Optometry Australia believes more needs to be done to maximise the potential of the profession Down Under, despite ranking well in a global survey of the industry.
Australia hit most marks in the World Council of Optometry (WCO) survey, which was conducted in 2023, released in August 2024 and involved Queensland University of Technology’s Professor Peter Hendicott – WCO’s immediate past president.
The poll of 39 nations investigated the optometric demographics within WCO member countries and information related to the scope-of- practice and legislation.
It showed that in those countries, one optometrist serves 23,200 people on average, with just 46.2% of those polled meeting the recommended ratio of one professional to 10,000 people.
Australia was one of those nations to meet this target with 6,785 optometrists resulting in a 1:3897 ratio, according to the report.
Ms Skye Cappuccio, CEO of Optometry Australia (OA), said the survey, which Australia contributed to as a member of WCO, was a good thumbs-up for the profession in this country.
“In a general sense, Australia is performing strongly in the areas highlighted, including regulation of the profession and continuing professional education,” she said.
“Australia is also performing strongly with regard to the specific areas of clinical scope and practice highlighted in the survey.”
She said while Australia was comfortably meeting the mark on the ratio, there was a need for more data.
The situation differed across the country, she said, and “there are signs that the supply/demand balance is tipping, and supply is outstripping demand in many parts of the country”.
Since the survey was conducted, the latest Optometry Board of Australia statistics show registered optometrist numbers have now reached 7,051. OA believed this is primarily being driven by increased graduate numbers, rather than immigration.
Now, a quarter of Australian optometrists are 29 years or under.
But there’s debate about whether Australia needs more optometrists.
In 2023 Specsavers commissioned a Deloitte Access Economics report that forecasted a shortage of 1,102 full time equivalent (FTE) optometrists in 2042, representing a 12% shortage compared to hours of eyecare required by then.
Cappuccio said the survey was a valuable “global snapshot of the practice of optometry, and insights into the diversity of optometry as a profession internationally”.
That snapshot highlighted Australia had a well-established health practitioner regulation system,
clear and appropriate continuing professional education requirements, and a scope-of-practice more advanced than many countries internationally.
But the picture wasn’t as healthy when compared with those nations against which Australia tended to judge itself.
Those countries included Canada, New Zealand, the US, and the UK, “where there are relevant similarities between the health system and the entry-level requirements of optometrists”.
Cappuccio said that comparison revealed Australia was not maximising the potential of its national optometry profession.
She said while Australia was performing strongly in specific areas of clinical scope and practice highlighted in the survey, there were some opportunities not highlighted for the scope of Australian optometrists to “evolve in ways that would benefit the communities they serve”.
“Our optometry workforce needs to be responsive to the specific Australian context,” she said.
Australia had a highly-educated and highly-skilled optometric workforce, but “in a number of ways, the scope-of-practice for optometrists in Australia lags behind these international counterparts”.
OA has made similar calls in the past.
In its recent response to the Federal Government’s Scope of Practice Review, it said the profession faced “various funding, regulatory, technological, cultural, and inter-professional barriers” preventing it from practising to its fullest scope.
It also called for a detailed comparison of health professionals in other countries to identify opportunities for further scope enhancements and highlighted examples of health systems where prescribing of oral medications and intravitreal injections – which Australian optometrists are prohibited from performing – are administered by non-ophthalmologists.
Currently, Australian optometrists with an endorsement for scheduled medicines can prescribe a specified list of topical medications and all optometrists registered to practise can use diagnostic drugs as part of their practice.
OA supported the review’s proposal for a national skills and capability matrix that would set out the skills and capabilities of health professionals, including members of regulated, self-regulated and unregulated professions.
And it backed moves to establish an independent body tasked with identifying and implementing emerging best practice evidence into primary health workforce models.
Cappuccio said the WCO survey had highlighted once more that there were “clear opportunities for the scope of Australian optometrists to evolve in ways beneficial to the community”.
The global poll also revealed that 33% of the 39 countries do not regulate minimum levels of education for entry-level optometric practitioners, 20% limit the use of diagnostic drugs, and 25% limit the use of therapeutic pharmaceutical agents.
Dr Yazan Gammoh, chair of the WCO Education Committee and lead author of the study, said the survey was “unique in highlighting the global variations in the scope of optometry practice from the perspective of the WCO Competency Framework for Optometry”.
The results obtained from this study are expected to assist policymakers and stakeholders in fulfilling the World Health Organisation’s call for optometry services to provide people-centred eyecare through evidence-based information.
They may also inform the recently launched WHO SPECS 2030 initiative, which envisions a world in which everyone needing a refractive error intervention has access to quality, affordable, and people-centred refractive error services.
Other key findings:
• The average male-to-female ratio was 45% males vs. 55% females globally. It was 40% vs. 60% in Australia.
• Optometry is not regulated in France, Portugal, India, Kenya and Cameron.
• Thirteen countries (33%) do not require a Bachelor’s degree as a minimum to practice optometry.
Conclusion: Many countries where optometry is recognised struggle to have an adequate number of optometrists; this hinders access to eyecare. This is compounded by unregulated minimum levels of education for entry-level optometric practitioners. In addition, several countries limit or prohibit many optometric procedures that restrict the ability of optometrists to provide eyecare and vision health services at the primary care level.
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