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Opchat Magazine Professional Matters Pages Have your say.


Have Your Say will publish your ideas anonymously or by name (up to you) and will also ask questions to all the organisations, membership, academic or regulatory that affect you on your behalf if you so wish.

Email for publication with your opinons and ideas or with questions you wish PHN to pursue on your behalf.

Decide whether you wish your name published otherwise please state your current or past role in the Optical Sector.

PHN reserves the right to modulate on all debates.

Subject Matter:

PHN sends letter to all opinion formers, optical bodies and academia requesting views on future changes that might be enforced on Optical Provision in the UK.
Open Letter to all Optical Bodies, Academia and Opinion Formers sent by email.
Reply from GOC Chair to Open Letter
Association of Independent Optometrists and Dispesning Opticians responds to open letter sent by PHN to all Optical Bodies, membership groups and trade associations.

PHN sends letter to all opinion formers, optical bodies and academia requesting views on future changes that might be enforced on Optical Provision in the UK.

Our staff at PHN have been asked on many occasions, and have personally experienced a growing attitude at meetings, that technology is pressurising the professions into creating a new and streamlined health provision for the public.

Pressures in moving secondary care into our sector and the call for a simplified method for the public to gain access to an up to date dispensing Rx, when and where they wish, are putting pressure on the current system.

So PHN has written to all organisations, opinion formers, regulators and academics for their view on the opportunities and risks these pressures might create.

We will publish all their responses on our Have Your Say pages as we receive them.

Open Letter to all Optical Bodies, Academia and Opinion Formers sent by email.

July 2017

Dear Colleagues

At Opchat News we have been approached by a number of interested parties to ask the question about the precarious state of the provision of Optical Care created by great leaps in technology and the shrinking ability in numbers to provide refraction caused by the highly successful campaign to move to a MEC’s based optometric world.

The movement of ophthalmology provision down into the community in standalone clinics fed by optometry is a measure of how far the ever-increasing need for eyecare is moving closer to the High Street.

Still more optometric provision is being switched to triage, monitoring and MECs.

This is creating a future environment where optometric cover will be stretched and a void will develop between those that are seen to be needing full optometric care and those just wishing access to an up to date refraction prescription that they can use to purchase additional or new spectacles.

There is of course an untapped number of dispensing opticians who with very little extra education could fulfill the role of refractionist and release the optometric workforce to associate and add to the growing needs of ophthalmology/optometry.

Still along the same career pathway are optical assistants many who have added to their skills to assist in pre-testing using the latest technology.

In short there is no shortage of willing personnel to be promoted or retrained to do the work which will secure the visual health of the nation and guarantee it remains within regulated hands for public safety.

It is now over a year since the Foresight Project was delivered, over a year also that PHN as co-media partners of 100% Optical organized a debate on behalf of the WCSM highlighting the need to break down barriers created by regulatory laws to allow cross professional working within the Optical Sector.

Yes, that debate foreran the announcement of the GOC educational review set up. But where are we now?

Many independents have reservations about large chains becoming closer to the ophthalmology sector with the inclusion of OCTs for some inexplicable reasons, the same I fear who disliked the same chain “cosying up to the RNIB”. But these are good moves for the profession.

What they should fear is the same group buying and using the latest in subjective autorefraction devices to test out their commercial capabilities.

These very accurate devices could easily do the work of 3 refractionists at a time. But is this the way we wish regulated optics to move to?

Add these machines to personal hand held smart phones along with compliant online spectacle providers and we would have a recipe for disaster in safety and protection for the public and or the continuance of regulated high street dispensing and the industry that has always been there for them.

Whenever there is a perceived opposition to change such as stalling on, “allowing Dispensing Opticians to write RXs that will remain for the most viable for 24 months”, then there is perceived notion, incorrectly by media and outsiders, that the profession is “looking after its own”.

That is usually followed by parliamentary intervention like the “Ready Reader” debacle in the late 80’s.

As has been said recently, “There are people with serious funds to invest looking at optics and thinking it has been a closed shop stuck with old histories for too long. The government could be offered a national comprehensive eye screening service using the latest refractive and retinal scanning technology without the public ever needing to go anywhere near an optical outlet.”

Our readers ask the question that given the manpower is available to move along the career pathway why aren’t the Optical bodies working with speed and mutually to insist on this change. One hopes the apparent lethargy has nothing to do with cross party or membership issues.

This an opportunity for all: allowing optoms to move along the pathway and work in ophthalmology based environments using the latest technology in laser work and more, allowing dispensing opticians to take on the mantle of refraction care most closely and better understood by them to provide the perfect dispense and for optical assistants to upskill and provide benefits to both professions.

Our readers would like your opinions on these important issues.

PHN will be publishing later in July this letter and its circulation and the replies received which we will be happy to print.

The professionals deserve to know where they stand to prepare for the future.

