“Missed opportunity” if eye health is not prioritised in 10-Year Health Plan, MP says

Improving eye care services and ensuring high quality care should be a priority for the 10-Year Health Plan and failure to include these things would be a “missed opportunity,” MP Marsha de Cordova told the eye health sector on Monday (28 April).

Eye health needs to be included in the plan in order to address issues around rising demand, as well as to prevent sight loss and reduce wider health inequalities, de Cordova said.

She was speaking at the April meeting of the All-Party Parliamentary Group (APPG) on Eye Health and Visual Impairment, of which she is the chair.

The event, held at the Houses of Parliament, featured speakers from ophthalmology, the charity sector, and those with lived experience of sight loss.

Worries over a “two-tier” health system

Mike Wordingham, policy manager at the Royal National Institute of Blind People (RNIB), said it is vital that a cross-section of voices from across the eye care sector are included in the plan.

The RNIB has consulted with members and service users on their concerns, he said.

Wordingham added that, while the RNIB supports the 10-Year Health Plan, he is concerned that blind people “could be left behind.”

Concerns raised during the consultation included those around inaccessible transport, poor signage at community diagnostic centres, and whether staff would be accurately trained in sight loss, Wordingham said.

“Moving services closer to home, or into our homes, won’t help if we can’t actually access them,” he said.

“People told us that they want access to individualised care, delivered by the right professionals, in the right place, at the right time.”

Speaking about technology, Wordingham emphasised that, while the RNIB welcomes simpler and faster care, platforms must remain accessible to all and that human contact should not be neglected.

The consultation responses raised concerns over a potential “two-tier healthcare” system, he added, noting that: “there is a need for equitable access to care across different demographics, and alternative platforms to be accessible for all.”

Getting this right isn't just about those of us who are blind or partially sighted now. It is about fundamentally future-proofing the NHS for everyone

Prevention of sight loss is key to maximising people’s independence, Wordingham said, but “people stress that advice needs to be accessible and realistic. Healthy living campaigns are no good if you can’t read the packaging or get safe access to gyms or exercise.”

Wordingham noted three priorities identified in the RNIB’s workshops: ensuring that patients understand their eye care journey, that they receive clear information about their diagnosis, and that they can access both emotional and practical support.

Currently, he believes, “eye care services are at a crisis point. The way they are currently operating is unsustainable.”

He noted that the eye care waiting list is still higher than 2019 levels, and that the NHS spends £4.1 billion per year on eye care.

This will increase to £5 billion by 2035, he said.

As a result, the RNIB has laid out six practical steps that the charity believes the NHS should utilise to deliver better eye care.

The first is to improve connectivity by ensuring that all NHS eye care providers have an NHS email address.

The NHS also should ensure that all primary eye care providers have access to advice and guidance from secondary care, Wordingham said, and referrals should be streamlined via the creation of a single point of access.

The fourth suggestion is to embed the RNIB Eye Care Support Pathway, which was published in 2023 and is supported by more than 20 organisations within the eye health sector.

The skill set of optometrists in primary care should be fully utilised, Wordingham emphasised.

The sixth suggestion is that the NHS incorporates further planning for missed appointments into its guidance.

“If implemented nationally, these six proposals could save the NHS millions of pounds every year, pre-empt possible time for those who truly need it most, improve patient experience through faster, more convenient, community-based care, and help prevent pointless sight loss, protecting independence and quality of life, relieving pressure on already overstretched services such as GPs,” Wordingham said.

He added: “Getting this right isn't just about those of us who are blind or partially sighted now. It is about fundamentally future-proofing the NHS for everyone.”

Emphasising examples of best practice

Dilani Siriwardena, the incoming vice president of the Royal College of Ophthalmologists, noted that the college is optimistic about eye care being included in the 10-Year Health Plan.

“Small pockets” of best practice exist throughout the country, Siriwardena said, adding that the eye care profession knows what is needed because of these positive and proven examples.

At the same time, she emphasised that the number of people with sight loss is set to double by 2030, partly due to the ageing population.

Nine million outpatient ophthalmology appointments in 2024 equates to around 1000 ophthalmology appointments carried out every hour, Siriwardena said.

Ophthalmology as a profession has always been open to improvement and if given a policy focus eye care can exemplify the Government’s three shifts, she added.

The ‘three shifts’, set out after Labour formed its government in 2024, involve moving from analogue to digital technology, from sickness to preventative care, and from care in hospital to care in the community.

A pressing need for ophthalmology is IT integration with primary care optometry, Siriwardena said.

She noted that currently, only 8% of Royal College of Ophthalmology members report having digital connectivity with optometry.

A change in this direction would be “transformative,” Siriwardena believes.

The second aspect that Siriwardena hopes to see embedded into the 10-Year Health Plan concerns the ophthalmology workforce.

She explained that, while the desire for clinicians to specialise in ophthalmology exists, 285 more ophthalmology training places are required across the whole country in order to reach “a very basic requirement of three consultant ophthalmologists per 100,000 [of the] population.”

A targeted budget for tackling sight loss is the third aspect that she hopes will be embedded within the plan, Siriwardena explained.

Budgets will not be confirmed until after the 2025 Spending Review, which is expected late this spring. 

The 10-Year Health Plan will be published in June to align with the budget confirmed, the government projects.

The risk of inaction

“We have to be in a position where we prevent sight loss,” optometrist turned MP for Leicester South, Shockat Adam, told attendees.

“We have the capacity – and I’m speaking as an optometrist and [about the] brilliant colleagues that we have in ophthalmology – to prevent disease from happening in the first place.”

At the same time, he acknowledged that optometry does not have the same prescience amongst policymakers as general practice, dentistry or pharmacy.

There is an opportunity with the 10-Year Health Plan to “highlight that there are healthcare professionals on the High Street who can be utilised much better than they already are” in order to reduce the prevalence of unnecessary sight loss, Adam believes.

He added: “That is my first and fundamental goal: to raise the awareness of what we can do, and what is already available.”

That is my first and fundamental goal: to raise the awareness of what we can do, and what is already available

Adam shared his story of being a pre-registration optometrist in a hospital, and witnessing an elderly woman being asked to sign a consent form explaining that she was now blind.

Primary care can feel more personal and more like a family than a hospital setting to many patients, he said.

A “collective approach is needed” to bolster this, Adam believes.

Siriwardena emphasised that, if eye care is not embedded into the 10-Year Health Plan, optometry will remain disjointed from other primary health care services and “we won’t deliver what we’ve talked about.”

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There will also be a stronger commercial objective in the direction of cataract surgeries being performed by independent providers, she believes.

Adam noted that, as an ageing population, “we are outliving our eyes.”

Speaking about financial constraints, however, he noted that “everything leads back to the Treasury.”

Early prevention and integrated working are needed, he said, adding that ultimately, embedding eye care in the plan will save the NHS money.

Children with visual impairments is currently the focus of the APPG on Special Educational Needs and Disabilities, of which he is vice chair, Adam also revealed.

Siriwardena emphasised that children must not be left behind in the creation of the 10-Year Health Plan, and noted a roadmap published in November 2024 by the Children’s and Young People’s Health Policy Briefing Group that laid out how health system could ensure that it makes children a priority. 

Siriwardena also noted that there must be a focus on the economic and social benefits of eye care in the plan, and that optometry reaching areas of high deprivation must also be a priority.