High street opticians should be used to help cut waiting lists and provide more treatment and aftercare closer to home, a report by Healthwatch England has said.
The report looked at patients’ experiences of waiting for specialist eye care, surveying 1,051 people on the waiting list between July and September 2024.
It found that of these, 22% had multiple appointments before being referred and that once referred 64% had been waiting more than four months for care, with a further 24% waiting over a year.
Most respondents (70%) said their vision had deteriorated while waiting for care, and 54% said it had affected their ability to work.
The majority of respondents (85%) supported the idea of optometrists being able to refer patients without needing to see a GP, and over 65% said opticians should help monitor and treat eye conditions.
Ophthalmology is the largest outpatient specialty in the NHS, with more than 8 million appointments in 2022-2023.
Healthwatch England, which represents patient voices to NHS decision-makers, gave three recommendations to policymakers within the report to meet these challenges, including that the government should make better use of community optometrists to help cut waiting lists and provide care closer to home (see box for full recommendations).
Chris McCann, deputy chief executive at Healthwatch England said: ‘Long waits for eye care are having a huge impact on people’s daily lives, including their ability to work, manage daily tasks, socialise or take part in hobbies such as reading.
‘We know that highly skilled optometrists in the community are in every locality in England. Our survey shows overwhelming public support for better using this capacity through models such as Optometry First, where optometrists and their teams support patients before and after hospital care. This provides an ideal opportunity for them to take on more responsibility for managing people’s eye care and referring them for specialist treatment.
‘There also needs to be better communication and support for those stuck on waiting lists. The positive impact of Eye Care Liaison Officers, a Royal National Institute for the Blind programme that provides vital support to those diagnosed with a condition that affects their sight, is well documented.’
He added: ‘We ask the NHS to ensure trusts and other commissioners and funders of eye care services support the increase and sustainability of this programme, which is not currently available to all patients.
‘Lastly, the NHS should publish condition-specific data to ensure patients with the most serious eye conditions get help first.’
It comes after a report by Primary Eyecare Services suggested that investing in community-based eye care and technology could held to save around £98 million. The report also called for better use of primary care eye practitioners to triage, manage and prioritise patients presenting with urgent and minor eye conditions.
In January 2024, Labour committed to allowing high street opticians to provide outpatient appointments for eye problems if elected into Government to help reduce the workload.
Their manifesto for the July election also pledged to allow opticians to make direct referrals to specialist services for tests.
Report recommendations:
- The NHS should publish ophthalmology waiting list data by condition, rather than publishing all ophthalmology treatments together. Condition-specific data would allow increased scrutiny of waiting time progress for the most serious conditions, and ensure resources are being appropriately allocated.
- The Government should make greater use of optometrists to help cut waiting times and provide more treatment and aftercare closer to home. Optometrists in the community are highly skilled and in every locality in England. Respondents to our survey supported making better use of their skills, which could improve patient experience.
- Improved support and communication for patients while they wait. Eye Care Liaison Officers, (ECLOs) provide vital support to those diagnosed with a condition that affects their sight. In England, the current ECLO coverage in the top 150 ophthalmic centres is 71%. The NHS should ensure trusts and other commissioners and funders of eye care services support the increase and sustainability of the funding of this programme alongside RNIB, with universal access as the ultimate aim.
Source: Healthwatch England
