‘Unintended consequences’ of proposed healthcare reforms in Wales need a rethink, urge eye experts

The Association of Optometrists warn that key changes to primary eye care funding will disadvantage some of the most vulnerable patients in Wales

  • Proposed Welsh Government funding cuts will see a number of domiciliary services reduced by 30%
  • Figures reveal that an estimated 30,000 people who rely on access to sight care in their home could be left with poor or inadequate choices
  • In a survey of optometrists providing sight care in Wales, 40% said they were worried that giving care to patients in their home will be more difficult, with over half (52%) admitting they are either unsure of the benefits of the new proposals or believe they will have little effect on reducing pressure on other healthcare services, like hospitals and GPs, as intended
  • The Association of Optometrists (AOP) is calling on the Welsh Government to halt changes that could threaten vital services for elderly and housebound patients

Patients who receive sight care and low vision services in their home are at risk of losing access if the latest healthcare reforms proposed by the Welsh Government go ahead in their current form, as early as autumn 2023.

Eye care professionals have raised serious concerns over proposed funding cuts, which will see a number of domiciliary services undergo a cut to the visiting fee from £38.27 to £26 per patient. The fee for annual low vision assessments, which often includes providing aids that support a patient’s independence and referrals to services such as GPs, will be reduced from £80 to £53.

Responding to the proposals, Adam Sampson, Chief Executive of the Association of Optometrists, said: “There is no doubt in my mind that that the Welsh Government’s intentions are good. We all want patients to be able to access timely care and for the backlog to be cleared. But looking at the detail of the proposal, there are a number of unintended consequences that will have a significant impact on some of the most vulnerable patients in Wales.

“Crucially, we are urging the Welsh government to rethink the funding cuts to the domiciliary service and the low vision service. Optometrists are telling us the existing services will disappear, particularly in rural areas, because members simply will not be able to afford to deliver them. For patients who have no other way of accessing care outside their home, these proposed changes will limit patient choice and access to healthcare, with potentially devastating consequences to their quality of life.”

Kamal Kalsi, an optometrist working in domiciliary services for over 20 years and the AOP’s Councillor for Wales, said: “Patients will often say to me, ‘You are the only person I will see outside of my family for days or weeks at a time’. In some cases, they don’t have family or friends visiting at all. Not only do these services help to protect the sight of vulnerable elderly patients, but they significantly reduce the risk of falls and can provide an absolute lifeline to many other vital community services such as GPs, social services and mental health support.”

The domiciliary service is delivered throughout Wales, covering more than 30,000 patients.

In a survey of its members in May, the AOP found that almost half (44%) highlighted further concerns over services for specific groups – particularly those on low income, eligible for an NHS sight test voucher. Over 60% said these patients would be negatively impacted, facing increased costs and less choice on the glasses they can buy if they are: under 40 on low income; over 40 and under 60 on low income; over 60 and eligible for an NHS voucher.

The proposals remain under review as part of nationwide consultation in Wales, which closed on 19 June. The AOP has submitted its response to the Welsh Government.


For more information, please contact Serena Box, PR and Media Manager, at the Association of Optometrists, [email protected] or telephone 020 7549 2040.

Notes to Editors

Association of Optometrists

The Association of Optometrists (AOP) is the leading representative membership organisation for optometrists in the UK. We support over 80% of practising optometrists, to fulfil their professional roles to protect the nation’s eye health. For more information, visit