500 signatures reached
To: Matt Hancock, Secretary of State for Health and Social Care
Update the Opticians Act or introduce a law to include a minimum 45 minutes for all eye examinations
A new law is required to regulate the routine eye examination time in the UK for patient and practitioner safety.
Why is this important?
Many Optician practices across the UK carry out each eye examination at an average time of 20 minutes per patient or a staggering 10 minutes in some cases.
These are unacceptable time scales and they place patients in danger as missed pathology can lead to serious eye disease and can sometimes lead to other serious health conditions.
The practitioners who carry out these eye exams are also putting their careers at risk by agreeing to work to these time scales. Missed pathology will almost certainly lead to fitness to practise (FTP) hearings with the GOC, and the potential for erasure from the optician’s register is a real concern for all practitioners.
The GOC’s overarching objective is the protection of the public (Opticians Act Section 1). However, they have not yet addressed this time scale issue.
The GOC Registrant Survey 2016 states:
“One area identified by participants as having an effect on patients was the length of the sight test. Some participants explained that employers and businesses can put pressure on registrants to conduct as many eye tests as they can in a day. This can result in registrants not being able to always spend enough time with patients. Participants also mentioned that they were under pressure to achieve certain “conversion rate” targets (i.e. to ensure that an eye test with a patient leads to the patient then buying glasses or contact lenses within the store).”
We also believe that The College of Optometrists, the Association of Optometrists (AOP) and the Association of British Dispensing Opticians (ABDO) have collectively failed to provide clear and concise guidelines on this matter.
Many people working within the industry feel that the answers possibly lie with the major High Street Opticians and their influence on all the bodies mentioned above, which surprisingly includes the governing body (GOC).
The vast majority of these representative bodies, if not all, have at least one board member affiliated with a national high street optician chain. This is seen by many as a conflict of interest. A recurring question amongst practitioners is, how are these board members influencing these representative bodies behind closed doors?
Every high street optical chain is reliant on high patient volume within their business models. Reduced exam times and the absence of law in this area, means more patients can be seen in each clinic. Which is great for business, profits and turnover, but not so great for the quality of patient care and it’s certainly not beneficial for the well-being of the practitioners that carry out the eye exams.
Unfortunately many practitioners who work within these high street businesses are ‘performance managed’ to work to these time scales. Failure to adhere to the current time scales leads to practitioners being ‘performance managed’ out of the businesses.
This unacceptable behaviour highlights the profits before patients syndrome, which has been like a cancer that’s spread through the profession over the years. This conveyor belt system leads the public to view practitioners in this field as glasses sellers or salesmen. Whereas the truth is far from this view.
A Journal of Optometry study
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911451/) found that Optometrists working in Multiple Optician chains were twice as likely to refer false positives to the Hospital Eye Service (HES) compared to Independent Optician practices. When you factor in the shortage of Ophthalmologists (Centre for Workforce Intelligence, 2014) working in the HES. False positive referrals can have a significant impact on the HES.
The same study went on to claim; “Myint and colleagues found that lack of TIME to repeat measurements, or remuneration for doing such, as the most commonly reported barriers to effective glaucoma detection in the UK”. The study also found that after the introduction of the new Scottish NHS GOS contract which allows for longer exam times, “there was a significant reduction in false positive referrals and a significant increase in true positive referrals.”
An example of the effect this can have on the HES: (https://www.aop.org.uk/ot/professional-support/health-services/2019/11/11/glaucoma-patient-who-went-blind-receives-three-point-two-million-pound-compensation)
The AOP’s own “Optometrists Futures Survey” from October 2018 (section 7.3.2) clearly highlights the need for changes to increase the exam times. Almost two years have passed and this point has yet to be addressed by the AOP.
The Optical Workforce Survey (2015),
Lead by The College of Optometry, states the following regarding the pressures on the HES:
“Since 2004, the Department of Health (DH) has been trying to encourage
the delivery of more routine and minor emergency eye care outside hospital settings in community optical practices.
The aim is to free up hospital capacity to cope with increasing demand from both the ageing population and new technologies such as treatments for wet age related macular degeneration (The King’s Fund, 2009).”
This highlights the urgent need to reduce false positive referrals caused by the commercial pressures which impose inadequate examination times on practitioners.
The current pandemic also highlights the importance of longer eye exam times. The use of PPE, disinfection and social distancing measures will require added time to carry out eye exams once the suspension on routine sight testing has been lifted.
There is also the lingering prospect of potential monopolies being formed,
(https://www.financierworldwide.com/essilorluxottica-and-grandvision-agree-8bn-merger#.Xs-8WxbTWEc).
