This month saw the launch of the National Clinical Strategy for Ophthalmology for Wales. Our Llywydd (lead for the College in Wales) Rhianon Reynolds was instrumental in the strategy’s development. In this exclusive blog she discusses the lessons she learnt from the process and outlines why she thinks the strategy can be valuable for all eye care professionals, not just those working in Wales.
In the foreword to the strategy, College President Ben Burton sets the scene, saying: “ophthalmology services are under pressure across the whole of the UK, but the situation in Wales is particularly alarming”. It’s true. We’re short of consultants, hospital eye services have run out of space, and we desperately need more training places. But there are encouraging signs too. Being asked to develop a blueprint tells me there’s appetite for change and we’ve seen huge transformation in primary care eye care services across Wales in recent years.
I’m proud of the work we’ve done on the strategy, and happy with its four main themes. But it will only work if people in all health boards and all subspecialties get behind it and commit to the change.
Yes it’s a strategy for Wales but there are elements that are pertinent across the different nations of the UK as well, particularly in terms of centralising care and in recognising and widening awareness of patient needs. Everyone knows about cataracts but they don’t appreciate everything else ophthalmology is and so we tried to get across in the strategy that ophthalmology is not just cataracts.
Another common issue is looking at driving the multi-disciplinary team forward, which I think Wales does very well and I think the other nations could learn from. There are recommendations in the strategy around MDT working.
Developing the blueprint was a challenging process, which started in around spring of 2023. Gwyn Williams, my predecessor as Llywydd, was the person who got this commissioned and really got the ball rolling with it. I took on more of the leadership role after I was appointed Llywydd in November last year.
Gathering insights was fundamental. We ran face-to-face day-long workshops in each of the regions of Wales and invited all the consultants within the region. These proved very interesting and the way they worked was different in each of the regions.
For me it highlighted how much the regions vary. There isn’t a one size fits all solution. So, while the document gives overarching strategic aims, because the way the regions work are different, each has their own challenges in in terms of staffing and in terms of the infrastructure that sits in them.
What we’re trying to do through the strategy is not to make people work harder but to work smarter. So that when they go into work they don’t feel this overwhelming pressure of thousands of patients on the waiting list weighing down on their shoulders. You should be able to go into work and do what you do effectively without that pressure.
The benefit you’ll get is that you’ll have a better working life because you’ll be doing the bits that really make the difference rather than the firefighting, the pressures, the constant requests to do more. If you put the time in now to make the change, to implement this strategy, that’s the way that you’ll be able to work in the future.
We’ve done this. You’ve told us what you want. I’m proud of what we’ve done. I’m pleased with it. And I am now anticipating how much work we’re going to have to do to start implementing it.
We’ve made it into a plan. Now you need to play your part because that’s what’s going to be crucial. That’s what’s going to be essential to get the government and NHS leadership to play their part as well.