Written question WQ88849

There is no specific funding that has been made available for optometrists to administer injections for wet macular degeneration and diabetic macular oedema in the community.

However, one of the most important developments in the hospital eye service is the growing role of ophthalmic non-medical practitioners. These are nurses, orthoptists and optometrists who work under the guidance of consultant ophthalmologists to deliver vital procedures, which includes delivering eye injections to treat wet macular degeneration and avoid sight loss.

Non-medical practitioners have been delivering these injections for many years in Wales. Now, with increased funding, non-medical practitioners can complete the appropriate training through Health Education and Improvement Wales (HEIW), reducing the demand upon our ophthalmology doctors.

Through the planned Care transformation funding over £1m additional investment has been provided to health boards over the last two years to redesign their hospital ophthalmology services. This includes training and moving services into the community in relation to age related macular degeneration and diabetic services. In addition, £760k funding has been provided for the development of a simulation suite, which will be Wales’s first simulation suite to meet new UK wide requirements for trainee ophthalmologists and will also enhance multi-disciplinary training across primary and secondary care.

NHS Wales commissioning of services, including training for delivery, remains the responsibility of the local health board. It must assess the training requirement of the workforce to meet the needs of the local population and plan and prioritise healthcare provision within the resources available. This is informed via their joint needs assessment and subsequent development of their health board plans and local primary care Cluster arrangements.

To support NHS Wales to get services right for patients, it is important to ensure the whole workforce receives the right training and induction from the start about prudent healthcare. The changes to optometry core services are an excellent example and offers significant benefit to citizens across Wales.

Optometrists play an important role in communities across Wales and will maintain their own continuing professional development; however, the changes through the new optometry contracted terms of service is an opportunity not just to expand the clinical services provided by optometrists in the community, but to enhance continuous professional development over and above the regulator’s obligations, building support, leadership, and quality improvement for the profession.

Continuous professional development is underpinned by the inclusion of an optometry section within Health Education and Improvement Wales plan. The attainment of higher qualifications requires optometrists to undertake placements within hospital eye departments, gaining experience of managing complex cases, and building relationships with the whole clinical team. This aspect is essential for the successful delivery of the future approach for eye care services.