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Enhanced eye care services

Extend community eye care services, reducing the pressure on A&Es and GPs

Patient having an eye test

A nationally commissioned service of Minor Eye Care Services (MECS) and Community Eye Care Services (CUES) would provide more equitable eye care while bringing down NHS backlog in ophthalmology and cut costs.

MECS and CUES are currently optional, locally commissioned services which provide urgent eye care services in the community without the need for referral to secondary care hospital eye services, and unburdening GP Services. As MECS or CUES are not universally commissioned many practices (39%) do not offer these services, but 75% say they are ready and equipped to do so.16

A new clinical specification for community minor and urgent care has been developed. However, without a clear mandate to commission as a standard service specification, ICBs will continue to commission extended eye care services on an ad-hoc basis as they have been, resulting in a postcode lottery for eye care. We believe that patients, regardless of where they live or work, should be able to access these services and experience the same level of care.

Case example

In a data set from Hereford in 2022, 92% of referrals to eye casualty by GPs could have been seen in optometric practice via MECS and 83% of self-referrals to eye casualty could have been seen in MECS.17

Case example

A study from 2014 compared the impact of the introduction of MECS in Lewisham and Lambeth from 2013-2014 on ophthalmology hospital departments. It found that in Lewisham general practitioner (GP) referrals to hospital ophthalmology decreased by 75%, and 30% in Lambeth.

In terms of costs, the study found that for the comparison area which did not have a MECS service introduced (Southwark), the costs over 2013-2014 increased by 3%, however in Lewisham and Lambeth where MECS were established, costs fell by 14% and increased by 3% respectively, both lower than the area without MECS.18

References

16. OT Insights report, October 2023
17. Daire J Hurley, Simon Neary & Evelyn O’Neill. (2022) An analysis of the conditions referred to an eye emergency department. Expert Review of Ophthalmology 17:3, pages 211-216