EYECARE about the HEALTH and WELLBEING of the people of XXXX

1. EYECARE about the HEALTH and WELLBEING of the people of XXXX XXXX Optometrist, BSc(Hons), MCOptom Member of XXXX Local Optical Committee

2. What is an Optometrist? • A primary health care professional with a specialist training in the eyes who can: • assess and correct defects in vision • detect ocular disease, injury or abnormality • treat eye diseases within their competence • detect some disorders of general health which can manifest within the eye

3. Attaining qualification • A three-year undergraduate study at University leading to a BSc, and/or a BCOptom. • Minimum of a one-year post-graduate qualification working under supervision with assessments and a final Objective Structured Clinical Examination (OSCE) through the College of Optometrists.

4. Regulation • By the General Optical Council (GOC) • Registration on the Opticians Register is compulsory for optometrists to practice with an annual renewal • Specialist ocular therapeutics registers • There is a voluntary register for Dispensing Opticians with a separate register for dispensing opticians who can fit contact lenses

5. Continuing professional development • Continuing Education & Training (CET) is: • Regulated by the GOC • Mandatory over a 3-year cycle • Compulsory peer review • Involves a diverse range of competencies • College of Optometrists set standards & have developed various higher qualifications e.g: • Independent prescribing • Glaucoma

6. What can Optometrists do? • Refraction: assessment and correction of myopia (short-sight), hypermetropia (long sight), astigmatism (rugby ball shaped corneas) etc • Presbyopia - loss of ability to focus on near visual tasks • Squint/lazy eyes • Assess whether or not vision is adequate for driving - DVLA requirements

7. What else can Optometrists do? • Assess binocular vision • Assess colour vision • Fit Contact Lenses (CLs) (Optometrists or Dispensing Optician CL fitters) • Assess suitability for Low Vision Aids • Provide domiciliary eye care (additional service) • VDU assessments

8. What sort of eye disease can Optometrists detect? Examples are: • Age Related Macular Degeneration (AMD) • Glaucoma • Diabetic retinopathy • Cataracts • Retinal/vitreous detachments • Dry eyes

9. The importance of Eye Health • 1.8 million people live with sight loss in the UK (Future sight loss UK, RNIB 2008) • By 2020 this will increase by 22% • Almost 4 million by 2050 • Ophthalmology accounts for 8th highest level of programme spend in England and is rising

10. The importance of Eye Health • In 2010/2011 there were 6,365,308 out- patient attendances in England • 4.5 million GP consultations/year include an eye problem • Direct cost around £26 billion/year • This is set to increase • Over 50% of sight loss is preventable

11. Age and Eye Health • Prevalence of many of the main causes of sight loss increase with age • Given current demographic trends, we are likely to see increasing levels of avoidable sight loss • Significant impact on future demand on health and social care services • 64% of people certified as visually impaired (VI) are over 75 year olds and 32% 18-74 year olds SOURCE: NATIONAL STATISTICS 2008,COUNCIL TABLES- BLIND AND PARTIALLY SIGHTED, PB1

12. Local picture of XXXX • Predictions of the number of people in XXXX using • POPPI (Projecting Older People Population Information) www.poppi.org.uk • PANSI (Projecting Adult Needs & Service Information) www.pansi.org.uk • XXX people with serious visual impairment in XXX who require help with daily activities • This will slowly increase over the next few years

13. Some suggested solutions • Since 2004, the DoH has been trying to encourage the delivery of more routine and minor emergency eye care outside hospital 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 e.g. wet AMD treatments.

14. What eye care can be provided in the community? • Minor Eye Conditions Service • Some Glaucoma Services • Pre & Post Operative Cataract Service • Children’s Vision Service • Low Vision Service • Eye Care Services for Adults & Young People with a Learning Disability

15. Benefits of Community Eye Care services • Supports national and local strategic priorities • Community rather than hospital care • Evidence based practice • Patient choice • Care closer to home

16. Referral to Ophthalmology in XXXX • GP- xxxx • Other - xxxx • Cost of first ophthalmology out-patient attendance in 2014 = £118.13 • TOTAL REFERRALS TO OPHTHALMOLOGY xxxx SOURCE INFORMATION DEPARTMENT THE ROTEHRHAM NS FOUNDATION TRUST 2012

17. What can Health & Wellbeing Boards do? • Make eye care and prevention of sight loss a priority for public health • Encourage Early Intervention • Encourage Clinical Commissioning Groups to increase the impact of their eye care commissioning strategy

18. Eye Health and Health & Wellbeing Boards • Health and wellbeing strategies that address some general public health issues also impact on eye health and support prevention of sight loss. The following are examples of links between public health and sight loss: • Smoking • Obesity • Diabetes

19. Smoking and Eye Health • Age-Related Macular Degeneration (AMD) • As strong as the link with lung cancer • Doubles the risk • Develops at an earlier age • Stopping smoking reduces the risk • Treatment options for AMD are limited • Cataracts • Diabetes

20. Obesity and Eye Health • Diabetic retinopathy • increase risk of developing type 2 diabetes • Age-related macular degeneration (AMD) • obesity may increase the risk of developing dry AMD • also increases the speed of progression of AMD • Dry AMD is likely to impede the ability to carry out daily activities such as driving, reading a newspaper or watching television • Cataracts • can double the risk of developing cataracts

21. Diabetes and Eye Health • Diabetic Retinopathy • Good blood sugar control and good blood pressure control substantially reduce the risk of sight-threatening diabetic retinopathy. • Strategies that seek to prevent diabetes and improve the quality of diabetes care will help prevent avoidable diabetes related sight loss.

22. Other costs of Visual Impairment • Mental Health Higher incidence of mental health issues in those suffering from sight loss. • Falls Higher incidence of falls due to poor vision, cataracts etc.

23. How can the LOC help? • We can help you to work with Health and Social Care providers • Encourage a multi-disciplinary approach • Early intervention • Quality, Innovation, Patient centred, Patient satisfaction, Patient choice • Improve efficiency and reduce costs

24. Current Community Eye Care Services

25. The LOC aim • To work with the Health & Wellbeing Board and other partnership organisations to help deliver high quality and accessible eye care • Integrating service delivery with others • GPS • Ophthalmologists • Orthoptists • Nurses • Social Care personnel

26. References • http://www.dh.gov.uk/health/2012/09/programme-budgeting-guidance/ • www.vision2020uk.org.uk • www.rnib.org.uk/datatool sight loss data tool • http://www.rnib.org.uk/aboutus/Research/statistics/Pages/sight-loss-datatool.aspx • http://www.commissioningforeyecare.org.uk/ • http://www.locsu.co.uk/enhanced-services-pathways/

27. Thank you for listening