RCOphth held two sessions at Annual Congress 2023 in Birmingham examining the key policy priorities of ophthalmology. The first session explored the challenges and potential solutions to the ophthalmology workforce crisis – informed by an expert panel – while the second session saw the National Clinical Director for Eye Care Louisa Wickham discuss national coordination of eye care services. Both events facilitated a highly engaging discussion between panellists and the RCOphth member audience who were invited to pose questions, input with their experience and suggest solutions. These well-attended panel sessions were received by members as an opportunity for informative debate of the issues most pertinent to ophthalmology services.
Workforce panel session highlighted immediate and long-term solutions needed for training
The first session saw an energetic and constructive discussion on how we expand workforce capacity to meet patient need. The session kicked off with a short presentation on the findings of our recent workforce census. This highlighted the serious capacity shortages facing ophthalmology in the UK – including the fact that 76% of eye units do not have enough consultants to meet current patient demand.
Chaired by Annabelle Collins from the Health Service Journal, a panel featuring Professor Bernie Chang (outgoing RCOphth President), James Lorigan (Commissioning Lead for Eye Care at NHS England), Rebecca Ellis (ACP, Training Programme Director, Ophthalmology, London, NHS England), and Vikas Chadha (Chair of RCOphth Curriculum Sub-Committee), discussed:
- The need for both more ophthalmology specialty training places and opportunities to develop the skills of those in the wider multidisciplinary eye care team (MDT)
- The fact that capacity could be increased quickly by upskilling the MDT and enabling optometrists to work to the top of their license, while highlighting the need for increased ophthalmology training places as the essential priority to securing sustainable NHS eye services in the long-term, particularly in light of expanding medical school places
Another issue explored during the audience discussion regarded the provision of training opportunities in independent sector providers and enforcement of existing guidance. Specific challenges were raised in relation to both the overall lack of training opportunities provided by ISPs alongside concern that training requirements outlined in local ISP contracts were not being adequately enforced by commissioners. This is an issue that RCOphth has been working hard to address with NHS England and independent sector providers – last year we published a blueprint for delivering cataract training in the independent sector. It is vital now that all stakeholders work closely with commissioners to ensure that training capacity is provided so that we develop the next generation of ophthalmic surgeons.
Cross-sector action vital to boost ophthalmic capacity
The following day saw an important session examining what is needed to facilitate nationally coordinated eyecare services, in partnership with The Eyes Have It group, a partnership including Roche, Macular Society, Fight for Sight, The Royal College of Ophthalmologists, the Association of Optometrists and RNIB, to promote and champion eye health amongst Parliamentarians and policymakers.
This session was first informed by a presentation from the National Clinical Director for Eye Care Louisa Wickham, detailing her vision for service transformation in England. This vision centres around the development of a ‘Single Point of Access (SPoA)’ regional triaging model, underpinned by appropriately trained healthcare professionals (including optometrists and ophthalmologists).
The SPoA model, being trialled in North Central London, would be:
- Delivered by a single trust but operate across neighbouring trust borders
- Provide regional triaging of patients to relevant services which may include diagnostic and surgical hubs, primary care optometry or hospital eye services
- Supported by a ‘telemedicine support unit’, providing the SPoA with triage and referral management services, including through the provision of patient-initiated follow-up and home monitoring
Following the presentation, a panel debate chaired by Keith Valentine (CEO, Fight For Sight) and featuring incoming RCOphth President Professor Ben Burton, Thom Renwick (Roche) and Louisa Wickham explored key priorities including the importance of innovation in the eye care sector to ensure capacity meets current and future patient need – especially to facilitate more integrated care and uptake of innovative treatments and technologies. Agreement coalesced around the need for comprehensive action across the entire eye care system – as called for by The Eyes Have It partnership – to ensure all patients can access the right care, when and where they need it.
Another issue explored during the audience discussion regarded the provision of training opportunities in independent sector providers and enforcement of existing guidance. Specific challenges were raised in relation to both the overall lack of training opportunities provided by ISPs alongside concern that training requirements outlined in local ISP contracts were not being adequately enforced by commissioners. This is an issue that RCOphth has been working hard to address with NHS England and independent sector providers – last year it published a blueprint for delivering cataract training in the independent sector. It is vital now that all stakeholders work closely with commissioners to ensure that training capacity is provided so that we develop the next generation of ophthalmic surgeons.
If you have any questions or comments relating to the Congress sessions outlined above, please email us at [email protected]
