Policy briefing: Budget response 2024

What has been announced?

The UK Government has announced a budget setting out £40 billion of tax increases that will aim to improve public services such as the NHS. The main changes announced in the budget are:

• Increased taxes on employers due to an increase in employer national insurance contributions
• Increased spending on a range of public services including the NHS.

What do we say?

We are pleased to see the announcement of an additional £22.6 billion of funding for the Department of Health and Social Care (DHSC) from 2023-24 to 2025-26. It has been clear for some time that secondary care is under immense strain with significant waiting lists of which ophthalmology is one area under continued pressure and where patients are struggling to access care.

That is why we have been making the case for how optometry can help to tackle the ophthalmology backlog and save the NHS money. However, for this to happen it is important that a small portion of the £22.6 billion of additional funding is directed towards the chronically underfunded NHS sight testing service. A service that is the bedrock of eye care and does so much, for so little, a service without which most glaucoma would go undiagnosed until there had been significant vision loss.

This funding flow is even more crucial, given the increased pressure that this budget has placed on practices. The increase in employers National Insurance (NI) contributions from 13.8% to 15% and the reduction in the threshold when NI contributions must be paid from £9,100 to £5,000 is another unwelcome cost pressure on many practices. For some small practices, the rise in the threshold of Employment allowance (a national insurance concession for small businesses) from £5,000 to £10,500 may help to offset this rise. However, for the wider primary eye care sector, the cost of delivering NHS sight testing services will have been increased by this change to NI, that in conjunction with additional changes to minimum wage and the wider wage pressures this will trigger, will be unwelcome for many practices.

We also note that the Chancellor has announced an additional £3.1 billion of capital investment in 2025-26, and it has been suggested that some of this will go towards diagnostic centres. As we have said previously, within primary eye care that investment already exists and there is little need to replicate this in diagnostic centres. Instead, this funding should be directed towards those areas of diagnostics where there is current under provision, that is not true for primary eye care which has the diagnostic equipment and skills but lacks the connectivity to the wider health system.

Funding is needed to uplift the NHS sight test fee and commission, the range of services that our members can deliver to reduce the pressure on secondary care. Minor and urgent eye care services, alongside glaucoma care delivered in an optometry setting, can make a significant difference to patient care, but they must be widely commissioned to be effective.