Looking forward to your replies, future thinking and consideration of the importance of these issues.
Opchat News

Published By Primary Health Net Ltd

Reply from GOC Chair

July 2017

Dear Editor

Thank you for your letter which raised a number of interesting points about the future of the professions.

The professions are in exciting times, with new technologies and new patient pathways creating opportunities for optometrists, dispensing opticians and unregistered staff to take on new roles. As part of our consultation and engagement around our Education Strategic Review, we are hearing a lot of interesting views on the future of the professions which we will account for as we develop our proposals.

As the regulator we are keen to see regulation permitting technological progress, whilst also guaranteeing that patient safety is upheld. It is important to note though that we do not have any remit in workforce planning.

I look forward to seeing what other stakeholders have to say in response to your thought-provoking piece.

Gareth Hadley

Association of Independent Optometrists and Dispesning Opticians responds to open letter sent by PHN to all Optical Bodies, membership groups and trade associations.

Dear Sir,

The letter that PHN has issued to 'interested parties' has the potential to stimulate valuable debate about the long term future of eyecare in the U.K.

First of all it must be observed that Scotland and Wales have demonstrated a relatively sophisticated understanding of the importance of a national strategy towards eye health. This is not just in respect of the physical well-being of the public, but also towards the much harder coded benefits to the economy of minimising sight loss. Unfortunately, there appears to be no such understanding in the Ministry of Health and in particular the policy towards eye care in England which appears to be more about how to minimise increases to an outdated and moribund GOS fee regime and less to do with the eye health, and by extension general health, of the nation.

So what has this to do with the basic precept in PHN's letter about Dispensing Opticians being enfranchised to refract?

Well, first of all Optometry is not a luddite profession and Independent Optometrists in particular have demonstrably been the early adopters of new technology to enhance the level of clinical eyecare that they routinely provide their patients. Indeed AIO has welcomed the announcement that Specsavers will introduce OCT into all of its outlets, whilst also recognising that over 1,000 Independent practices already offer their patients OCT today.

Making OCT the norm in eyecare has to be good for eye health amongst the general public, particularly if Specsavers uses its marketing muscle to promote the message.

However tactical or even corporate strategic moves, that are launched in an overall systemic policy vacuum in respect of something so important as people's sight, have the potential to be more about commercial bottom lines than the nations eyesight, and the resultant well-being both health and economic for the nation.

Refraction is currently totally integrated in the eye examination process routinely carried out by Optometrists day in and day out. It forms a very important part of the wider process for analysing patients eye health, and as Specsavers will find out, is a natural starting point for referring patients for OCT as well as MECS.

To arbitrarily enfranchise Dispensing Opticians to refract without a clearly articulated strategy for progressing the role of optometry in a statutorily defined primary community care programme risks taking a backward step in eye care, in England in particular.

However if such a step was to be part of a policy driven future that placed the eyecare of the nation at its heart, and was clearly defined as part of the eye examination process, then Optometrists are far more likely to embrace the concept of Dispensers performing refraction.

In the meanwhile Dispensers who want to expand their role can already do so with the relatively straightforward conversion course to join the optometrist register.

There is quite clearly a huge demand for diagnosis, assessment and management of minor eye conditions which cannot be satisfactorily met by secondary care, and which optometrists in primary care are already well placed to meet.

There is arguably however no unmet need for refractive services and with the significant increase in the number of optometrists qualifying each year (particularly with the creation of new optometry schools and the expansion of existing departments) there is unlikely to be an unmet need in the foreseeable future. Since there are thousands of registered optometrists working in primary care, compared with only a few hundred ophthalmologists in secondary care, only a small proportion of most optometrists time is likely to be taken up by MECS type services as currently defined. So even if and when there is an expanded distribution of this work to the community across the whole country, it is unlikely that there will be long waiting lists for 'routine sight tests' any time soon.

What optometry cannot accept is that the future of eyecare is allowed to continue to evolve by accident rather than with clear direction. AIO is watching with great interest and hopes that the lead being taken by Wales and Scotland in embedding primary eyecare services in community optometry will show demonstrable benefits. Indeed, as their strategies take hold, perhaps they should pilot Refraction by Dispensing Opticians as part of a clearly articulated strategy.

England can continue to lag behind in the world of optics as usual with its entirely dysfunctional CCG postcode lottery and totally outdated GOS fee regime which ultimately results in proclivity for blindness to be an accident of geography.

The regulator's response to the PHN letter has been that we live in 'exciting times' for the professions. That may be the case, however they could also prove to be dangerous times for long term eye health care.

The PHN letter asked why the optical bodies 'aren't working with speed and mutually to insist on this change'. Such a question is naive and does not recognise the totally fragmented state of representation in the world of optics. That the Optical Confederation has seemingly failed, despite the extraordinary efforts of Chris Hunt, is sad commentary indeed that optical professional and trade bodies are unable to work together for a motive based on long term eye health care for the nation, which would also be to the long term benefit of their members and the people that they serve.


Mike Ockendon

For AIO.


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