New NHS guidance established to improve eye care accessibility in England


Clinical ophthalmology efforts will target the 'busiest' outpatient speciality.

A physician and patient look at a chart together. They're both smiling. Image credit: ©Coetzee/ –

A new set of NHS testing protocols aim to reduce ophthalmology wait times. Image credit: ©Coetzee/ –

A new initiative from the National Health Service is intended to make eye care more accessible to patients in England. NHS leaders announced their efforts late last month.1 The measures aim to reduce wait times for care, a goal that government officials labeled as a "top priority."

Earlier in May, researchers raised concerns about eye care accessibility throughout the UK. According to the NHS, ophthalmology is the busiest outpatient speciality in secondary care. Ophthalmology practices make up almost 10% of the secondary care waiting list. As part of a broader reform to protocol, the NHS is targeting ophthalmology with its next Evidence Based Intervention (EBI).

To combat the long wait times, NHS guidance proposes improvements to diagnostic imaging early in the eye care pipeline. If effective, this will give consultants a more comprehensive view of patients' needs and allow physicians to prioritise patients who need specialty care. It will also give patients more information about their health status and care plans, to reduce anxiety for those who do need to wait for appointments.

Patients seeking treatment for suspected glaucoma and cataracts will have access to more accurate testing and have a larger role in treatment decision-making. According to the NHS release, “As many as two in five of suspected new glaucoma cases and half of all suspected diabetic maculopathy cases referred to secondary care via routine optometric tests or diabetic eye screening are false positives.”

An updated testing protocol will offset these negative results of poor sensitivity and specificity in existing tests. The “two-factor authentication” testing could also be a cost-saving measure, since reducing unnecessary referrals is projected to relieve some tax burden.

NHS medical director Professor Sir Stephen Powis explained the ophthalmology measures are expected to have major impact in improving ocular healthcare access across England. “We expect these changes will prevent thousands of unnecessary referrals to ophthalmology services – giving back patients and staff alike their valuable time,” Powis said.

“Improving access to the latest digital imaging technology will improve the speed and quality of eye care treatment for patients,” Minister Neil O’Brien added. “Tests such as these are part of the wide range of work being carried out to reduce waiting lists, which is one of this government’s top priorities.”


1. New NHS measures to improve eye care and cut waiting times. News release. National Health Service England, May 28, 2023.
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