College draws conclusions on UK Glaucome Care

College draws conclusions on UK Glaucome Care

Introduction 

Glaucoma is a chronic, progressive eye disease and a leading cause of irreversible sight loss in the UK, accounting for around 10% of sight impairment registrations. It affects approximately 2% of adults over 40, rising to around 10% of those over 75, and the number of people with glaucoma is projected to increase by over 10% in the next decade due to an ageing population.

Conclusions 

UK nations have a significant opportunity to help manage the increasing number of glaucoma cases and limited HES capacity⁵⁸. This can be achieved by supporting all optometrists to use their core skills to prevent referral initiation, and utilising the capacity afforded by optometrists with higher qualifications in primary care to further prevent onward referral of suspected cases to HES and manage low-risk glaucoma cases in the community. While such services are being rolled out in Wales and Scotland, full coverage is still to be achieved (at the time of writing) and full shared care services are yet to be commissioned in Northern Ireland. England has variable and limited availability of both GRFS and shared care pathways. Therefore, there are still opportunities to improve HES capacity and patient outcomes.

It is evident that GRFS and community shared care pathways are safe and effective, significantly reducing the burden on HES, with clinical quality comparable to hospital-based clinicians. Given the current ophthalmologist workforce shortages and HES capacity issues, these pathways release HES capacity to focus on patients in greatest need, reduce waiting times and help prevent avoidable sight loss due to delays in accessing glaucoma treatment. Patients benefit from a wider choice of locations for services, reduced travel time and distance, and have a high level of satisfaction with the care provided. This aligns with broader environmental sustainability needs and broad national health systems’ goals of moving care into the community and improving integration between primary and secondary care. Local planning with a whole system view to selectively commission community enhanced case-finding/referral services and shared care management pathways will enable a more resilient national eye care system fit to meet the growing needs of each nation’s aging population.

Read the full report here 

Paul Morris, director of professional advancement at Specsavers, welcomes the report:

‘We welcome the College of Optometrists’ report, which provides clear, evidence-based reassurance around the safety and effectiveness of delivering appropriately commissioned glaucoma services in community settings.

‘Its findings chime with what we set out in Specsavers’ Access to Care report– that bringing care closer to home, through community optometry, improves access for patients.

‘This matters more than ever. Recent research has warned that the number of people living with glaucoma in the UK is already higher than previously estimated and is set to rise significantly as the population ages. If we are to prevent avoidable sight loss at scale, we need care models that are accessible, joined-up and focused on early detection and ongoing monitoring.

‘Community optometrists have the skills, technology and local reach to play a crucial role in this. The College’s report adds further weight to the case for consistent commissioning of glaucoma services that allow care to be delivered safely and effectively, closer to where patients live.’