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The new commissioning framework in England

Optometrist looking at woman's eyes
Photo taken before COVID-19

We have welcomed the UK Government’s proposals to move towards integrated commissioning over wider areas in England34,35. This will give the opportunity to reduce the confusion arising from local commissioning of extended primary care eye services.

In 2021-22, for the first time, NHS England’s planning guidance sets a requirement for eye care: to reduce variation in access and outcomes by implementing whole pathway transformations and performance. A new annex sets out NHS England’s further requirements for eye care.

By the end of the first quarter of 2022, the systems that will be expected to have been set up are:

  • Urgent eye care services in primary care optometry with an ‘Optometry First’ approach for all urgent (non-emergency) eye care
  • A plan to increase the level of glaucoma, medical retina or diabetic eye screening in primary care
  • An integrated cataract referral and post-operative pathway achieving a decrease in the number of post-operative appointments delivered in hospital
  • Glaucoma and medical retina referral filtering pathways to reduce hospital face-to-face consultations

34www.aop.org.uk/our-voice/policy/consultations/2021/01/12/response-to-the-nhs-england-and-nhs-improvement-consultation-on-next-steps-for-icss
35AOP responds to NHS reform announcement