Feature, News, Report

Bringing 2024 into focus

Ophthalmic workforce constraints, further disruption of the optometry market and new therapies for myopia were key issues that shaped 2023.

Prominent figures within the ophthalmic sector offer their predictions for 2024, with Insight asking three key questions:

• What will be the key features to shape their segment of the eyecare landscape in Australia in 2024?

• What will be the challenges and opportunities for their respective organisation?

• Are there any major announcements to keep an eye out for in the coming year?

Skye Cappuccio
Optometry Australia, CEO

In 2024, we anticipate a growing emphasis on digital health. In addition to the Federal Government’s 2023 commitment to enhance the integration of allied health with digital infrastructure, including My Health Record, several state governments are advancing plans to improve digital information sharing between community providers and public hospitals. Additionally, we foresee continued adoption of diagnostic artificial intelligence throughout the sector. Optometry Australia is working to secure optometry’s active participation in digital transformation initiatives, ensuring thoughtful integration into practise.

We are hopeful that the outcomes of the lengthy review of optometry Medicare Benefits Schedule (MBS) items will be announced and implemented in 2024. While these changes are expected to be positive, they may not be revolutionary. Nevertheless, we are committed to ensuring that once announced, these changes are well-understood across the profession.

Encouragingly, there is an increasing recognition of the full clinical scope of optometrists and the implementation of collaborative care models. These models aim to alleviate pressure on overstretched tertiary care systems. Looking ahead to 2024, we remain optimistic about the continued innovation and broader adoption of proven models in this space.

Dr Grant Raymond
RANZCO, president

The regulatory landscape for training ophthalmologists and assessing ophthalmologists trained overseas will change in 2024. RANZCO is likely to respond by increasing our focus on collaborative care, upskilling GPs, improving our internal processes and, of course, advocating for patient safety. The college will continue to focus on issues surrounding Indigenous eye health, workforce distribution and maintaining our high standards of education and training.

The key challenge for the future is responding to legislative changes whilst advocating for sustainable, safe equity of eyecare. Increased resourcing is required by governments in Australia and New Zealand to deal with the backlog of elective eye surgery resulting from COVID. Also, an opportunity exists to draw government focus to the need for preventive strategies.

In 2024 the college will be launching a new education and CPD platform. This is a one-stop-shop for our trainees, members and fellows to do everything relating to education, training, up-skilling and CPD.

Dr Peter Sumich
Australian Society of Ophthalmologists, president

Clinically, 2024 will likely continue the demise of multifocal IOLs as EDOFs continue to offer almost the same benefits, with fewer downsides. Implantable glaucoma dosing devices are about to break ground, and this could be a paradigm shift.

Economically, cost of living pressure will continue to limit discretionary spending and interest rates will bite harder. Eye services are often shielded, but the environment will be harder for clinics that are not offering “quality and higher service”. Public hospitals are not coping with surgical demand and this sector will continue to struggle with volume.

Politically, the health minister has nominated the second half of his term towards private health reform. The competing priorities of medical providers, hospitals and private insurers currently appears insurmountable. The Australian Medical Association workshop, which I attended, clearly indicated nothing will get in the way of profits for insurers. Whilst we proposed a Private Insurance Authority to act as a cop on the beat, the insurers were determined to fund instead a “research institute” to cut costs out of the system and limit care to areas they perceive as “low value”.

Dr Loren Rose
Myopia Australia founder; ophthalmologist

In 2024, we will expand our knowledge of myopia progression in children, especially when it comes to interventions and learning how to apply and combine these based on patient risk and demographic.

New interventions due for release will further our armaments. We will also be looking more into the progress of myopic adults and how we may be able to apply new technology to this group.

As an ophthalmologist in the field, it provides an overview of all emerging therapies and a constant eye on more systemic concerns such as syndromic myopia. I am passionate and excited by our new ability to intervene with multiple therapies and am keen to do this safely. However, with the emphasis on myopia progression, we sometimes lose sight of the associations, which can be life and sight-threatening.

An exciting new development is an International Myopia Registry via the Save Sight portal, in its early stages. This registry will be available to all eyecare professionals and help document the progression and treatments in Australia and overseas, including children and adults.

