Policy briefing: Spending Review

The AOP’s summary – and what it means for optometry

What has been announced?

The Government has published the much-awaited Spending Review. The document outlines the government’s departmental budgets for day-to-day spending until 2028-29, and capital investment decisions until 2029-30.

Total departmental budgets are set to grow by 2.3% across the Spending Review period. However, for optometry, it is important to consider the specific spending commitments made to the Department of Health and Social Care (DHSC) regarding the NHS and particularly the NHS in England.

The Spending Review states that the NHS will receive an additional £29bn across a three-year period; this will take the day-to-day spending (revenue) to £226bn by 2028-29. This is money that will be spent on staff, wages, medicines and consumables. In addition, there has been an announcement of an additional £2.3bn increase in DHSC’s capital budget; this budget funds spending on buildings and technology. There will also be an investment of £10bn in NHS technology and transformation by 2028-29 and there is an aim to begin to move care out of hospitals. There are also smaller commitments to services such as smoking cessation programmes of around £80m per year.

The devolved governments of the UK will receive an uplift in revenue funding and capital funding.

The Government asserts that this funding settlement will move the NHS ‘past the recovery phase’, cut waiting times, and deliver an NHS that is ‘fit for the future’. The foundation for this reform is the Government’s three shift from analogue to digital, from hospital to community, and from treatment to prevention.

What do we say?

The announcement of additional funding for the NHS is welcome. More money into the wider NHS system – specifically outside of the hospital setting – should mean a greater opportunity for the NHS to fund services that improve patient outcomes, and bring care closer to where people live. However, the increased funding is likely to come under immediate pressure from a growing, ageing population, and the increase of people living with long term health conditions. Alongside this is the prospect of potential industrial action as resident doctors demand improvements to their pay. The Spending Review makes it clear that any such increases must be funded from the newly announced funding envelope.

The Spending Review highlights the Government’s commitment to the importance of moving care from hospital to community, and optometrists can play a significant role in helping them to achieve that principal aim. By utilising the skills and equipment in primary care optometry, pressure on GP colleagues can be released. The evidence that primary care optometry can have the same effect for secondary care is clear; as the recent report by PA Consulting shows, optometry-delivered services can create capacity and deliver health and economic benefits. It is imperative that some of the newly announced funding is utilised to commission these services in all parts of England.

The PA Consulting report also demonstrates the health and economic value that the General Ophthalmic Services (GOS) sight test delivers, but a commitment to further investment in GOS is needed to ensure the service is sustainable in the long term.

One critical factor to fully optimise what optometry can achieve for the NHS is IT connectivity. We say that it is vital that a proportion, as little as £25m (0.25%) of the £10bn earmarked for NHS technology is utilised to ensure that optometry is fully connected to the wider NHS. Not only is this consistent with the wider aim to move from analogue to digital, but it is only by doing so that the true potential of optometry will be unlocked, enabling the government to lay the foundations for its ambition for a ‘Neighbourhood Health Service.’