I took as an auspicious sign that eight hours after we debated “What does eyecare need to see from the next government?” at a panel discussion at this year’s Congress in Belfast, the Prime Minister called a general election for 4 July.
If Rishi Sunak had been following our debate, he would have heard an encouraging level of consensus about eye care sector priorities from the ophthalmology, optometry and patient representatives taking part. Adam Sampson, Chief Executive of the Association of Optometrists, Julie Silvestri, Clinical Director for Ophthalmology at Belfast Health and Social Care Trust, and Keith Valentine, Chief Executive of Fight for Sight and Vision Foundation, shared their perspectives on workforce challenges, barriers to joined-up care between optometry and ophthalmology, and the implications of growing independent sector provision of NHS ophthalmology services.
One serious obstacle to bringing down waiting lists and supporting the upskilling of the wider multidisciplinary eyecare team that was highlighted is the very low number of consultant ophthalmologists in Northern Ireland. This was a timely point to make in the same week that we published a position paper outlining the need for a phased increase of ophthalmology training places across the UK to ensure we can better meet patient need.
There was also a clear view that we need to tackle the technical barriers that hamper better integrated services. A lack of common communication systems – such as e-triage, image transfer and even email – were all cited as areas to address.
What came through strongly in this session – and our other Congress event “What next for integrated eyecare?” – was that the four UK nations each have different strengths and weaknesses when it comes to enabling more joined up care between optometry and ophthalmology services. And we can all take lessons from these. Raymond Curran, representing the Department of Health in Northern Ireland, highlighted the progress made in Northern Ireland introducing electronic patient records, and some of our audience members outlined that the funding model in Scotland and Wales has effectively facilitated more optometry-led care.
A survey we undertook in early 2024 confirmed that England appears to lag behind other UK nations in having well-integrated services with optometry. Just 12% of clinical leads in England reported that their ophthalmology services are very well integrated with optometry, compared to 50% across the other UK nations.
The discussion on “What next for integrated eyecare?” heard from Louisa Wickham, National Clinical Director for Eye Care at NHS England. She stressed the need to simplify the pathway and develop more intelligent triage processes. Picking up on the theme of tackling digital barriers, she explained that facilitating two-way communication through NHS Mail and referrals through electronic referral systems are priorities in the short-medium term while facilitating image transfer is the “holy grail” in the longer term.
This tallied with the key priorities laid out by Dr Gillian Rudduck, President of The College of Optometrists. Touching on many of the points raised in our joint vision for better integrated eyecare services, she highlighted the need to support optometrists to be first contact practitioners.
Supporting patients with better information was another ambition shared by panellists. Robert Shilliday, Director for RNIB Northern Ireland, outlined the need to implement the eyecare support pathway as well as provide accessible health information.
A lively audience discussion heard questions around referral refinement and funding and as we approach the general election it is these issues, as well as IT interoperability, that our sector needs to align on if we are to form a vision for the future.
And what of the outcome of that election? If it forms the next government, the Labour Party has committed to “negotiate a deal” with optometry practices to deliver more routine NHS ophthalmology outpatient appointments. It’s vital that we all collaborate to plan how to deliver such a commitment.
With Congress now over for another year, our work continues. With stakeholders in England, Scotland, Wales and Northern Ireland, we’re advocating for the three steps we’ve identified to future-proof NHS ophthalmology services. We want to see an expanded and upskilled eyecare workforce including through an additional 382 ophthalmology training places by 2031, better integrated services prioritising resolving digital blockers, and more effective targeting of limited ophthalmology budgets to where patient need is greatest.