Gwyn Williams, Llywydd of The Royal College of Ophthalmologists Wales Committee, reflects on the Minister for Health and Social Services in Wales’ encouragement to the eyecare community to develop rapid plans in response to the recommendations in the Pyott Report.
Wales has had many problems with the delivery of effective eye care services for a long time, made a lot worse by the challenges of the Covid pandemic, exacerbating backlogs which are potentially putting patient care at risk. After recognising the extent of the challenge before us the Planned Care Programme (a joint programme between NHS Wales and the Health and Social Service division of the Welsh Government) commissioned a fully independent external report into the current challenges facing ophthalmology in Wales.
With the support of The Royal College of Ophthalmologists, Andy Pyott, a senior consultant based in NHS Highland in Scotland was commissioned to carry out the research. I am delighted with the report that Andy produced as it truly reflects the state of eye care services in Wales and has made ambitious but realistic recommendations, the most important of which highlight the need for investment in regional centres of excellence with full regionalisation of eyecare. The ophthalmic and optometric communities in Wales are exceedingly grateful for the work that Andy Pyott has carried out.
The Pyott Report carried out in 2021, has been well received by the ophthalmic and optometric communities and the Department of Health and Social Services within the Welsh Government. Primarily, it led to an important meeting in February 2022with the Minister for Health and Social Services, Eluned Morgan, attended by members of the RCOphth Wales subcommittee, the President and Vice President of The Royal College of Ophthalmologists and members drawn from all the health boards in Wales. The Health Minister was receptive to the challenges and the report’s findings and followed up with a letter which challenged the eyecare community ‘to develop bold and ambitious plans. With these plans ‘to be delivered at a pace to tackle the growing number of patients waiting for eye care and to transform the service here in Wales’.
Additionally, the Health Minister made clear that one of the current priorities was to respond to the needs of those patients waiting for a cataract operation and that this would need to be undertaken using all available capacity. The longer-term plan however is to develop a sustainable regional solution within NHS Wales.
Without addressing the challenges outlined in the Pyott Report, NHS provided eye care in Wales is at serious risk of collapse, especially in North and West Wales. Amongst the report’s key recommendations, the development of regional centres of excellence is vital toward ensuring not just sustainability but the very survival of ophthalmic care in Wales. It is crucial that the multi-disciplinary team model is fully utilised; from optometrists seeing patients for the NHS in their practices and in the hospital eye service, to non-medical practitioners working at the very top of their remit. These colleagues are a vital lifeline and their training and development are imperative, on top of the urgent need for more staff.
The Planned Care Ophthalmic Board has now formally asked clinical leads to form regional planning groups to discuss how regional centres of excellence can be set up, how regional services should be provided, and how the eyecare service of tomorrow can be delivered. The planning of regional ophthalmic centres of excellence and a fully integrated eyecare service spanning three regions in Wales, including the development of links to community optometrists is a matter of urgency.
We are in an emergency situation and we need infrastructure and the right workforce in the right location, including optometrists working in their practices and in hospitals to help address the backlogs of patients, as well as a planned long-term investment in ophthalmology in Wales or we will be facing a tide of avoidable blindness for patients.
I know I am calling on everyone involved in eye care services in Wales to do a lot more work with this project, but this is our one chance, with the Health Minister showing a high level of interest, to make change happen. For our colleagues and staff in eye care services, and importantly for our patients, I am hopeful that we can save eyecare in Wales, and this is the best chance we have had in recent memory to redraw how we do things in Wales.
The Pyott Report External Review of Eye Services in Wales Nov 2021 FINAL
The Ophthalmology Letter to all Health Boards from WOPCB (Mar 22) from Gwyn Williams, Llywydd Wales Committee, The Royal College of Ophthalmologists and Fiona Jenkins, Chair WOPCB