03 December 2025
The Welsh Parliament has published a series of recommendations following an inquiry by the Health and Social Care Committee into ophthalmology services in Wales.
The inquiry report highlights that while reform of primary care optometry has resulted in “impressive results” in releasing capacity from hospitals, further action is needed to address systemic issues within secondary care.
As part of the inquiry, the committee heard that 80,700 ophthalmology patients in the highest risk category for irreversible harm were waiting beyond target treatment dates at the end of March 2025.
The report noted that ophthalmology services in Wales have the highest number of patient pathways awaiting treatment and the second highest number of pathways with waiting times exceeding 53 weeks.
“Due to these prolonged waiting times, many patients face the risk of severe vision impairment or sight loss from delayed treatment. It is this critical issue that prompted the Committee to undertake this inquiry, aiming to understand and address the factors contributing to these extended waits and their serious consequences,” the report stated.
The patient perspective
As part of its submission to the inquiry, RNIB Cymru highlighted the effects of sight loss on individuals.
“We hear from grandparents who’ve lost so much sight while on a waiting list that they never saw the faces of their newborn grandchildren. People waiting for treatment have lost their jobs, which depended on them being able to drive, which they could no longer safely do. What makes this truly heartbreaking is the knowledge that things could have been so different if only they had received the right care and treatment at the right time,” RNIB Cymru stated.
The inquiry report paid tribute to the effect that reform within primary care optometry has had on waiting times for ophthalmology services.
Catherine Wood, of Cardiff and Vale University Health Board, told the inquiry that focusing on the implementation of the WGOS4 pathway had enabled the health board to see 65% of high-risk patients within clinically-recommended time frames.
Wood shared that 1000 patients had been shifted into community care over the past three months.
Optometry Wales chair, Owain Mealing, told the inquiry that WGOS5 services have resulted in a reduction in referrals to eye casualty.
He highlighted that previously there were some constituencies where patients would have to travel cross-border in order to be treated.
“With WGOS 5 you could be managed much closer to home by somebody you know,” he said.
The report noted that organisational reform of primary care optometrist is one of the Welsh Government’s four key priorities for ophthalmology.
“Work in this area to date has shown impressive results in releasing capacity in secondary care, with over 3000 appointments per month moving across into the community,” the report highlighted.
We hear from grandparents who’ve lost so much sight while on a waiting list that they never saw the faces of their newborn grandchildren
Workforce pressures
As part of the inquiry, Health Education and Improvement Wales (HEIW) provided evidence on the current optometry workforce – revealing that only 111 out of 442 students currently enrolled within Cardiff University’s optometry programme are from Wales.
HEIW also noted that fewer than 20 Welsh students were studying optometry in another part of the UK, while 15% of the optometrist workforce within Wales is looking to retire within the next 10 years.
The report noted that this raises concerns about the sustainability of the locally-trained optometry workforce within Wales – and the long-term ability to meet service demand.
Another challenge for ophthalmology services within Wales identified by the report was delays in the national implementation of a digital eye care electronic patient record.
While the Open Eyes platform was launched in Wales in 2021 following a £8.5 million investment, electronic patient records and referrals have not yet been rolled out nationally.
“Nearly five years after its launch, this critical project has still not been fully delivered,” the report highlighted.
A series of 16 recommendations made as part of the inquiry include expediting the full rollout of the Open Eyes electronic patient record and referral system by March 2026 and committing to an investment programme for secondary care – matching the £30m recurrent funding provided to primary care.
The report also recommends prioritising estate upgrades, increasing ophthalmology specialty training places and ensuring that waiting list data for ophthalmology is captured at a sub-specialty level.
Newmedica contracting and managed services director, Karen Croker, welcomed increased transparency around waiting list data in Wales.
She also highlighted the value of cross-border arrangements in increasing access to eye care among Welsh patients.
“Welsh health boards are doing some great work in ophthalmology but also face immense pressures faced in this specialty,” Croker said.
“Newmedica is proud to be working with health boards to address these pressures and provide access to care and treatment at our centres across the border in England,” she said.
The full inquiry report can be read online.
A light in the dark
OT talks to optometrists who are providing extended services in the community in a bid to tackle ophthalmology waiting times in Wales
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