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Academy of Medical Royal Colleges outlines priorities for NHS England’s proposed 10 year plan

19 October 2018

The Royal College of Ophthalmologists (RCOphth) has contributed to the Academy’s response to the proposed 10 year plan to deliver improvements in the NHS. Matt Hancock, Secretary of State for Health and Social Care, wishes to ensure that Medical Royal Colleges (MRCs) and clinicians are key contributors to the planning process.

The Academy has collated priorities and solutions to the challenges facing the NHS from its 24 members to form a high-level response. In addition, the appendix to the main response set outs the challenges and specific solutions facing individual specialties.

“The Academy believes that the overall objective for NHS England’s strategy for the next 10 years should be to secure equality of access to health and care services across the population and wider health spectrum while focussing on reducing unwarranted variation in both processes and outcomes.”

The RCOphth took the opportunity to ensure that the challenges facing ophthalmology are reported at a high level. Recommendations were made in four key areas; Standards, Workforce, Data, and Digital/IT. Emphasis was given to ophthalmic workforce demands over the coming years, as well as recommending that NHS England should mandate the national adoption of NICE guidance for all specialties. The latter recommendation was highlighted in the main report as crucial in improving clinical outcomes by shifting focus to standards rather than reaching targets.

The AoMRC grouped all the responses from the MRCs under the following main areas, of which ophthalmology features:


  • NHS England should mandate the national adoption of NICE guidance for all specialties


  • Investment in Ophthalmologists specialty training places to ensure there are enough doctors qualified in ophthalmology to meet the predicted 30-40% increase in demand over the next 20 years’
  • National workforce planning expertise and resource to work with clinical specialty experts and Colleges to produce clear picture of ideal workforce for medical, non-medical clinical and community staff provision for predicted demand
  • Health Education England funded support to provide national training programme for all non-medical professionals to deliver care safely in regional community and secondary care networks with ophthalmologists
  • Recognition by NHS England, Commissioners and Trusts on the negative impact on training and professional standards by taking routine cases out of the Hospital Eye Service and ensure training must be protected in service transformation or changes in provider
  • National and regional long-term workforce planning with appropriate training provision to meet local population demands and reduce dependency on Independent Sector Treatment Centres and Any Qualified Providers


  • Auditing of national clinical data is proven to raise clinical safety standards and enhance learnings and training to improve patient outcomes. National ophthalmic funding for three years for each of the sub-speciality areas (Cataract, Age related macular degeneration and Glaucoma) would cost a total of £0.9m over a three-year period
  • Providers can use NOD data to plan for the predicted demand
  • Other branches of medicine can adopt principles as data is uniquely collected via Electronic Medical Record (EMR) systems

Digital IT:

  • A joined-up network between hospital clinical and administrative IT systems and optometric systems is required much like the GP-Pharmacy join up
  • National support for ophthalmologists – suitable electronic patient records (EPR) solutions which fulfil College standards in all providers
  • Recognition that where aspects of AI will greatly enhance efficiency and diagnostic accuracy it may also lead to an increase in case identification and service demand

Developing the long term plan for the NHS: A response from the Academy of Medical Royal Colleges

Developing the long term plan for the NHS: Specialty specific recommendations

NHS 10 year plan – RCOphth response to AoMRC