Devolved nations show path for England on community eye care access

Scotland, Wales and Northern Ireland are providing invaluable examples of how to make fuller use of community optometry – that England can draw upon, according to Specsavers 2026 access to care report.

‘The devolved nations have shown what can be achieved when community care becomes a central part of the healthcare system,’ says Paul Morris, director of professional advancement, Specsavers.

‘Wales has expanded optometrists’ roles through WGOS. Scotland has built one of the UK’s most advanced community eye care systems. Northern Ireland has developed community pathways that are reducing pressure on hospitals.’

The report notes how Wales, Scotland and Northern Ireland all provide access to community urgent eye care services. It allows patients with minor eye injuries and conditions to be seen quickly by primary care optometrists.

While most Integrated Care Boards (ICBs)in England now commission these services, four do not and a further nine only do so in parts of their area. The report notes how universal access through local optometrists could save 425,000 GP appointments, 200,000 hospital eye service appointments and 240,000 A&E attendances each year, delivering a net NHS benefit of £30.7m annually.

On glaucoma, the report notes rising patient need with one million people in the UK already affected by the condition with a further 600,000 expected to also face the condition by 2060.

‘Glaucoma already accounts for a quarter of hospital eye outpatient activity,’ says Mr Morris. ‘Rising demand, hospital workforce shortages and follow-up backlogs continue to delay care. This increases the risk of avoidable and irreversible sigh loss.’

He notes that in Wales, Scotland, Northern Ireland and NHS commissioners in parts of England have introduced community glaucoma pathways that make better use of primary care optometry capacity and expertise.

‘In England, Greater Manchester has led the way with its Glaucoma Enhanced Referral Scheme, which allows optometrists to carry out additional tests and share results electronically with hospital consultants.

‘The scheme has reduced hospital referrals by more than 50% and cut false-positive referrals to around 10%, compared with around 40% in areas without similar schemes.’

Mr Morris adds: ‘The evidence is there. A priority now is ensuring patients across England have access to the same community-based models that are already benefiting patients elsewhere in the UK.’

Read the report: https://www.specsavers.co.uk/reports/access-to-care-2026