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NHS Long Term Plan – The Ophthalmic Angle

Last week I blogged about the government’s newly announced Long Term Plan for NHS England which was introduced earlier this month.

Targeted significant improvements are envisaged for a number of different sectors in the NHS, including provision for mental health services and cancer care.

However the RNIB (Royal National Institute of Blind People) has just published a policy briefing looking at the proposals from an ophthalmic angle. Sadly there appears to be very little additional targeted support envisaged for blind or partially sighted people despite ophthalmology being the largest NHS outpatient speciality.

Helen Lee, Eye Health Policy Manager at the RNIB was quoted as saying:

‘The NHS long-term plan is welcome, particularly the focus on prevention and the use of new technology. Although there is a clear intention to address the rising demand for health services across the board, RNIB is not convinced there is sufficient focus on eye health to address serious issues such as a worrying lack of capacity in eye clinics’

‘Timely treatment for eye conditions is critical when it comes to preventing avoidable sight loss, and we would urge NHS England to ensure its delivery plans have a serious focus on the current issues affecting eye health’

The RNIB is arguing that this is a wasted investment opportunity at a time of crisis in eye care. Better use could be made of technology and the skills of the eye care workforce to improve referrals and the eye care pathway, to better ensure patients can access treatment quickly, in circumstances where time can often make the difference between a good and poor outcome.

Whilst every sector in the NHS makes the case for increased funding, particularly in times of austerity, the case for more eye care funding was made very powerfully by the All Party Parliamentary Group on Eye Health and Visual Impairment in their report entitled ‘See the Light: Improving Capacity in NHS eye care in England’ in June 2018.

In the report it was recognised that whilst the NHS provides excellent care to many people with eye conditions and there is much good practice, the current system is failing patients on a grand scale with services being delayed and time-critical appointments being cancelled. A number of specific recommendations were made by the group (some of which could have been addressed in the government’s Long Term Plan) including:

  • To appropriately resource and support Local Eye Health Networks within sustainability and transformation partnerships (STP’s) and Integrated Care Systems to drive improvement;
  • For NHS Digital to implement routine data collection in ophthalmology departments on waiting times for follow-up appointments, delays to follow-up outside clinically recommended timescales, patients lost to follow-up, and consequences;
  • To urgently review the National Tariff for ophthalmology which currently seriously disadvantages some patients with glaucoma, wet aged-related macular degeneration (AMD), and diabetic retinopathy who require follow up appointments and are particularly at risk of avoidable sight loss.

It is sincerely hoped that these goals and others will still form an important part of the NHS’ strategic vision for eye care for the next 10 years and beyond, so that the incidence of avoidable sight loss can be appropriately contained.


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