Eye Care in Local Clinics Can Cut NHS Patient Wait Times

A study has found that shifting eye care services from hospital eye services (HES) to local optometric clinics significantly reduces patient wait times and optimizes NHS resources. The research, published in Ophthalmic and Physiological Optics, highlights how community-based optometrists can provide timely and effective treatment for conditions such as neovascular age-related macular degeneration (nAMD) and glaucoma, leading to improved patient outcomes and cost savings.

Key Findings from the Study

Researchers identified several advantages of utilizing local optometry clinics over traditional hospital-based eye care:

• Reduced Waiting Times: Patients experienced significantly shorter wait times when receiving care in community optometry settings. Suspected nAMD cases were seen within four to five days, while glaucoma monitoring appointments were available within five days. This is a vast improvement compared to longer hospital wait times.

• Shortened Waiting Lists: The backlog of patients awaiting treatment was drastically reduced. The study reported only three patients waiting for nAMD treatment and five for glaucoma at local clinics, compared to 216 and 5,691 patients, respectively, in hospital eye services.

• Efficient Use of Consultant Time: By transferring routine management of common eye conditions to community optometrists, hospital-based ophthalmologists can focus on complex cases, making more efficient use of healthcare professionals’ time and expertise.

• Comparable Patient Experience: Patients receiving treatment in local clinics reported experiences similar to those attending hospital eye services, demonstrating that community-based care is a viable and effective alternative.

A Nationwide Model for Eye Care Improvement

The study, led by Professor Barbara Ryan of Aneurin Bevan University Health Board and Cardiff University, was conducted in collaboration with Swansea University, the University of South Wales, and Sight Cymru. Initially tested within three health boards in Wales, the program has since expanded nationwide, demonstrating the scalability of this approach.

Professor Barbara Ryan emphasized the urgency of improving eye care services, stating:

"Currently, patients are at risk of losing their sight due to long waits for hospital eye appointments. These research findings give hope that there is a solution available in every local high street."

Dr. Mari Jones from Swansea University's Centre for Health Economics echoed these sentiments, highlighting the cost-effectiveness and efficiency of shifting care to community optometry settings:

"This project has shown that empowering local optometrists in optician practices to manage conditions like nAMD and glaucoma can drastically reduce patient wait times and costs without compromising quality of care. By shifting eye care into community settings, patients receive timely, expert care close to home, while hospital specialists focus on complex cases."

Implications for the Future of NHS Eye Care

With increasing demand for eye care services, leveraging community optometry clinics presents a sustainable and scalable model for optimizing NHS resources. By decentralizing care and integrating primary care optometrists into the healthcare system, the NHS can significantly improve patient access to eye care services, ultimately preventing vision loss caused by treatment delays.

The success of this model in Wales could serve as a blueprint for broader implementation across the UK, ensuring that more patients receive timely and effective eye care without overburdening hospital-based services.

Reference:

Barbara Ryan et al, Hospital to community in Wales: What is the value of optometrists playing a greater role in managing neovascular AMD and glaucoma in primary care?, Ophthalmic and Physiological Optics (2024). DOI: 10.1111/opo.13397