Ophthalmology services hit by staff shortages and NHS delays

Recent reports reveal an NHS backlog and a shortage of ophthalmologists. NHS England clinicians filed 551 reports of patients who lost their sight in 2019 because of a backlog. Of the 551, 219 resulted in “moderate or severe harm”, according to a Freedom of Information Access request by the Association of Optometrists. 

The report cites delays caused by the COVID-19 pandemic dating back to 2019.

The delays are concerning given estimates are that more than a million people in the UK are living with avoidable sight loss globally, as we reported in Time to Focus. Of the 2.2 billion people with sight loss or blindness, at least 1 billion have a condition that could have been prevented or has yet to be treated.

Shortage of NHS Ophthalmologists

A more recent report by the Royal College of Ophthalmologists (RCOphth) highlights the scale of staff shortages in NHS ophthalmology services. It predicts that these will worsen over the coming years.

The 2022 workforce census report reveals that most NHS ophthalmology services need more capacity.

Over three-quarters (76%) need more consultants to meet current patient demand, and over half (52%) have found it more challenging to recruit consultants in the last 12 months.

While recruitment is challenging, many are also looking to leave the profession. A quarter of consultants will leave the ophthalmology workforce within five years (most will retire).

A lack of skilled consultants will make it hard to clear backlogs:

• 74% of eye units are more concerned about the impact of outpatient backlogs on patient care than they were 12 months ago,
• 63% estimate clearing their backlogs will take at least a year.

A passion for research could aid retention

A welcome finding from the RCOphth survey is the passion for research reported by ophthalmologists.

The survey discovered a keenness to become involved in research, particularly among trainees, with over half (54%) of trainees saying they’d like to be more involved in research than they are currently.

Fight for Sight is focused on ensuring clinicians can pursue research to better understand eye diseases, which can lead to improved care and treatments. In collaboration with RCOphth, we recently funded Dr Abdus Samad at King's College London and Dr Tasanee Braithwaite at Guy's and St Thomas' NHS Foundation Trust, London. 

In addition, some 44% of SAS (Speciality Doctors and Specialist Associates) doctors want to be more active in research, and 39% of consultants do.

Fight for Sight welcomes this enthusiasm but we also know that research into sight loss is underfunded compared to other conditions. Sight loss research is getting a fraction of the investment it desperately needs – a situation exacerbated by the advent of Covid-19. In 2018, just over 1.5 per cent (£24 million) of the £1.4 billion that UK Research and Innovation, government and other public bodies invested in medical research was for eye research.

Fight for Sight is encouraging researchers at the early stages of their careers and as their careers develop.

Doing research boosts engagement

Engaging in research could help the ophthalmology speciality retain good people. The RCOphth survey reveals a positive connection between research participation and job fulfilment.

Overall, 64% of respondents reported a job fulfilment of seven out of 10 or higher over the previous 12 months. Still, for those who participated in the research, 83% of SAS doctors scored seven or higher.

Figures for consultants and trainees were 72% and 69%.

Commenting on the release of the survey, Keith Valentine, Chief Executive of Fight for Sight, said:

“It is encouraging to see that research is a lever for engaging and, potentially, retaining a skilled ophthalmology workforce. However, seeing the current shortfall in skilled ophthalmology professionals and a delay in appointments is concerning and could mean that some people experience avoidable sight loss.”

Medical research could reduce health disparities

Elsewhere, the All Party Parliamentary Group(APPG) on Medical Research published a report making a case for medical research as a critical tool to reduce health disparities.

The report outlines research is a vital but under-used tool in the fight to address health inequalities in the UK. The insight is timely as Fight for Sight and Vision Foundation merge. 

Together we'll combine breakthrough research and life-changing services with building a better world for blind and partially sighted people.

Read our tips on keeping your eyes healthy. 

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