NHS backlog emergency forcing people to go private or risk permanent sight loss, latest survey finds

Yearly rise in the number of optometrists seeing patients experiencing delays of 12 months or more for secondary NHS care

  • Almost a fifth of optometrists have at least 20 patients facing delays of over a year
  • 81% say patients are been forced to pay for private treatment, including cataract surgery and help for glaucoma and age-related macular degeneration or risk sight loss, within the last six months due to long NHS waiting lists
  • The Association of Optometrists (AOP) is calling the situation an ‘emergency’ and urging Government to use eye care services on the High Street, nationwide, to slash the backlog and end the postcode lottery of commissioned eye care services
  • The AOP says huge numbers of High Street optometrists are qualified to offer the extended services required to take the burden off the NHS
  • Today the AOP are writing to the new Parliamentary Under-Secretary of State for Primary Care and Public Health, Dame Andrea Leadsom asking for urgent support and to double down on commitments made by her predecessor, Neil O’Brien.

New data shows that the NHS backlog emergency is forcing many patients to go private or risk permanent sight loss, and the situation is getting worse say eye experts, who are calling for an end to postcode lottery commissioning.

More than three-quarters (79%)i of optometrists have patients experiencing significant delays of 12 months or more for their secondary care referrals, follow up appointments or treatments.

This marks a rise from 72% at the same point last year and almost a fifth of optometrists (19%) now have at least 20 patients facing this situation.

The figures come from the Association of Optometrist (AOP), whose survey examined the experiences of more than 1,000 High Street optometrists across the UK.

Its findings show 81% have patients that have been forced to pay for private treatment within the last six months due to long NHS waiting lists, or potentially risk permanent sight loss.

Currently, 640,736ii people are waiting for NHS ophthalmology appointments in England alone – an increase of more than 12,000 since the AOP released figures in March 2023. Almost 20,000 have been waiting more than a year.

The Association of Optometrists (AOP) says the Government must commit to a national approach to eye health services to make sure patients can access the care they need quickly and close to home.

Under the current system, many essential appointments take place in hospital, but waiting times for follow-ups and treatment could be significantly reduced if care provided by optometrists was commissioned consistently.

Many optometrists working in the community already successfully provide follow-up services in some parts of the UK.

One such practice is Sight Opticians in Peterlee, County Durham where all routine referrals are triaged with their local hospital, and any extra tests needed, such as internal images of the eye or visual fields assessments, are carried out before the secondary care appointment.

Optometrist at the practice, Adam Smith says: “We have a long-established extended service and have seen the huge impact it can have. It reduces both unnecessary referrals to hospital where certain care and tests can be carried out in a local practice. Patients are saved the wait while also getting more appropriate care faster.”

Another example is Specsavers Bolton, where a new initiative at the practice has seen a 50% reduction in glaucoma referrals into hospital.

Optometrist Director at the branch, Matthew Thornton, says: “High Street optometrists undergo years of training not only to spot eye health conditions, but also to treat many of the most common ones.

“In our glaucoma enhanced referral service (GERS), patients with suspected glaucoma can be referred to a qualified optometrist for further investigation, rather than straight into secondary care at a hospital. This reduces the number of people waiting for a hospital glaucoma appointment by half.”

Responding to last week’s Cabinet reshuffle, Chief Executive of the AOP, Adam Sampson has written to the new Parliamentary Under-Secretary of State for Primary Care and Public Health, Dame Andrea Leadsom asking for urgent action.

Chief Executive of the AOP, Adam Sampson said: “We all recognise that the NHS is under greater pressure than ever before and the latest figures paint a very stark picture. More people than ever are waiting longer than ever for sight-saving treatment.

“We’re now in a desperate situation. Patients are being forced to spend their savings on private treatment to avoid losing their sight – not to mention the many where paying for private care is simply not an option. The NHS should always be free at the point of need. And in the middle of this turmoil it is deeply concerning that the Ministerial health team have again changed significantly following the latest cabinet reshuffle.

“Optometry has already been recognised as the right solution and a way out of this emergency. Optometrists are qualified to provide many of the extended services needed to cut waiting times while also being available on High Streets across the UK.

“But we need action now to end the variability in commissioning which is blunting the impact of eye care services in England. Which is why we’re calling on the new Parliamentary Under-Secretary of State for Primary Care and Public Health, Dame Andrea Leadsom, to take urgent steps and double down on the commitments made by her predecessor, Neil O’Brien.”

Marsha de Cordova, Labour MP for Battersea, and Chair of the All-Party Parliamentary Group on Eye Health and Vision Impairment has been leading the campaign in Parliament to have a national strategy for eye care introduced.

She said: “England is the only country in the UK without an eye health strategy. Despite the worrying backlog, the Government still refuses to introduce a strategy that will ensure better health outcomes for patients. A national approach will remove the postcode lottery of care, and reduce the risk of patients getting stuck on hospital waiting lists and in turn prevent the avoidable and irreversible sight loss we’re seeing today.”

UK MPs across all parties will today receive a briefing from the AOP highlighting the scale of the problem and urging them to act swiftly to tackle the issue.

The AOP’s campaign is calling on members of the public and the optometry profession to contact their constituency MP to support the demand for change, with more information available at 


For more information, please contact Serena Box, Head of Media, PR and External Affairs, 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 voice of the optical profession, representing over 80% of practising optometrists. The AOP elevates the work of its members, safeguards their interests, and champions eye health across the UK. For more information, visit


The Voice of Optometry panel, set up by the AOP in 2017, provides research from the optometry sector. 1093 practising optometrists completed the online survey between October - November 2023.
ii NHS England, Consultant-led Referral to Treatment Times, September 2023