Sight test passed its sell by date ??
I understand that the AOP chairman Elisabeth Frost opened this week’s National Optometric Conference by attacking the current NHS sight test.
Just what is wrong with the current sight test then??
As i see it from a untrained point of view it does whats needed, ie you walk out with a form telling you whether you need glasses or not, you've had your eyes patholigy tested. What more can be done.
Over to you trained folks i think.
I think some community optometrists concerns revolve around the expansion of what optometrists are expected to do within the remit of the "sight test" and the poor funding of the NHS test.
Which is why the AOP is promoting the add on charging policy for specified additional test which they think fall outside the "sight test".
John, the NHS sight test only has the requirement to detect "signs of disease" - not to diagnose them.
Many times these signs are erroneous and simply add to waiting list times as hospital staff investigate non-existent problems.
The difficulty is that I am not prepared to work to 21st Century standards for 1940's pay and conditions.
NHS dispensing disappeared in the early 1980's and resulted in better dispensing opportunities for patients. Without the disappearance of NHS dispensing, everybody would still be using round segs, no flat tops and definitely no progressives!
The same is now true of the sight test - it is out of date. I can offer my patients much more but am restricted by NHS regulations.
OK, so to give your patients more you are going to have to charge more.John Tickner said:
the sight test - it is out of date. I can offer my patients much more but am restricted by NHS regulations.
From a non optician point of view the standard sight test needs to be kept simple, say as is now. But getting the NHS to stand the extra charges is going to be a fight and a half.
Also are you saying that if you pick up on a eye problem then you should be allowed to treat it rather than refer to local eye hospital. Of course this would be if you have the skills to do such things. This would be a good idea as it could speed up treatment and release Dr at hospitals for the more serious problems.
You are quite correct, John and I do charge more. I offer patients a sight test OR and eye examination.
The problem is that patients want an eye exam for free and the hospitals want me to do the work for free. Personally, I am in favour of a simple eye test that is refraction or refraction and screening only. It would make it far easier for me to differentiate my services, and thus easier to charge more.
The NHS will not stand the charges unless they can be shown that there is an overall cost saving. I believe there would be an overall cost saving in using specialist optometrists, but discussions within the health service usually always centre around the sight test!
This is the point the AOP are making. Forget the sight test as a be all and end all. A sight test is about spectacles. Optometrists should be about primary health care, much as a dentist cares for teeth, an optometrist should care for eyes.
I treat eye disease in my practice independently and in an informal co-managed manner. Again, the difficulty is that UK patients are not used to paying for this treatment.
If your GP has been treating you for conjunctivitis for three weeks and it has not gone away, why is it that patients object to paying around £25-30 when I correctly diagnosis and treat their anterior uveitis ? Many patients happily pay their chiropractor and podiatrist - but baulk at paying their optometrist. The reason is because of the unrealistic expectation that it will be free (a sight test), when it is not a sight test they need, and has nothing to do with spectacles.
Apologies for the rant, but I hope you get my drift.
Two tier sight test ? The sooner the better - for both of us I think!
No apologies needed, at least you are helping me get my head round what was being proposed by the AOP.John Tickner said:
Apologies for the rant, but I hope you get my drift.
Two tier sight test ? The sooner the better - for both of us I think!
I totally get your point about people not wanting to pay for optical related things yet quite happly
fork out hundreds of pounds at the dentist. Yet if our teeth fall out we can get false set and have no problems, yet you cant say that for your eyes.....
How did that slogan go You only get one pair LOOK after them..
John
welcome to Optiboard!
I think the difficulty with all this is not the aspiration to provide a more comprehensive eye examination for a reasonable fee, or the provision of high quality community based eye treatment but the reality that patietns are not at present well informed enough to understand the added value they will get from these services.
The NHS will always try and get as much as possible for as little as possible (that's not a bad thing!)it's up to optometrists to convince them and more importantly their patients that their services are value for money. At present some are but some aren't and they drag every one else down.
change of tack
Could this possibly be how the independent optician will survive in the future. I can see the big boys going for the sight test and hope to survive on all that comes with it and the independents going all out for total optical eye care, relying less on selling glasses and contacts but gaining from the rewards of eye care..
Is this how any of you can see things going?
Some independants possibly may survive by moving away from the GOS sight test and into a more appropriately funded primary eye care role, but there probably isn't enough market share for all to survive. Plus the subsidy of the sight test by the mark up on dispensing is difficult to get away from for some.
I think the more interesting prospect is the possibility of a move away from all practitioners being GOS (General Ophthalmic Services) providers to the PCTs (Primary Care Trusts) employing/contracting specific practitioners to provide GOS care e.g. childrens eye care etc.
"To live in interesting times" it's both a blessing and a curse.
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