Pyott Report sets out a blueprint for eye care services in Wales

  • 08 Jun 2022
  • Pyott Report

Andy Pyott carried out extensive interviews in 2020, both virtually and face to face with all the relevant stakeholders to map out the existing provision of services, barriers and good practices.  Stakeholders included ophthalmologists, optometric colleagues, management at health boards, government advisors and other related allied professions.

The Pyott report makes key recommendations to ensure that eye care services in Wales are sustainable. In the report, it is recognised that patient demographics, the ophthalmic workforce shortfall and location of services present serious challenges for eye care services in Wales. This is compounded by the lack of investment over time into the inadequate infrastructure of many Welsh eye departments. Wales has fewer ophthalmologists per capita than the most ophthalmic-deprived areas of England and recruitment and retention of staff were found to be another major challenge.

There are 10 key recommendations in the report. These encourage eye care services to review a number of practices and employ innovation in the workforce and service delivery.  This can be done by ensuring that out of date practices and improved use of the workforce through better communications and shared best practices and learnings, eradicating disjointed patient care and efficiencies for the workforce.

More can be done to build on the current good use of non-medical staff, ensuring they are working to the top of their licence as well as consideration given to rolling out independent prescribing initiatives to all Ophthalmic Diagnostic Treatment Centres to meet the needs of the population.

This includes community optometrists to support patient pathways by enhancing the level of training in the community and increasing the numbers with Independent Prescribing (IP) qualifications; recognising that this requires sustainable support and training, which does add to the demand for ophthalmic services.

Health boards should review and be accountable for the importance of accurate and real-time data to manage services and avoid cancellation of patient appointments and identify local improvements where possible such as cross-linking with community optometrists.

The whole ophthalmic community can identify national priorities to expand specialist corneal services and encourage cataract surgery centres to engage in efficient high-volume

surgery on a regular basis, with recommendations to streamline the cataract pathway with agreed anaesthesiology cover for a sustainable cataract service.

Andy Pyott, author of the report said, ‘Without any doubt, everyone involved in EyeCare in Wales be they front line staff, managers or service planners, are determined to improve the service for their patients. There is much that has hindered this process. I hope that this report highlights not only those areas where things have gone well but will also help identify those areas for improvement. Some of this will require new ways of thinking, and practice. After local consultation, the plans set out in the report will require significant support and investment. All this is vital to developing a sustainable ophthalmic service in Wales.’

Gwyn Williams, Llywydd of The Royal College of Ophthalmologists in Wales, commented, ‘The continuing rise of outpatient activity and COVID-19 in Wales, has exacerbated a significant impact on service and has resulted in delays for follow-up appointments and increasing the risk of harm and adverse outcomes for patients.  No one involved in delivering care for patients wants this. I welcome the Pyott report as it provides a framework for how we can begin to make a difference and provide the care patients deserve.  Indeed, we are truly encouraged by work that has already started in some regions.’

The Minister for Health and Social Services in Wales, Eluned Morgan, is now expecting the Ophthalmic community of Wales to develop bold and ambitious plans that can be delivered at a pace to address the growing number of patients waiting for eye care.

The Pyott Report can be found here