Dr Kathy Chapman
Macular Disease Foundation Australia, CEO

Macular Disease Foundation Australia’s (MDFA) second social impact survey has been completed and the feedback we have received from 2,000 people living with a macular disease will influence our work throughout 2024 and beyond.

What we have learned from our community is that competing health priorities and the presence of mental health issues reinforce the need for the need for comprehensive, ongoing and holistic support for people with macular disease. Our new My Eyes patient-focussed service launching in May 2024 will assist in supporting some of these needs.

Our community also wants us to continue to advocate for more affordable eye injections and specialist fees, which are by far the most frequently mentioned areas of concern. Affordable low vision aids, assistance with the costs of transport to treatment, and improved access to bulk billed eye injection services in and outside of metropolitan areas are not new issues and will remain our focus in 2024.

Amanda Trotman
Optical Distributors and Manufacturers Association, CEO

The number of independent practices to do business with continues to be important to suppliers and distributors, so the maintenance of a good number of independent optometrists who can engage with their chosen suppliers – and who have a succession plan in place for upcoming optometrists wanting their own business opportunities – remains key.

We are seeing suppliers more vested in practice outcomes and partnering with practices on marketing and products to match the practice’s specific demographics.

There is strong demand for live events and seeing products on show under one roof, however, we still need to be innovative given the amount of free CPD now available through multiple channels.

Work will continue on what have been slow moving projects such as with the TGA to finally see spectacle frames exempt as medical devices, and communications to government on the unacceptable situation that has seen the tariff concession revoked on spectacle frames.

OSHOW24 Sydney will be a highlight on the calendar to see the latest products while ODMA eyetalk will leverage its consumer facing publication, Lookbook, more widely.

Dr Kristin Bell 
RANZCO, ophthalmologist

Ongoing workforce challenges will feature in 2024, including worsening maldistribution impacting access to care in regional, and disadvantaged communities. There is an also an impending overall shortage with insufficient Australian training places.

RANZCO’s redrawn Binational Selection settings have, over the last three years, seen 4% of trainees selected identify as Indigenous, and 30% have strong rural attributes. This will drive positive change in our specialist workforce diversity and distribution. Changes in the regulation of overseas-trained specialist, resulting from the ‘Kruk’ Review, may ease workforce pressures but presents challenges for RANZCO in changing processes whilst maintaining quality and safety.

RANZCO continues to engage with the National Medical Workforce Strategy and Commonwealth Medical Workforce Division to seek KPIs for public hospital fulltime equivalents be implemented to support sustainable ophthalmic workforce growth. A wide-ranging government review to investigate how to equitably distribute health care workers is another opportunity.

We also look forward to progressing the work of the RANZCO Collaborative Eyecare Working Group, by engaging with Optometry Australia, Orthoptics Australia, GPs, AONA, etc, to document evidence-based, patient-centred collaborative care models for an Australian context.

April Petrusma
Optical Dispensers Australia, CEO

With strong industry backing, the education and resources offered by ODA will evolve in 2024 with some new training opportunities soon to be announced.

In late 2023, ODA extended our popular ‘Webinar Wednesday’ program to New Zealand dispensing opticians. The 2024 program will provide CPD ODOB Accredited education to our New Zealand colleagues and offer Australian ODA Members ‘ODA CPD’ points towards their yearly ODA Currency Certificate.

This year will see the first ODA and Optometry Australia (OWA) collaboration bringing together optical dispensers and optometrists at the WAVE conference in Fremantle, WA. Optical dispensers can engage in a full day dispensing stream on 16 March, with a combined lecture planned to conclude the conference.

After last year’s successful ODA Gala and National Excellence Awards, it’s returning even bigger in 2024 on Friday 1 March at Melbourne Town Hall. It will recognise the achievements of outstanding optical dispensers and Cert IV graduates and feature an extended program with live entertainment.

Plans are afoot for an ODA international aid trip to Fiji in mid-2024, which ODA Members can apply for. More details coming soon.

Tony Jones 
ProVision CEO

In an increasingly-competitive market, patient satisfaction and profit optimisation will be important factors for future success in independent optometry. Seeking greater practice efficiencies through increased engagement with support systems and intelligence platforms, and executing more data driven decision-making, will also serve to strengthen independent practice fitness in 2024.

