10-Year Health Plan: 1000 new specialty training posts to be created

The Government’s 10-Year Health Plan has promised an increased number of training posts in under-served specialties.

With a focus in specialties where “there is the greatest need,” 1000 new training posts will be created over the next three years, the 10-Year Health Plan said.

The Department of Health and Social Care told OT that the specialties that would receive the new posts would be confirmed “in due course.”

Royal College of Ophthalmologists President, Professor Ben Burton, said that the plans mark “an important step toward a more sustainable NHS.”

“We welcome the recognition of ophthalmology as a priority specialty in outpatient redesign and the commitment to expanding specialty training with 1000 new posts,” Burton said.

“We will make a strong case for a fair share of these places in ophthalmology to meet growing patient demand.”

The Royal College of Ophthalmologists’ 2022 workforce census found that 76% of units did not have enough consultants to meet current demand. The census also called for an increase in specialty training places.

An additional 285 ophthalmology training places are needed in England by 2031 to meet patient need, the Royal College said.

UK medical graduates will also be prioritised over those from overseas when it comes to specialty training, the 10-Year Health Plan said. The ambition is to reduce international recruitment of medics from 34% to less than 10% by 2035.

Delivery of the recommendations made in 2022’s Health and social care review: leadership for a collaborative and inclusive future report will be accelerated. The seventh and final recommendation of the report was to “encourage top talent into challenged parts of the system.”

The elective care waiting list currently stands at 7.4 million, with only 60% of patients seen within the NHS target time of 18 weeks, the plan noted.

In elective care, a patient-initiated follow-up approach, where patients are not booked in for follow-ups by default but are given the responsibility for booking their own appointments where appropriate, will become “a standard approach for all clinically appropriate pathways by 2026.”

Follow-up appointments will be managed via the NHS App. It is hoped that this approach will work to free up appointment slots.

The NHS e-referral service, which allows GPs to request guidance from specialists, helped divert 1.3 million referrals from hospitals in 2024 to 2025, the plan said. The service will be expanded to cover a larger number of specialties over the next decade.

There will also be a focus on more patients receiving specialist care at home, with consultant-led elective services being provided virtually through the NHS App.

This means services will be “available to everyone, regardless of where they live, where safe to do so and always subject to patient choice,” the plan said.

It added that the NHS “will not allow privately-provided digital healthcare to be the only option and we will increase the availability of virtual services for NHS patients.”

The plans will “contribute to our goal to end outpatient care as we know it,” the 10-Year Health Plan said.

It added that: “By 2035, most outpatient care will happen outside of hospitals.”

The need to future-proof ophthalmology services

Burton noted that although shifting care into communities “is welcome where appropriate,” more detail is needed about how plans will be funded.

Consultant oversight also “remains essential to ensuring quality referrals, accurate diagnoses and safe treatment pathways,” he said.

He also expressed concern that there has been little precedent to encourage private providers to avoid ‘cherry picking’ certain procedures when taking on NHS work.

“Outsourcing to for-profit providers in ophthalmology has led to staff losses, wage inflation, and supply-induced demand, leaving insufficient resources for NHS units,” Burton said.

“The new commissioning framework must address these issues if we are to provide a comprehensive, sustainable eye care service.”

The Royal College of Ophthalmologists is “particularly encouraged by the promise of a single patient record,” as outlined in the plan, Burton added.

He emphasised that the “two-way sharing of data and images across care settings is essential to delivering truly joined-up care, reducing delays, avoiding duplication, and improving patient outcomes.”

Burton added: “We look forward to working with the government and other partners to ensure that ophthalmology services are future-proofed and deliver the highest standards of patient care.”