Written question WQ89064

The Welsh Government remains committed to reducing waiting times for the people of Wales and to reducing the risk of sight loss and irreversible harm. In my Ministerial Ophthalmology Summit in November 2022, I was very clear on my expectations that we cannot do more of the same and expect different results. Health boards must look to work differently, making use of the technology available to them and working together across health board boundaries and regions. The summit report can be found here.

I was very clear of the actions I wanted to see following the summit and a follow up summit is being planned. I commissioned a National Clinical Strategy for Ophthalmology to identify how the Pyott report recommendations will be made and sought detail on:

• demand, capacity, activity and backlog positions,

• workforce and training in Ophthalmology,

• Infrastructure and pathways to ensure services become most sustainable and

• Reduction of long waiting times.

While we have seen progress made in reducing long waiters achieving the eye care measures remains a challenge.

Over two-year waits have reduced from 9,300 in March 2022 to 2,385, a 74% improvement as of June 2023. Performance against the eye care measures however remains challenging with 49.3% of patients being seen within their due date in June 2023. This is a decrease of 0.3% since March 2022.

With the longer-term strategy work focussing on the future model of eye care in Wales, the Ophthalmology Clinical Implementation Network (CIN) is focusing on the shorter to medium term improvements. This work will be supported by the results of the Getting it Right First-Time (GiRFT) reviews of Glaucoma and Cataract to ensure pathways are delivered based on clinical evidence, ensuring safe and efficient practice.

The results of the reviews will link to the optometry reform allowing for the maximum use of total resources freeing up clinical urgency slots for those with the greatest clinical need.

As you indicate, you are already aware of the work underway to reform optometry through implementation of a new optometry contracted terms of service, which I announced in September last year. The emphasis is on more treatment and care delivered in the community.

The overarching focus of optometry contract reform is centred on alleviating pressure on secondary care hospital eye services. We are increasing the range of services delivered closer to home in primary care optometric practices, where there is a skilled workforce with the capacity to meet the predicted substantial increase in demand. Moving the delivery of some eye care services from hospitals to primary care optometry, represents the most viable and sustainable solution.

Currently my officials are undertaking a deep dive into local plans and progress against them. Ophthalmology specific meetings have been escalated within health boards and will focus on addressing the backlogs across the waiting lists, ensuring they our maximising the use of the new ways of working including the optometry reform opportunities.

The key focus of the commissioned plan I requested from my summit is to use the information to set out what the long-term blueprint for eye care looks like, with regional solutions and the case for additional investment where required, to ensure services are fit for purpose.

The four clinical leads for this strategy work have been appointed, representing each region in Wales: North Wales, South-East and Southwest. The strategy is aiming to provide the first report and recommendations back to the Welsh Government by the end of January 2024, with follow up reports and further work through to March 2024.