Lack of funding threatens commissioning of urgent care eye services in England

As demand for eye care in England continues to rise sharply, outpacing the capacity of hospital eye services and leading to delays in treatment and avoidable sight loss, The College of Optometrists is calling on local commissioners to universally commission and fund community minor and urgent eye care services across all regions in England. 

Patients with eye symptoms typically visit their GPs, yet most GPs lack specialist ophthalmic training and equipment. Ophthalmology has the most outpatient appointments within the NHS, accounting for nearly 9% of all outpatient appointments in England. It’s estimated that the national roll-out of community minor and urgent eye care services in England can reduce hospital eye services appointments by at least 200,000 per year and over 400,000 GP appointments per year, while also realising financial benefits to the NHS. Up to 70% of eye-related A&E cases could be managed in primary care by optometrists, providing a significant opportunity to shift care closer to home. 

These services, currently commissioned as Community Urgent Eye Care Services (CUES) or Minor Eye Conditions Services (MECS) depending on the local area, allow people with problems such as red, itchy or painful eyes, minor eye injuries, flashes and floaters or sudden vision problems to be assessed by their local high street optometrist.  They don’t need a GP referral, and most cases can be treated or managed by the optometrist, although some patients may be referred to the hospital if they are found to have a more serious condition.    

These services are only available in 73% of England, unlike in Scotland, Wales and Northern Ireland where all patients have access to community-based minor and urgent eye care services. Optometrists are concerned that the postcode lottery will be increased further by potential funding cuts in the Westminster government's upcoming 10-year health plan.  

The universal commissioning and funding of community minor and urgent eye care services across England would fill a critical gap between routine sight tests and hospital emergency care, end the postcode lottery for access to services, and significantly reduce unnecessary GP and A&E visits. This would free up hospital clinicians to focus on more critical emergencies and complex cases.