Navigating an uncertain economic environment will be the universal challenge for all independents, but practice differentiation (through product, clinical, or service) is a significant opportunity. Many of our members have grown and nurtured areas of special interest in previous years to great success.

ProVision is looking to launch some new technology-based services (including a business intelligence platform) to help our members meet the market in terms of expectation. These will be game-changers for our members and have been developed in response to member demand.

Carly Iles
Vision 2020 Australia, CEO

There are several key areas we are excited to progress in 2024 across the eye health landscape, particularly maintaining progress in collaborative care which will involve greater collaboration between optometry, orthoptics and ophthalmology, as well as the implementation of the Vision 2020 Australia children’s vision screening framework by the states.

What is also a priority for 2024 is key sector collaboration to develop a plan for First Nations eye health to replace ‘Strong Eyes, Strong Communities’ post-2024.

The rising rates of myopia and diabetic retinopathy will be a challenge as we move into 2024 and beyond. Ensuring the workforce is adequately equipped to deal with these challenges will be vital, as well as instilling good public awareness around prevention strategies.

Additionally, ensuring the needs of people who are blind or have vision loss are better supported through the NDIS review process is an important priority, as is the imminent reforms across aged care.

A/Prof Mitchell D Anjou
Indigenous Eye Health Unit director, The University of Melbourne

I anticipate 2024 will be characterised by continuing uncertainty and significant progress in the Aboriginal and Torres Strait Islander eyecare sector. There is a need to embrace Aboriginal and Torres Strait Islander leadership, support self-determination and a national plan is necessary.

First Nations Australians still lose vision from preventable and treatable causes because they can’t access or afford care. The Australian Government goal of ending avoidable blindness by 2025 is not looking on track and the sector needs to urgently unite to achieve this goal. There is deep hurt from the referendum outcome and consequent responses are distressing. Reconciliation approaches have not delivered and those aspiring to be allies need to reconsider their strategies to better engage and support.

I’m excited to see where the First Nations Eye Health Alliance (FNEHA) will take us. I know FNEHA will host a great conference in nipaluna (Hobart) in May (National Aboriginal and Torres Strait Islander Eye Health Conference 2024 – NATSIEHC24) and I expect the contribution of FNEHA to grow in 2024. First Nations leaders and organisations will shape activities and my guess is a focus on workforce, health promotion and community ownership of eye health.

Shaun Tatipata
First Nations Eye Health Alliance chair, Indigenous Eye Health Unit associate director, Deadly Vision Centre director

What a ‘Deadly’ year 2024 is stacking up to be. I am excited by the growing strength of the Indigenous leadership across eye health and what that means for eyecare for Indigenous communities. With the establishment of the First Nations Eye Health Alliance and eye health featuring high on NACCHO’s agenda, I am predicting an Indigenous-led process to develop the next National Indigenous Eye Health Plan, helping to steer our collective efforts.

If embraced, the sector (and governments) will have an opportunity to pursue an Indigenous perspective of success enabling us to tackle both the unmet eyecare needs in communities whilst increasing representation in the eyecare workforce improving cultural safety. A genuine commitment to such an approach can only strengthen the ongoing engagement of mob in the deep collaboration spaces that have led to the gains made to date in closing the gap for vision.

Another exciting prediction is that ophthalmology will have a greater proportion of Indigenous trainees/students than any of the other eyecare professions. A big call to make – but wouldn’t that be something.

Philip Rose
Eyecare Plus, general manager

Despite a drop in retail spending due to increased interest rates, independent optometry has continued to perform well in 2023. Average practice growth in our group has been healthy.

During 2023, we further expanded our national advertising efforts. We incorporated Catch-Up TV into our digital advertising. This has been supported by our suppliers as they recognise the benefits of consistent messaging to our patients. Eyecare Plus’ aim is to increase our overall patient brand awareness in 2024, while our locally owned practices continue to operate as they are accustomed.

Our National Office Marketing team has had great success helping members with their Google Business Profiles and their SEO results. Under the motto, “Get real with Reels” we have now launched a training program to help our members better utilise social media.

Managing succession planning will also be our focus in 2024. This is an opportunity the whole independent optometry industry needs to embrace. We plan to help more young optometrists become owners of profitable practices.

