FAQs for members on the Welsh Government consultation on changes to eye care services in Wales

The Welsh Government has put forward proposals to reform ophthalmic services in primary care, May 2023

Q1) What has the Welsh Government launched?

The Welsh Government has launched a consultation on proposed reforms to how eye care services are delivered in Wales.

Q2) What are the timescales?

The consultation process is open until the 19 June 2023.

Q3) Why has the Welsh Government decided to initiate this consultation now?

This work began in Autumn 2019 with Welsh Government working with stakeholders in Wales to develop “NHS Wales Eye Healthcare: Future approach for optometry services”, published in March 2021. After further discussions with a small working group the proposals in the published consultation were agreed, pending formal consultation.

Q4) How is the Welsh Government describing the aims of their consultation?

Welsh Government consider this the next step on their journey to address hospital waiting times and to improve eye healthcare in Wales. They believe these changes will drive forward better access to higher quality service delivery and improved outcomes for the citizens of Wales.

Q5) What is the AOP's current view on the consultation?

Positives - There are a number of excellent suggestions in the proposals, including a higher level of remuneration for optometric clinical services, something that the whole sector has championed. The proposals are also aiming for more care to be delivered closer to where patients live, increasing access and utilising the highly skilled optometry workforce.

Areas of concern - There are a few areas of concern alongside these changes. These include a reduction in the value of the NHS voucher (GOS3) for many patients and a potentially increased burden on domiciliary and low vision services. This could have a negative impact on some of the most vulnerable in our society. The proposals also currently include a number of areas that have not been defined. This makes it difficult to assess if items such as recall periods, additional reporting and governance are fair and deliverable within the agreed fee.

In our view, without answers to our concerns and with so many variables undefined, it isn’t possible currently to endorse these proposals. In our view the consultation process should only have begun once all of the details were available.

Q6) What does this mean for members in Wales?

We think it will depend on how and where you practice. In large practices with a wide range of patient types, these changes could be very good. For members in small practices, who serve disadvantaged groups or communities we have concerns around the viability of these changes.

Q7) What could be the outcomes from the consultation?

There are broadly three options:

  1. The changes are rejected, nothing changes and practices continue as they are now.
  2. The changes proceed as proposed. Following an implementation period and formal approval by Welsh Government the changes would become law.
  3. The changes are partially agreed, but with some alterations. This would require another period of discussion between representatives of the profession and Welsh Government to address some, or all of the concerns.

Q8) What is the timeline for possible changes to primary care ophthalmic services in Wales?

If the proposals proceed without any alterations, Welsh Government has an ambitious timeline for implementation of Autumn 2023.

Q9) What role will we play during the consultation?

The AOP will be listening and advocating for the views of our members in Wales. This will include providing support around some of the more complex regulatory changes in the proposals.

Q10) How will the AOP put together its response to the consultation?

The AOP is in the process of conducting member surveys, focus groups, and face to face events across all aspects of our membership so that we can accurately articulate those views to Welsh Government. We will also consult with our Policy Committee and Virtual Policy Committee.

Q11) How can members share their views?

In order to represent our members’ views we need to hear exactly what those views are; come along to the face to face event on 5 June, or the online event on 13 June, take part in our survey or comment on the topics in our community forums.

Q12) How will we be working with Optometry Wales?

The AOP is working closely with Optometry Wales, providing analysis, document review and modelling of the impact of these proposals.

Q13) How will we be working with other stakeholders in the sector?

The AOP is convening regular sector updates with our partner organisations from across the sector, this includes ABDO, the College of Optometrists and FODO. We are also reaching out to other non-optical sector groups, so that we can fully appraise the impact of changes on vulnerable patients.