudes of stakeholders regarding the development, participation and operation of two schemes that are representative of two of the most commonly commissioned enhanced optometric services: a minor eye conditions scheme (MECS) in South London and a glaucoma referral refinement scheme (GRRS) in Manchester. The study is part of the Enhanced Scheme Evaluation Project (ESEP), funded by the College of Optometrists, and is being undertaken by a collaborative team from City University London and Manchester Royal Eye Hospital.

The most common reason given by optometrists for participation in enhanced schemes was to further their professional development; however, as providers of ‘for-profit’ healthcare, it was clear that participants had also considered the impact of the schemes on their business. Lack of fit with the ‘retail’ business model of optometry was a frequently given reason for non-participation. The ophthalmologists involved in the MECS and GRRS expressed very positive views regarding the schemes and it was widely acknowledged that the new care pathways would reduce unnecessary referrals and shorten patient waiting times. GPs involved in the MECS were also very supportive and felt that the scheme could provide an ‘expert’ local opinion that could potentially reduce the number of secondary care referrals.

This study demonstrates strong stakeholder support for the development of community-based enhanced optometric services. Enhanced schemes must, however, provide a sufficient financial incentive so as not to compromise the profitability of optometry practices.

The study was recently published in BMJ Open and the full text can be accessed online at:

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