Dr Amanda French
Orthoptics Australia, president

Recommendations from the Strengthening Medicare Taskforce have prompted investment in reviewing the health system and workforce, with initiatives set to continue well into 2024. There is a particular focus on allied health, through the ‘Unleashing the Potential of our Health Workforce Review’ with a view to enabling allied health professionals to work to the top of their scope-of-practice. Orthoptics Australia will continue to advocate for the improved efficiency and equity within eye health that would come from orthoptists working to the top of their scope and into advanced practice areas.

Advancing technology within eye health has long been a significant driver of change, however, the Australian Digital Health Agency’s ‘National Healthcare Interoperability Plan’ and other work within the area of digital health is likely to prompt transformation in how health professionals work collaboratively and share information related to patient care. Orthoptics Australia has already begun to discuss increasing collaboration within eyecare, partnering with RANZCO and Optometry Australia to focus on improving paediatric eye health care, an area of speciality for orthoptists.

Paul Bott 
Specsavers ANZ, managing director

At Specsavers, our commitment is changing lives through better sight and hearing.

In 2023, we cared for the eye health of more than four million patients and screened the hearing of more than 600,000, and in 2024 we will continue to encourage Australians to have essential tests for their eyes and hearing. We know that the more people have routine eye tests, the more likely we are to detect sight-threatening eye conditions in early stages and give patients the best chance to protect their vision. Similarly, the earlier we detect hearing loss, the better the long-term outcomes can be for patients.

Through all economic climates, we are, and always will be, committed to our core values of providing best quality, accessible and affordable services and products for all Australians. With nearly 400 practices across Australia and employing more than 7,000 team members who are each passionately focussed on their local communities, we are incredibly proud of the work being done to improve the lives of Australians and we look forward to continuing to increase our impact.

Amanda Cranage 
Vision Eye Institute, CEO

Staff and doctor wellbeing and retention, the changing needs of an aging population and access to treatment, and sustainability are just some of the big issues that will affect private ophthalmology in 2024.

When I became VEI CEO in June 2023, the long tail of COVID was a top priority and remains so. A fatigued workforce – prompting some to exit the industry – is an added challenge and places staff recruitment and retention front and centre. It’s a critical time, and the leadership teams who will succeed are the ones that show up in this space with actions – not words. Some ophthalmologists have also reconsidered their work life balance, straining surgeon availability.

Simultaneously, there is an opportunity to partner with governments to reduce public cataract wait lists by utilising VEI’s national network clinics and day hospitals.

Elsewhere, the first approved geographic atrophy (GA) therapy is imminent and we need to consider how to manage the influx of GA patients into already-busy clinics. We see AI diagnosis playing a crucial role. Sustainable practices – weighed against quality and safety – remain front of mind too. VEI is a member of Global Green and Healthy Hospitals, and our sustainability working group is overseeing several projects to collect data, gather insights, and devise strategies to reduce our carbon footprint and overall waste.

Prof Keith Martin
Centre for Eye Research Australia, managing director

At CERA, we’re exploring transformational technologies like gene therapy, hyperspectral imaging, and laser therapies to beat vision loss and blindness. I’m excited that we’ll soon be able to bring our breakthroughs to even more people.

Alongside our partners at the Royal Victorian Eye and Ear Hospital and the University of Melbourne, we have made great strides over the last few years to streamline research pathways for patients.

As we announced in 2023, I am delighted that thanks to $10 million in support from Breakthrough Victoria, CERA is now building a state-of-the-art clinical trials centre here in Melbourne. It will have the capacity to double our clinical trial activity when it opens in 2024. This will allow us to bring the new therapies we are developing locally, as well as more international clinical trials, to Victorian patients as early as possible.

Richard Wylie
Glaucoma Australia, CEO

Firstly, 2024 will be a watershed year for early glaucoma detection because now a sample of saliva can determine whether a person is at increased risk of developing glaucoma well before the disease can be diagnosed.

This world-leading, Australian-developed technology now offers the potential to screen people at risk, in particular first-degree relatives, well before any signs of glaucoma (or sight loss) have occurred and provide a polygenic risk score for them developing glaucoma later in life.

The second theme that will become more prominent in 2024 is the “mainstreaming” of enrolling patients into expert-led patient support programs. The data clearly shows that patients achieve better treatment outcomes when they are supported throughout their treatment journey, and these improved treatment outcomes have the potential to save the health system billions of dollars per year.

 

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