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The College maintains standards in ophthalmology and this includes providing authoritative guidance on, and advice on innovation and efficiency in service delivery within, commissioning of eye services in the UK. These publications are for use by commissioners, provider organisations and all professional groups, who will be working together to ensure appropriately commissioned safe ophthalmic care.

All guideline recommendations are agreed via consensus of the guideline development group (GDG).  They are based on the evidence presented to and reviewed by the group. Where an agreement is not secured, there is a majority vote with the chair holding the casting vote.  The RCOphth complaints procedure is followed if any member of the GDG formally judges that the issue remains unresolved.  Our clinical guidelines are published in accordance with the majority consensus process, unless otherwise noted in the guideline document.

We collaborate with relevant organisations and multi-professional groups working in the eye health sector and which represent those involved in commissioning, delivering, supporting and receiving ophthalmic care.

Commissioning Guidance Description
AMD Commissioning Guidance Executive Summary June 2021

AMD Commissioning Guidance Full June 2021

New Guidance on Commissioning Age related macular degeneration (AMD) services
Emergency Eye Care Commissioning – Executive Summary

Emergency Eye Care Commissioning – Full Guidance


Commissioning guidance for emergency eye care services. This multidisciplinary guidance provides advice on robust triage based on risk-prioritisation at all first points of contact in the system, including triage protocols for services and commissioners to discuss and agree for their local area. This guidance has been developed with a multidisciplinary group including the British Emergency Eye Care Society.
Sustainable Ophthalmic Pathways – Cataracts
A comprehensive guide for commissioners, providers and medical and healthcare professionals with up to date recommendations on delivering efficient and equitable ophthalmic services.
Commissioning Standards – 2018 This document outlines standards for safe commissioning for ophthalmic services, and signposts to the important guidelines, quality standards and key performance indicators. This will help commissioners to assess the quality of their current service and support safe development of new models.
Cataract Commissioning Guide – 2018


This commissioning guide aims to provide patients and the public, health and social care professionals, commissioners and service providers with a clear description of what constitutes a high-quality service. The guidance helps an organisation to assess its current performance against evidence-based measures of best practice and identify priorities for improvement in the management of cataract care pathways.

(Developed using NICE accredited processes)

Local Tariff Variation and Ophthalmology Commissioning – 2017 Local tariff variation is a tool that potentially can be used to encourage the development of innovative patient services. The local variation rules are intended to give commissioners and providers an opportunity to innovate the design and provision of services for patients. Given the clinical diversity of ophthalmology and the extensive commissioning evidence and advice available, the use of local variation should be considered to facilitate the adoption of nationally mandated patient pathways as well as those that are recognised or recommended as best practice.
Strabismus surgery for adults in the United Kingdom indications, evidence base and benefits – 2017 This commissioning resource has been published to help clinicians and commissioners understand the overall cost benefit, and proven effectiveness of strabismus surgery and its positive societal implications. Access to strabismus surgery should not be restricted on non-clinical grounds.
Advice on Commissioning of Ophthalmic Services for Children – 2017 This is a briefing document on the themes and issues relevant to commissioning of ophthalmic services for children, on behalf of the Paediatric Sub-committee of The Royal College of Ophthalmologists.
Glaucoma Commissioning Guide (Recommendations) – 2017


Developed using NICE accredited processes the College has worked with stakeholders to produce guidance for commissioning adult-onset glaucoma and adults who are at risk of developing glaucoma. The full document can be accessed here: Glaucoma Commissioning Guide Long.
Commissioning better eye care: Adults with low vision – 2014 This guidance from The College of Optometrists and The Royal College of Ophthalmologists is to help those designing and commissioning eye care to improve the value of their services.