Optometry First

A New Model for Eye Care Delivery in England

Optometry First seeks to broaden the scope of care delivered in primary care beyond the existing sight testing service and release capacity within the specialist services for more complex care. The aim is to fully utilise the existing primary eye care workforce, estate, and equipment to do the following:

• New Patients – optimise first contact care to fully resolve eye care problems where clinically appropriate and, when not possible, signpost or refer to the most clinically relevant service to ensure resolution as early as possible in the patient journey.
• Follow-up Patients – provide services to monitor and manage people with long-term conditions considered low risk and not needing ongoing secondary care intervention.

It aims to improve the efficiency and accuracy of case-finding, reduce the need for hospital attendance and improve patient experience and opportunity for self-care.

Optometry First utilises the core competencies of optometrists, supported by their practice teams, and higher qualified primary care practitioners and the multidisciplinary hospital ophthalmology team where necessary, across a network of local optometric practices and the hospital eye service.

Optometry First does not require optometry higher qualifications for rapid initial deployment, but can be enhanced by embracing all skills already available within primary care teams. ​Where necessary, clinical care will be supported by advice and guidance and remote review from higher qualified primary care optometrists or the hospital eye service for more complex cases to support co-management without the patient having to attend a hospital.

A fundamental change is that patients with defined long-term eye conditions are managed within primary care optometry, working collaboratively with the hospital eye service.

Optometry First is not simply a collection of pathways but a principle of “optometry first” with the primary care professional empowered to exhaust their full capability, working to the top of their licence, to best meet the patients’ individual needs, ensuring the see the right person, in the right place, at the right time.

Strong Interest in Early Adoption of Optometry First

Following a call for expressions of interest in piloting Optometry First, NHS England received interest from 17 of the 42 ICSs across all seven NHS regions. LOCSU was invited to help identify the three best-positioned systems to test the Optometry First model.

As a result of the selection process, the three early adopters of Optometry First are Bassetlaw (North East & Yorkshire Region); Isle of Wight (South East Region); and Sefton (North West Region).