Transforming eyecare services in Wales

An innovative partnership to bring critical eyecare appointments closer to patient’s homes has helped to transform services in Wales.

In December 2019, nearly 115,000 patients at risk of irreversible sight loss were waiting for a hospital eye appointment in Wales.

Cardiff University’s Clinical Innovation Accelerator, a partner in the Accelerate programme - led by Life Sciences Hub Wales - are working to bring High Street optometrists, clinicians and Welsh Government together to reduce the burden on hospitals.

An ageing population combined with the risks associated with diseases such as diabetes is increasing the pressure on eyecare services. In 2019, waiting lists for eye appointments were growing. Some 38% of those on the list having already exceeded their target appointment date but capacity within the hospital was fixed.

Accelerate was able to provide a clear structure, identify key stakeholders and establish a time frame in which to establish a revolutionary clinical model that taps into academic expertise, provides a thorough understanding of the life sciences ecosystem, and supplies the facilities needed by innovators and entrepreneurs to realise ideas.

Thanks to Welsh Government support, Cardiff and Vale University Health Board developed a service framework in which registered High Street optometrists assume the management of designated high-risk eye patients, under guidance.

The use of state-of-the-art imaging technology, dedicated software and electronic patient records allows patients to undergo tests at their local optometry practice. Images and results are uploaded for review by a consultant ophthalmologist, and high street optometrists were then able to assess the relief of pressure on ophthalmology services through the best use of community care.

Transforming Eyecare Services Wales has supported novel pilot services to manage up to 9,000 designated patients across  five domains of care: Glaucoma (new referrals and follow-up); Wet Age-Related Macular Degeneration; Diabetic Retinopathy; and Unscheduled Eye Casualty.

The scheme has brought many benefits: reduced waiting times, adoption of new technologies, increased capacity in secondary care to assess and manage eye care patients, new skills and competency training for independent optometrists, and closer links with secondary care which could lead to the provision of additional services by optometry enterprises.

It also brought Cardiff University expertise closer to eyecare-related health in a community setting and is leading to peer reviewed publications and new health economics insights in ophthalmic care.

The Clinical Innovation Accelerator helped identify and support key themes including increased scope and capability of high street opticians, promoting industry expansion and employment opportunities, and innovation through a new digitally integrated system.

In future, this technology could lead to diversification of other domains of health and social care employing e-patient records, prompting future collaboration between commercial, academic, third sector and clinical partners with potential to roll out our model across NHS Wales.

Read the published case study