The Government’s 10-Year Health Plan presents an unprecedented opportunity – one we must not miss. 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 focus and spending from hospital-based care to community services delivered through neighbourhood teams.
Many proposals in the Health Plan echo long-standing priorities championed by The College of Optometrists [1]. Primary eye care demonstrates how a highly accessible, prevention-focused service can improve patients’ outcomes, reduce health inequalities, and support long-term sustainability.
However, most citizens in England with low-risk eye conditions do not have access to primary care-based management and monitoring schemes. Despite the potential of primary eye care to alleviate the pressures on hospital eye services, inconsistent commissioning and fragmented approaches have led to a postcode lottery in service availability, perpetuating inequalities in access to care.
Delivering a sustainably accessible, equitable, and responsive primary eye care service will require:
- Optometrists commissioned to practise to the full extent of their training and competence, supported by appropriate workforce planning.
- Access to enhanced, shared care pathways based in primary eye care for all appropriate patients.
- Full utilisation of primary care optometry within neighbourhood health services, supporting prevention and early intervention.
- Routine collection and disaggregation of data on access, outcomes and patient experience to identify and address inequalities.
The College of Optometrists urges the APHG to include the following recommendations, which offer practical policy solutions to deliver lasting improvements in primary care:
- Prioritise sight loss prevention.
- Ensure primary care optometry is recognised as a core provider in commissioning and planning of neighbourhood health services.
- Raise public awareness of optometry-led first contact and specialist services to reduce pressure on GPs and A&E.
- Retain and expand proven, effective enhanced eye care pathways.