The research from PA Consulting – which was supported by the Association of Optometrists (AOP), Fight for Sight, Primary Eyecare Services and Roche Products - explores the role of High Street optometry in end-to-end eye care and eye health in the UK that will achieve both cost savings to the NHS and directly benefit patients, clinical staff and the wider economy.

The report, Key Interventions to Transform Eye Care & Eye Health, identifies four system-wide changes that could release nearly two million appointments per year within overstretched hospital eye services, A&E and General Practice – the equivalent of 9,600 appointments per year for each Acute Trust in England.

The analysis examined the current value of primary eye care provision and found that NHS services delivered in High Street optometry offer over £1.5bn of value from correcting sight in children and young people and nearly half a billion in adults, most notably from early detection of glaucoma and age-related macular degeneration in older people. PA Consulting findings equates this to a return of £3.98 for every £1 spent.

The four system-wide changes identified in the report for national government and NHS England to commit to are:

• A national roll-out of Community Urgent Eye Services – using the skills of primary eye care practitioners to triage, manage and prioritise patients presenting with urgent and/or minor eye conditions.
• A national roll-out of the Integrated Glaucoma Pathway – including ongoing monitoring to prevent the development or exacerbation of glaucoma for patients at risk.
• A national roll-out of the Integrated Cataract Pathway – primary care optometrists confirm patient eligibility for surgery. After surgery they check for and treat post-operative complications and monitor patient outcomes.
• To transforming the potential of Optical Coherence Tomography – including in community settings and harnessing its continued technological advance.

The overall net gain in benefit for the NHS from implementing the four tailored system-wide changes breaks down as: Community Urgent Eye Care Services (£30m per annum), Integrated Glaucoma Pathway (£13m pa), Integrated Cataract Pathway (£34m pa), and Optical Coherence Tomography (£21m pa).

Adam Sampson, chief executive of the AOP, said: ‘This report from PA Consulting's report is different – and offers real cause for optimism.

‘Yes, the report highlights that the NHS faces ever-increasing demand for eye care and eye health services. But the data shows that the existing service delivered by optometrists on High Streets across the UK delivers outstanding value. And it further signals four simple ways in which the role of High Street optometry in end-to-end eye care and eye health in the UK can be extended, which will cut waiting lists, achieve cost savings to the NHS, and support the drive for growth in the economy.

‘The eye health sector is committed to the government's plans to shift more care out of hospitals and into the community as part of its 10-year plan for health. Now we need NHS England to support this step-change, and invest in the services that empower primary care to really deliver for patients.'

Dharmesh Patel, chief executive of Primary Eyecare Services, added: "This report emphasises the critical need to expand eye care services within primary care optometry settings to alleviate the burden on GPs, A&E and hospital ophthalmology, enhancing patient care and supporting NHS sustainability.

‘With major eye conditions projected to increase by 25% by 2032, this report highlights interventions based on existing innovative delivery models utilising primary and community optometry practices. Along with partners, we stand ready to scale up delivery of eye care in the community at a local, regional and national level at pace.'

The AOP's Sight won't wait campaign has been calling for a national approach for eye care services to utilise the existing optometry workforce to cut hospital waiting lists, reduce sight loss and improve patient outcomes.

In response, Ruth Rankine, primary care director at the NHS Confederation, said the report provides yet more evidence supporting a greater shift of care out of hospitals and into the community with the right investment.

She added: ‘The case for prevention and early detection is clear – it is better for patients and cheaper for the NHS. The fact that teams across primary care are managing record demand and hospital waiting lists remain stubbornly high highlights the need to make sure patients are seen by the right person at the right time.

‘Our analysis with CF (Carnall Farrar) found that for every £1 invested in community or primary care, there is up to a £14 return back into the local economy through gross value added. This new report adds to this evidence by suggesting that investing in high street opticians could deliver £98m in annual savings for the NHS.'