12 November 2025

The College responds to the government's call for evidence on the 10 Year Workforce Plan

In our response, we have highlighted the critical role of primary eye care and the optometric workforce in delivering integrated, cost-effective NHS services.

In our response, we welcome the government’s three shifts for the NHS in England, which align with the strengths of primary eye care and long-standing priorities we have been championing¹. However, the 10 Year Health Plan lacks detail on delivery, timelines, funding, and accountability for workforce development and service transformation. Achieving its ambitions requires a system-wide approach that makes best use of the existing primary eye care workforce, modernises commissioning, strengthens integration between primary and secondary care, and shifts spending from hospital-based care to community services delivered through neighbourhood teams.

There are almost 15,000 optometrists in England, 80% of whom work in primary eye care settings²
They are registered health professionals and a core pillar of NHS primary care, acting as the “front door” of the NHS³ for most patients with eye concerns
They conduct over 13 million NHS sight tests annually⁴ through 5,000 local practices equipped with modern diagnostic tools
They detect eye and general health conditions, provide assessments, prescribe corrective lenses, and manage a wide range of eye diseases
Optometrists working in secondary care provide core optometric functions and more specialist eye care, increasingly taking on the role that junior or middle ranking doctors in ophthalmology might have once had with eye care patients

In many parts of the UK, primary care optometrists play a crucial role in reducing pressure on hospital eye services and preventing avoidable sight loss. They do so by:

providing first-contact care for eye conditions
delivering urgent eye care in community settings⁶
carrying out routine eye examinations and sight tests

Optometrists with core competencies – as well as those with higher qualifications and independent prescribing rights – safely treat and manage a broad range of eye conditions across both primary and secondary care.

They also use up-to-date imaging technologies, such as Optical Coherence Tomography (OCT), to support diagnosis, ensure continuity of care, and improve efficiency across the system. This helps reduce demand on GP practices and ophthalmology departments while maintaining access to high-quality, local care.

The main barrier to better use of the primary eye care workforce is recognition. Despite clear evidence of the valuable contribution primary care optometrists make to preserving the nation’s sight, the 2023 NHS Long Term Workforce Plan omitted specific provision for optometrists. This is a missed opportunity to use their expertise to benefit patients and the NHS. Commissioners and colleagues in hospital eye services do not have an in-depth understanding of optometrists’ core knowledge, skills and competences.

The optometric workforce also demonstrates strong alignment with the Plan’s strategic objectives:

To nurture homegrown talent. Sustained increases in UK undergraduate admissions and growth in UK-qualified pre-registration placements demonstrate a strengthening domestic optometric workforce⁷. This trend reflects ongoing efforts to cultivate homegrown expertise and enhance national self-sufficiency within the optometric workforce.
To retain skilled staff. The overall optometric workforce capacity has remained stable over time, supported by positive engagement with career development pathways and expanded access to postgraduate qualifications and advanced skills training. These factors contribute to enhanced professional fulfilment, workforce resilience, and improved retention⁸.
To equip the workforce for a digital-first NHS. Optometrists are increasingly undertaking training in emerging and transformative technologies, including artificial intelligence and digital diagnostic tools. This means we can make a substantial contribution to the delivery of a digitally enabled, data-driven health service, consistent with the ambitions of a digital-first NHS^{9, 10}.

References

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