Reforming the NHS is a central pledge of the Labour government that entered office this summer. As we updated you last month, the conclusions of the Darzi Review were the first stage of this process.
The government has now begun work to develop a 10-year plan for the NHS in England, and is engaging with the public, clinicians and experts via a ‘Big Conversation’ to inform this.
The College will be responding in line with our policy priorities – emphasising the actions needed to ensure sufficient ophthalmology workforce to meet growing patient need, better integration of eye care across primary, secondary and community settings (including by tackling IT barriers), and a commissioning environment that supports comprehensive NHS ophthalmology services while deploying independent sector capacity where needed.
How you can contribute
You can also help us ensure the voice of our profession is heard by completing the specific NHS workforce questionnaire. There is a short registration process and then a survey which covers the following areas:
- What you like about your job, and what you find most difficult
- The challenges you face working in the NHS, and which should be priorities for addressing in the 10-year plan (both from a drop-down list)
- Further optional free text questions about your personal experiences of working in the NHS.
As well as sharing your own unique experience of working in the NHS in England, you may find it helpful to draw on some of the below statistics.
If you have any questions or suggestions to contribute directly to the College’s response to the 10-year plan, please contact [email protected].
Useful statistics:
Workforce shortages
- The Royal College of Ophthalmologists’ 2022 workforce census found that over three quarters (76%) of NHS ophthalmology departments do not have enough consultants to meet current patient demand. The majority of departments reported a need for extra posts just to keep up with current patient demand, with 84% saying they need at least one additional consultant and 77% needing at least one additional SAS doctor.
- The Royal College of Ophthalmologists 2024 position paper A sustainable Ophthalmology workforce calls for an additional 285 ophthalmology training places in England by 2031, to tackle current shortfalls. This should be delivered as part of the NHS Long Term Workforce Plan.
Backlogs
- Ophthalmology is the busiest outpatient specialty in the NHS, with nearly 9 million attendances in England (8.5% of the NHS total) in 2023/24.
- In its 2023 report The Hidden Waitlist, the think tank Reform found that ophthalmology is the specialty with the most follow-up waits, at 10,000 per NHS trust.
- In a 2024 survey of ophthalmology clinical leads, The Royal College of Ophthalmologists found that 70% reported they were more concerned about the impact of outpatient backlogs in their department on patient care than they were twelve months ago, with only 25% agreeing that their department is able to deliver a service that meets the needs of patients in their area. Respondents were most concerned about outpatient backlogs in glaucoma and medical retina, sub-specialties largely focused on follow-up patients.
Clinic and theatre space
- In a 2024 survey of ophthalmology clinical leads, The Royal College of Ophthalmologists found that sufficient clinic space (71%) and theatre space (53%) were the most important factors for enabling their ophthalmology departments to deliver a service that better meets the needs of patients
IT barriers
- In a 2024 survey of ophthalmology clinical leads, The Royal College of Ophthalmologists found that just 8% of NHS ophthalmology departments have well-functioning electronic patient record systems with optometry. Only 14% have well-functioning interoperable imaging standards, while 29% have well-functioning interoperable electronic eye care referral systems.
Role of independent sector providers
- Health Foundation analysis found that in October 2022 59% of NHS cataract procedures in England were performed by independent sector providers, up from 21% in February 2018.
- In a 2024 survey of ophthalmology clinical leads, two thirds (67%) of clinical leads in NHS ophthalmology departments report that the impact of independent sector provision on patient care has been negative. 28% report a mixed impact, and 5% a positive impact. Clinical leads were most likely to say the impact of independent sector providers on their ophthalmology department had been negative when it came to training opportunities (73%), funding of their department (58%), available workforce (50%) and their ability to deliver comprehensive services (48%). Leads were most likely to say the independent sector had a positive impact when considering cataract waiting lists (29%) and overall waiting lists (18%).