This will no doubt effect patient safety as the aim of increasing commercial revenue will take precedence.
By signing this petition you will help safeguard patients and practitioners as well as highlight the points made in this petition to the government.
These are unacceptable time scales and they place patients in danger as missed pathology can lead to serious eye disease and can sometimes lead to other serious health conditions.
The practitioners who carry out these eye exams are also putting their careers at risk by agreeing to work to these time scales. Missed pathology will almost certainly lead to fitness to practise (FTP) hearings with the GOC, and the potential for erasure from the optician’s register is a real concern for all practitioners.
The GOC’s overarching objective is the protection of the public (Opticians Act Section 1). However, they have not yet addressed this time scale issue.
The GOC Registrant Survey 2016 states:
“One area identified by participants as having an effect on patients was the length of the sight test. Some participants explained that employers and businesses can put pressure on registrants to conduct as many eye tests as they can in a day. This can result in registrants not being able to always spend enough time with patients. Participants also mentioned that they were under pressure to achieve certain “conversion rate” targets (i.e. to ensure that an eye test with a patient leads to the patient then buying glasses or contact lenses within the store).”
We also believe that The College of Optometrists, the Association of Optometrists (AOP) and the Association of British Dispensing Opticians (ABDO) have collectively failed to provide clear and concise guidelines on this matter.
Many people working within the industry feel that the answers possibly lie with the major High Street Opticians and their influence on all the bodies mentioned above, which surprisingly includes the governing body (GOC).
The vast majority of these representative bodies, if not all, have at least one board member affiliated with a national high street optician chain. This is seen by many as a conflict of interest. A recurring question amongst practitioners is, how are these board members influencing these representative bodies behind closed doors?
Every high street optical chain is reliant on high patient volume within their business models. Reduced exam times and the absence of law in this area, means more patients can be seen in each clinic. Which is great for business, profits and turnover, but not so great for the quality of patient care and it’s certainly not beneficial for the well-being of the practitioners that carry out the eye exams.
Unfortunately many practitioners who work within these high street businesses are ‘performance managed’ to work to these time scales. Failure to adhere to the current time scales leads to practitioners being ‘performance managed’ out of the businesses.
This unacceptable behaviour highlights the profits before patients syndrome, which has been like a cancer that’s spread through the profession over the years. This conveyor belt system leads the public to view practitioners in this field as glasses sellers or salesmen. Whereas the truth is far from this view.
A Journal of Optometry study
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911451/) found that Optometrists working in Multiple Optician chains were twice as likely to refer false positives to the Hospital Eye Service (HES) compared to Independent Optician practices. When you factor in the shortage of Ophthalmologists (Centre for Workforce Intelligence, 2014) working in the HES. False positive referrals can have a significant impact on the HES.
The same study went on to claim; “Myint and colleagues found that lack of TIME to repeat measurements, or remuneration for doing such, as the most commonly reported barriers to effective glaucoma detection in the UK”. The study also found that after the introduction of the new Scottish NHS GOS contract which allows for longer exam times, “there was a significant reduction in false positive referrals and a significant increase in true positive referrals.”
An example of the effect this can have on the HES: (https://www.aop.org.uk/ot/professional-support/health-services/2019/11/11/glaucoma-patient-who-went-blind-receives-three-point-two-million-pound-compensation)
The AOP’s own “Optometrists Futures Survey” from October 2018 (section 7.3.2) clearly highlights the need for changes to increase the exam times. Almost two years have passed and this point has yet to be addressed by the AOP.
The Optical Workforce Survey (2015),
Lead by The College of Optometry, states the following regarding the pressures on the HES:
“Since 2004, the Department of Health (DH) has been trying to encourage
the delivery of more routine and minor emergency eye care outside hospital settings in community optical practices.
The aim is to free up hospital capacity to cope with increasing demand from both the ageing population and new technologies such as treatments for wet age related macular degeneration (The King’s Fund, 2009).”
This highlights the urgent need to reduce false positive referrals caused by the commercial pressures which impose inadequate examination times on practitioners.
The current pandemic also highlights the importance of longer eye exam times. The use of PPE, disinfection and social distancing measures will require added time to carry out eye exams once the suspension on routine sight testing has been lifted.
There is also the lingering prospect of potential monopolies being formed,
(https://www.financierworldwide.com/essilorluxottica-and-grandvision-agree-8bn-merger#.Xs-8WxbTWEc).
This will no doubt effect patient safety as the aim of increasing commercial revenue will take precedence.
By signing this petition you will help safeguard patients and practitioners as well as highlight the points made in this petition to the government.
