People back greater use of high street opticians to cut NHS waiting times

With a new survey revealing people’s health deteriorating amid long waits for specialist eye care, Healthwatch England has called for greater use of high street optician services, including optometrists working in optician services, to help cut waiting times. 

An optometrist’s role is to detect defects in vision, signs of injury, ocular diseases or other abnormalities. Optometrists often work alongside other professionals in primary eye care, supporting people with a range of eye problems and referring people for specialist care.  Expanding their role and responsibilities, such as being able to treat patients for a greater range of conditions, would help more people with the most serious eye conditions to be identified and referred for specialist care earlier.

Responses from 1,051 self-selecting people currently waiting for specialist eye care appointments suggest that the vast majority (85%) of people support the idea of optometrists being able to refer patients without seeing a GP first. Over 65% are comfortable with them helping to monitor and treat eye conditions. 

The survey, which asked people to share their experiences of eye care between July and September 2024, found many people struggled while waiting for specialist care: 

• Of those currently waiting, 70% said they noticed some deterioration in vision.
• People currently waiting for eye care reported that long waits affect their ability to continue their hobbies, 75%; mental health, 69%; ability to work, 52%; and relationships, 36%.
• The most common type of support people reported needing was ‘knowing who to contact for further information’ about their care. However, only 14% of people said they knew who to contact.
• Barely any people (4%) said they had been given advice and information to help them with day-to-day activities, such as working. 

Eye care is the busiest outpatient speciality in the NHS in England, and with an ageing population, demand is set to grow further. 

According to NHS statistics, last December nearly 600,000 people were waiting for specialist eye care, a third of whom (33%) had been waiting more than the 18-week target set by the Government.

And getting referred for specialist eye care may be a long process for some. Of those currently waiting, almost a quarter (22%) had to have multiple appointments before being referred.

The patient champion calls for optician services to take on more responsibility for managing people’s eye care and referring them for specialist treatment to help cut waiting times. Additionally, actions such as those proposed in the Optometry First model are needed to improve communications and support for people waiting for eye care.  

Chris McCann, Deputy chief executive at Healthwatch England said: 

"Long waits for eye care are having a huge impact on people's daily lives, including their ability to work, manage daily tasks, socialise or take part in hobbies such as reading.

“We know that highly skilled optometrists in the community are in every locality in England. Our survey shows overwhelming public support for better using this capacity through models such as Optometry First, where optometrists and their teams support patients before and after hospital care. This provides an ideal opportunity for them to take on more responsibility for managing people’s eye care and referring them for specialist treatment.

“There also needs to be better communication and support for those stuck on waiting lists. The positive impact of Eye Care Liaison Officers, a Royal National Institute for the Blind programme that provides vital support to those diagnosed with a condition that affects their sight, is well documented. 

“We ask the NHS to ensure trusts and other commissioners and funders of eye care services support the increase and sustainability of this programme, which is not currently available to all patients. 

“Lastly, the NHS should publish condition-specific data to ensure patients with the most serious eye conditions get help first.”

The NHS publishes waiting list data for ophthalmology treatments as a whole. However, providing information specific to different conditions would improve oversight of waiting times for more serious cases and help ensure resources are used effectively.

Dave’s story: “It's like I'm just talking to a wall"

Dave, 67, from Newcastle, has been trying to get treatment for a painful cyst in his right eye for four years. Two years ago, he joined a waiting list to have the cyst examined by a specialist, but he's not heard anything since. He's also waiting for glaucoma and cataract treatments, but he can't start these until the cyst is removed (because there's a risk of infection if it bursts).

The cyst causes Dave a lot of discomfort. It's painful and excretes fluid that then hardens and crystallizes. This makes it hard for him to open his eye and blurs his vision.

"It's sore all the time," Dave says. "It leaks like glue. That makes it hard to see, especially at night and makes things like going to the shops difficult because it's like looking through a viscous liquid.

"But when I ask when I might get help, nobody ever tells me anything.  It's like I'm just talking to a wall!"