Colin Low
Co-Chair of the All-Party Parliamentary Group on Eye Health and Visual Impairment and a Crossbench Peer

By the time you read this, we will have just launched the “See the Light” findings from the inquiry carried out by the All-Party Parliamentary Group on Eye Health and Visual Impairment, of which I am Co-Chair, into capacity issues in eye care in England.

In the last twenty years, fantastic new treatments have been found for conditions like wet AMD, glaucoma and diabetic eye disease. A critical factor for those treatments is that they need to be given at the right time. While thousands of people receive sight saving treatment from the NHS on a daily basis, people are also facing delayed and cancelled appointments, resulting in individuals permanently losing vision. That situation cannot be allowed to continue.
The good news is that the inquiry found very practical solutions to improve capacity issues. We are calling on the Secretary of State for Health and Social Care to include eye health in the NHS Mandate. Without that incentive, many health service commissioners will simply fail to give sufficient consideration to eye care and continue commissioning the same services, which are currently failing to adequately meet the needs of patients.
Sight loss not only has a massively negative impact on an individual’s life but it also leads to increased health care and social care costs. Whilst, of course, blind and partially sighted people can and do live full and productive lives, for many people it leads to depression and isolation. It is not something that anyone would choose.
A failure to give sufficient consideration to improving capacity in eye care services is devastating individuals and costing the health service millions. As an example, it will come as no surprise that people with sight loss are more likely to have falls. That can rob an individual of their independence and require weeks of expensive hospital care.
I was delighted at the level of engagement that we have had from patients, health service commissioners, providers, professional bodies, commercial organisations and the voluntary sector. One hundred and eleven organisations provided evidence, and we heard from more than 500 patients. RNIB and the Optical Confederation provided the secretariat, and the Royal College of Ophthalmologists, the College of Optometrists, the Optical Confederation itself and others provided expert guidance in our analysis of the evidence. So while new treatments and our ageing population are an increasing demand on NHS eye care services, we are confident that if action is taken now, the situation can be improved.
We have identified a wide range of solutions, and the report includes 16 recommendations. As a priority in addition to specifically including eye health in the NHS England Mandate, we are calling for all local Sustainability and Transformation Partnerships (STPs) to address capacity issues in eye care in their plans. Currently, only three out of the 44 STP plans are prioritising service redesign in eye care.
It is essential that routine data is improved so that waiting times and delayed appointments can be accurately compared between areas and across eye conditions. There is a need to establish a national target to ensure that patients requiring follow-up treatment, such as injections for wet AMD, regular treatment for glaucoma or diabetic eye disease, are seen on time. With increasing demand, we need more specialist eye doctors (ophthalmologists) and all doctors need a minimum standard of eye health education. There is a significant workforce of eye health professionals such as optometrists, opticians, nurses and orthoptists that can be better utilised to improve capacity. There needs to be greater consistency in the learning outcomes from curriculum and training systems and improved IT connectivity so that, for example, people seen by their local optician can be quickly referred for specialist diagnosis and treatment.
At the launch of “See the Light: Improving capacity in NHS eye care in England”, we will be calling for support from MPs to ensure that action is taken now to save people’s sight.
For a full list of our recommendations, and to see how you can help ensure that patients receive the treatment that they need on time, please take a look at our report “See the Light” at: rnib.orgddukstappginquiry