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Eye health experts call for urgent action on hospital eyecare to reduce delays and improve patient safety

7 February 2020

The Association of Optometrists (AOP), The College of Optometrists and The Royal College of Ophthalmologists have joined forces to issue a statement outlining steps to tackle increasing pressure on hospital eye departments in England.

Calling on NHS England leaders, the organisations are urging that new models of eyecare with adequate funding, are introduced in a bid to protect patients from failings that pose a risk to sight.

The call follows recent findings from the Healthcare Safety Investigation Branch (HSIB) and the Getting It Right First Time (GIRFT) Ophthalmology report which highlighted serious inadequacies in eye healthcare and an urgent need for change.

Under existing services, as many as 22 patients a month across the UK suffer severe or permanent sight loss because their follow-up appointments and treatment in hospital do not take place quickly enough1.

Clinical Director for the AOP, Dr Peter Hampson said: “Under the current system, things are simply not working. We’re regularly hearing stories of patients that are suffering as they live with unnecessary sight loss. National recommendations were made on the referrals process for conditions like glaucoma over a decade ago and yet people continue to experience the same systemic failings. We believe it’s time to see a change. Making full use of the skills of other professionals, such as optometrists, could release time for ophthalmologists to manage cases where the patient has more complex needs.”

Melanie Hingorani, Chair of Professional Standards at The Royal College of Ophthalmologists and UK Ophthalmology Alliance said: “There is an enormous amount optometrists and ophthalmologists can do to reduce care delays for patients with eye conditions if we work together. However, we need NHS England and Improvement to enable greater collaboration by urgently addressing the many barriers in the current system limiting this.”

The College of Optometrists’ Director of Policy and Strategy, Dr Sarah Cant, said: “This joint statement is an acknowledgement of the root and branch reform that needs to happen across England to alleviate the pressure that hospital eye health services and patients are experiencing.  We know that there are some areas where optometrists’ skills are utilised in enhanced services schemes, resulting in patients being seen quickly and their treatments managed locally.  These need to be available across England if we are to tackle the systemic problems now being faced.”

In their joint statement, the organisations have set out immediate steps to improve patient eyecare referrals in hospitals in England. The document includes guidance for commissioners, hospital eye departments, individual ophthalmologists and optometrists to better integrate services and pool existing resources. For example, ensuring that only patients whose conditions need secondary care input are seen in hospital will improve capacity for patients with serious and sight-threatening conditions.


  • Demand for hospital eyecare in the UK is unprecedented and growing – in 2018/19, ophthalmology was the largest outpatient speciality in England, with over 7.9 million appointments
  • As the UK’s population ages, with the number of people aged over 65 projected to rise by over 40% in the next two decades, more people will need treatment for serious eye diseases such as cataracts, glaucoma and age-related macular degeneration (AMD)
  • It’s estimated that glaucoma cases will increase by 44% over the next 20 years, and AMD cases by 60%3

The joint statement, Improving patient safety and experience when referring to hospital in England can be accessed from the AOP website or via The College of Optometrists or The Royal College of Ophthalmologists websites.


[i] Foot, B., MacEwen, C. Surveillance of sight loss due to delay in ophthalmic treatment or review: frequency, cause and outcome, Eye volume31, pages771–775 (2017) see also:

[ii] Source NHS Digital Hospital Outpatient Activity 2018-19:

[iii] The Royal College of Ophthalmologists: