Wales

In Wales, there are seven local Health Boards which plan and provide hospital and community services and are responsible for primary care.

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Health Boards are responsible for managing the totality of their budget allocation and making the best use of all available resource. They decide how money for eye care services is spent at local level.

NHS Wales has nationally commissioned a number of enhanced eye care services that go above and beyond the remit of services that are covered by basic GOS. These services are delivered through the Eye Health Examination Wales (EHEW) scheme and enable more people to be managed in the community through an eye health examination, further investigation/examination after a sight test, or follow-up services.

The management of the EHEW and Low Vision service Wales moved to host Health Boards (Aneurin Bevan University Health Board for EHEW services and Hywel Dda University Health Board for Low Vision services) and the associated funding transferred to the Health Boards general allocation. 


EHEW is part of the Welsh Eye Care Services (WECS), which also include Low Vision Services, and a Diabetic Retinopathy Screening Service. WECS is unique to Wales and offers eye examinations for patients with an acute eye problem needing urgent attention, or those at increased risk of eye disease or who would find losing their sight particularly difficult. WECS is available for patients by visiting a WECS registered optometrist practice in Wales and is free at the point of access. All participating optometrists can refer directly to the hospital eye service. 

NHS funded sight tests – who is eligible?

In Wales, the following groups are eligible for NHS funded sight test:

  • under 16 years of age, or under 19 and in full-time education 
  • aged 60 or over 
  • registered as sight impaired or severely sight impaired 
  • diagnosed with diabetes or glaucoma 
  • considered to be at risk of glaucoma 
  • receive income support, or income based job seekers allowance, or income based employment and support allowance
  • receive tax credit
  • entitled to NHS Low income Scheme

In addition, most optometrists can also offer an NHS funded EHEW examination to the following groups:

Band 1

  1. has an acute eye problem
  2. is uniocular
  3. is hearing impaired
  4. has Retinitis Pigmentosa
  5. was referred by a GP
  6. is at risk of eye disease due to ethnic background 
  7. needs investigation to comply with Welsh Government agreed protocols and guidelines: 

    a. any patient with an eye problem not related to diabetes picked up in Diabetic Eye Screening Wales (DESW)

    b. any patient with Dry Macular Degeneration or non-treatable Wet Macular Degeneration may be monitored every year as an EHEW Band 1 because of the risk of further Wet AMD changes.

    c. any patient referred from a local Pharmacy using the Common Ailment Service.

    d. Ocular Hypertension (OHT) / glaucoma suspect monitoring. 

Band 2: Further investigations/ Examinations

Band 2 enables the optometrist or the ophthalmic medical practitioner (OMP) to further inform their referral, investigate clinical findings or determine management following a GOS or private sight test only. 

Band 3: EHEW Follow-up

After a Band 1 EHEW, an optometrist or OMP may need to see the patient again on another occasion to ensure the patient is being clinically managed in the most appropriate way. 

A Band 3 EHEW is to be used at the discretion of the optometrist or OMP to include any procedures they feel are clinically necessary. 

A Band 3 follows a Band 1 only, unless it is for an uncomplicated post-operative cataract examination when a General Ophthalmic Services (GOS) or private eye examination and then an EHEW Band 3 is used. 

 

More information on the Eye Care Wales Services website.

Details of NHS general ophthalmic fees and optical voucher values.  

The list of eye care services.

Also see...

 

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