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Date posted: 4th April 2023
This is an article by Marsha De Cordova, Labour MP for Battersea, originally published in The House magazine.
Sight loss is something that I live with, along with over two million others in the United Kingdom.
With an aging population and chronic underinvestment in eyecare services, it is increasingly important that we take a more coordinated approach to prevent avoidable sight loss and support those with vision loss to live rich fulfilling lives.
Long backlogs for hospital eyecare services starkly illustrate the problem. At the start of 2023, over 630,000 patients were waiting to see a consultant ophthalmologist following referral – that’s 9 per cent of the entire NHS backlog in England. These appointments will range from those waiting for a cataract operation to people needing a diagnosis for suspected glaucoma. Inefficiencies in eyecare are particularly consequential. Any delays can lead to deteriorating vision and potentially permanent sight loss and blindness.
A workforce census recently published by the Royal College of Ophthalmologists makes clear that wait times will get worse without immediate action. It found that 82 per cent of NHS eye units do not have enough consultants to meet patient need, with two-thirds using locums to cover vacancies and 63 per cent estimating it will take at least a year to clear their outpatient backlogs. In short, England’s eyecare is a crisis in the making. But it doesn’t have to be.
Investment in the eyecare workforce is one important part of the solution. This will include increasing the number of ophthalmology specialty training places to increase the ranks of consultant ophthalmologists in the coming years. This should be complemented by the creation of more roles like ophthalmic technicians and image graders, who can quickly expand capacity and help to deliver innovative care in surgical hubs and community diagnostic centres. Also crucial will be enabling more care to be delivered outside of hospitals by supporting optometrists and orthoptists to work to the top of their license.
The workforce challenges facing eyecare services are compounded by issues integrating primary care optometry – where patients will receive an eye examination and be referred to secondary care if surgery or specialist treatment is needed – with ophthalmology services. The process is often slowed down by a lack of joined-up IT infrastructure, leading to delays in patient care. Establishing a national electronic eyecare referral system would make it easier for optometrists to refer into secondary care without having to go through their GP. It would also make it much simpler to share images between systems, speeding up patient diagnosis and treatment.
This complex picture underlines the need for proper coordination of eyecare services. That is why I have introduced a National Eye Health Strategy Bill – to ensure we have a system where everyone can access the right eyecare, when and where they need it and which supports local decision-making with national accountability.
Our constituents deserve our attention on this issue. With demographic changes and age-related macular degeneration cases predicted to rise by 59 per cent over the next two decades, and cataract operations increasing by 50 per cent, we cannot afford to continue with the current piecemeal approach.
I know from personal experience that NHS eyecare services in England provide excellent care to patients despite the pressures they face. But the situation is not sustainable, and now is the time to build an eyecare health system that is fit for the future to ensure all patients can access world-leading care.
I urge my colleagues to support the bill through its Second Reading in the Commons later this year. This is an issue which affects all of us – every MP has constituents affected by ocular issues, and it is our duty as their representatives to ensure they do not suffer avoidable deterioration of eye sight and are supported to live fulfilling lives while experiencing sight loss. Investment in eye health is an investment in the future of our country and people.
The APPG on Eye Health and Visual Impairment, which I chair, will be focusing on the topic of the eye care workforce at our next meeting on 26 April.
The scale of the challenge is huge, and I hope MPs of all parties will come together to tackle it in the months ahead.