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The Way Forward Resources

The increasing demand for hospital eye services (HES) is not being met and continues to grow – currently seeing nearly 10% of all outpatient appointments and performing 6% of the surgery in the UK.

The Way Forward was commissioned by The Royal College of Ophthalmologists to identify current methods of working and schemes devised by ophthalmology departments in the UK to help meet the increasing demand in ophthalmic services. The information aims to offer a helpful resource for ophthalmologists who are seeking to develop their services to meet capacity needs.

The findings are based on more than 200 structured interviews with the ophthalmology clinical leads in all departments, in the four home nations, to identify the real life solutions being used to address the increasing demand.

The research covers each of the particularly high volume areas in ophthalmic care with both a short summary document and a more detailed report.

Some eye departments may still be meeting demand with traditional models of service delivery, but increasingly, the challenge that the growing patient population presents may lead to decompensation of those services as capacity becomes insufficient.

The different ways of working employed by those interviewed can form part of the solution. Current and future demand indicates that more ophthalmologists are needed and this continues to be pursued as a priority to deliver safe, quality services. Further expansion of the consultant workforce however will not be resolved in a suitable time frame to solve the current demand challenges.

The Way Forward a useful resource to share and collaborate with hospital managers, commissioners and medical and non-medical healthcare professional colleagues in the delivery of hospital eye services.  The Royal College of Ophthalmologists believes that clinicians can act as the architects of change for a service to be sustainable for the future.

Professor Carrie MacEwen, President

For more information on The Way Forward, contact the [email protected] or [email protected]


Summary of The Way Forward project commissioning

The College contracted the Leeds Ophthalmic Public Health Team, with Mr John Buchan as the Principal Investigator, to produce an initial report identifying best practice models for the delivery of ophthalmic services in the UK and offer suggestions on the range and composition of ophthalmic care teams.

The project includes:

  • NHS Funded ophthalmic care
  • The 4 Countries of the UK (England, Scotland, Wales and Northern Ireland)
  • Greatest focus on the most common eye conditions (cataracts, age-related macular degeneration, glaucoma and diabetic retinopathy)

The project excludes:

  • Care which is not free at the point of delivery i.e. privately funded ophthalmic care
  • A detailed analysis of Specialised Commissioning
  • The detailed mapping of referral pathways

Literature reviews and data collection included semi-structured interviews with clinical service leads, followed by an interim report.

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