16 March 2026
The UK health system is under “unprecedented” pressure, with over seven million people currently waiting for hospital appointments, according to consultant ophthalmologist and medical director at Newmedica, Nigel Kirkpatrick.
Within eye care , patients already under the care of hospital services often miss timely follow-ups for conditions like glaucoma and age-related macular degeneration (AMD), creating hidden risks, he highlighted when talking to OT ahead of his Future ready eye care: integrated solutions for an evolving landscape presentation at 100% Optical (28 February–2 March).
Speaking about the challenges within secondary eye care, Kirkpatrick emphasised the urgent need to understand where patients are in their referral and treatment journeys, and where delays exist.
“We need to know where these patients are and where the delays are, because only then we are able to design a service that actually meets their needs in the future,” he said.
Kirkpatrick described the past five years as “particularly volatile” for hospital eye care services. He explained that COVID-19 caused widespread disruption, temporarily halting many services, but also highlighting the potential of extended optometry-delivered community-based eye care.
“Actually, COVID-19 was a time when the independent sector, including ourselves, earned our spurs,” Kirkpatrick noted.
Despite a ‘Goldilocks’ level of cataract surgery – neither too high nor too low compared to other European countries – the backlog in glaucoma and AMD services remains significant, Kirkpatrick highlighted.
He expressed that political changes and the NHS 10-Year Health Plan announced in July 2025 present an opportunity to “reimagine” the delivery of eye care.
“The optimist in me hopes that things will be a lot better in the future. But it does involve shifting patients out of hospital-based care and embracing digital technology,” Kirkpatrick said.
Central to the solution is the role of primary care optometry, the ophthalmologist noted.
Kirkpatrick emphasised that frontline optometrists are perfectly positioned to prevent vision loss and reduce pressure on secondary care.
“Optometrists are the frontline general practitioners of eye care, by a million miles. They are absolutely key to the whole thing,” he said, adding: “We need lots of them, and we need them motivated, rewarded, and included in pathways.”
To prepare for this future-ready role, Kirkpatrick urged optometrists to build on their clinical training post-qualification.
When asked what enhanced skills he felt optometrists should focus on, he identified advanced skills in glaucoma management, medical retina, and independent prescribing as increasingly important, “not only for patient care but for professional satisfaction.”
“I think it’s the most satisfying stuff, and what optometrists want to do and how they want to spend their time,” he added.
However, there are challenges to overcome to enable eye care professionals to take on enhanced roles. With 42 Integrated Care Boards (ICBs) across England, there are 42 “versions of the truth,” Kirkpatrick told OT, expressing that this creates inconsistencies in patient access and commissioning.
This siloed approach contributes to inefficiency and risks creating a two-tier system, he said.
“If you remain siloed, then there’s a real risk of a two-tier system. That’s not good for the nation’s eye care,” Kirkpatrick warned.
Kirkpatrick sees digital integration as a crucial part of the solution. The NHS online hospital system offers the potential to link up patients, optometrists, and hospitals, reducing duplication and making eye care more accessible. “If we get that right, we may see a reduction of this postcode lottery,” he said.
When future-gazing, for Kirkpatrick joined-up pathways are key. “We’ve got to get efficient and joined-up. That’s the only hope for us,” he said.
With a growing ageing population and the increasing prevalence of conditions like glaucoma and AMD, Kirkpatrick is passionate that “the role of optometry has never been more vital.”
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