Optometry Australia joins Ophthalmology Implementation Liaison Group

Optometry Australia has joined the Ophthalmology Implementation Liaison Group (OILG). The group has been formed to consider implementation of recommendations made by the Medical Benefits Schedule Review Taskforce (MBSRT) in December 2020 to contemporise the ophthalmology items on the MBS.

The group is comprised of key stakeholders from across the eye care sector and Optometry Australia’s Optometry Development Manager, Ben Hamlyn, is representing optometry on the OILG.

Ben said that our involvement presents an excellent opportunity for Optometry Australia to advocate for enhanced access to timely, cost-effective, and affordable eye care for Australians as identified in the organisation’s recently released policy platform, Working Together for Better Eye Care.

Ben shares his views

The MBS Taskforce Review for ophthalmology was published in late 2020, and implementation of its recommendations are being considered by the Ophthalmology Implementation Liaison Group (OILG). The group is comprised of key stakeholders from across the eye care sector, including myself as the representative from Optometry Australia. This is an excellent opportunity for Optometry Australia to advocate for enhanced access to timely, cost-effective, and affordable eye care for Australians.

Eye health professionals are strongly committed to achieving the best outcomes for their patients. Every practitioner I know – whether they are optometrists, ophthalmologists, orthoptists, general practitioners, nurses, or aboriginal health practitioners – utilise their professional skills to the absolute best of their ability for the benefit of their patients. A range of factors affect how, when and, in some cases, whether patients receive care, and the type of care that they receive. One of these factors is the remuneration structures that enable care to be efficiently provided, including the MBS and public hospital funding agreements.

While patient related factors such as their location, understanding of eye issues, co-existing health conditions, previous experiences with the health system, and socio-economic circumstances are highly relevant, one cannot ignore the impact of health system related factors on the provision of timely and affordable eye care. How eye care is funded – whether it is directly by the patient, by government or through private health insurance – and the availability of qualified and appropriately trained health professionals has a major influence on the care options available to patients. Funding and remuneration systems need to encourage and support efficient, safe, affordable, and accessible patient care, and the MBS Taskforce Review has made important recommendations in this regard.

With Australia’s ageing population and vision loss already costing the economy over $20 billion a year, the OILG provides an important opportunity to consider collaborative approaches to eye care that enhance patient access and reduce out-of-pocket costs.

It is accepted that there is an ongoing undersupply of ophthalmologists in Australia, with the Federal Department of Health’s 2018 Future Health Workforce Report finding that this will continue through to at least 2030. With about 85% of ophthalmologists based in capital cities, access issues are exacerbated for people in regional, rural, and remote parts of Australia.

Optometrists have a key role to play in addressing this shortfall, working in collaboration with ophthalmologists and other health care professionals, as Optometry Australia has shown in its recently released Working Together for Better Eye Care Policy Platform.

Treatment of Age-Related Macular Degeneration (AMD) and Diabetic Macular Oedema with intravitreal injections (IVIs) is a good example of where a collaborative approach to care and the smart use of telehealth can significantly improve patient access and reduce out-of-pocket costs.

AMD is the nation’s leading cause of blindness and severe vision loss, as well as the most common macular disease affecting 1.3 million Australians. This number will grow to over 1.7 million by 2030. With over 80% of IVIs administered privately, high out-of-pocket costs can make treatment unaffordable for disadvantaged patients who face long public wait times, while regional patients often have to travel long distances to receive their injections. The result is that a significant number of Australians do not receive effective treatment, putting their long-term vision at risk.

To help address this problem, the MBS Review recommended that other health care professionals – including optometrists – have an enhanced role in the provision of intravitreal injections with the appropriate training and development of professional guidelines. This is in line with international evidence in countries like the United Kingdom, the United States and New Zealand, where other health care professionals work collaboratively with ophthalmologists, with high levels of patient satisfaction and increased throughput in retinal clinics.

Practising in remote parts of Australia, I deal first-hand with the challenges in providing disadvantaged patients with access to timely and affordable eye care. At the same time, I know there are practical ways to better utilise local and visiting optometrists, working in collaboration with their ophthalmologist colleagues, assisting in treatment planning, patient management, treatment, support, and gathering and electronically transmitting clinical data. Supported by access to relevant MBS items, including for telehealth (e.g., for store-and-forward) there is an opportunity for optometrists and ophthalmologists to work together treating patients with a range of eye conditions.

I look forward to representing Optometry Australia on the OILG and bringing my practical on-the-ground experience to these important discussions. As someone who is passionate about pursuing collaborative care models that enhance patient outcomes, this is a terrific opportunity to ensure that the MBS is actively encouraging these approaches.

Ben Hamlyn

Optometry Development Manager

Optometry Australia