Investment directed into primary eyecare can potentially deliver £98m (NZ$210.8m) per year in net benefits for the National Health Service (NHS) in England, with benefits expected to be similar in other UK nations. This would help the UK government fulfil its objectives set out in the Darzi review to reduce waiting lists and move care closer to home, a new report has found.

PA Consulting’s report, commissioned by the UK’s Association of Optometrists (AOP) and others, identifies four system-wide changes that could release nearly two million appointments per year within hospitals’ overstretched eye services, accident and emergency and general practice:

• A national roll-out of community urgent eye services, using the skills of primary eyecare practitioners to triage, manage and prioritise patients
• A national roll-out of the Integrated Glaucoma Pathway, including ongoing monitoring to prevent the development or exacerbation of glaucoma for patients at risk
• A national roll-out of the Integrated Cataract Pathway, with primary care optometrists confirming patient eligibility for surgery plus post-surgery check-ups, treating post-operative complications and monitoring patient outcomes
• Harnessing the potential of OCT in a community setting.

Lord Ara Darzi’s 2023 review revealed spending on acute care has risen from 47% of the NHS budget in 2002 to 58% in 2022, while primary care’s share of NHS spending has fallen from 27% to 18%. This is coupled with a high and increasing demand for eyecare and eye health services and a mismatch between patient demand and the NHS’s capacity, the report found. In response, the UK government pledged to reform the NHS by focusing on moving more care from hospitals into the community, changing from an analogue to a digital service and being bolder on a sickness-to-prevention healthcare model.

All too often, healthcare reports tell a story about how broken the NHS is and the challenges around the corner that could make the situation worse, said Adam Sampson, AOP chief executive. “This report from PA Consulting is different – and offers real cause for optimism. Yes, it highlights that the NHS faces ever-increasing demand for eyecare and eye health services, but the data show that the existing service delivered by optometrists on high streets across the UK delivers outstanding value. And it further signals four simple ways in which the role of high street optometry in end-to-end eyecare and eye health in the UK can be extended, which will cut waiting lists, achieve cost savings to the NHS and support the drive for growth in the economy.”

The AOP, Fight for Sight, Primary Eyecare Services and Roche Products provided financial support, editorial input and reviewed all associated outputs of PA Consulting’s report.