Eye Health Care Strategy for England: Westminster Debate

A Westminster Hall debate brought by MP Marsha de Cordova on the urgent need for a National Eye Health Strategy garnered cross-party support last week (May 17, 2023).

Labour MP for Battersea Marsha de Cordova opened the debate by calling out the “emergency in eye care” as she drew attention to her National Eye Health Strategy Bill.

“To respond to the current crisis in eye healthcare, the Government must commit to a national eye health strategy as set out in my bill,” she said.

An emergency in eye health care across the UK

Some 250 people begin to lose their sight every day, and 21 people a week will lose their vision due to a preventable cause. As Marsha de Cordova said, “On top of that, we know that 50% of sight loss is preventable.”

• Read our Time to Focus report for more statistics on the state of eye health care.

Marsha De Cordova, who has nystagmus, also pointed to a backlog in ophthalmology services, which the Covid-19 pandemic exacerbated. This backlog accounts for some 9% of the NHS total backlog in England and is one of the largest in the NHS.

Five priority areas for a National Eye Health Strategy

During the debate, Marsha De Cordova outlined five priority areas a strategy should prioritise, as follows:

1. A focus on an eye and sight loss pathway, which outlines care and support for people who receive a sight loss diagnosis,
2. Better collaboration between primary and secondary care,
3. Workforce expansion
4. Intelligence and data
5. Improving public awareness of eye health

So why these areas, and what does it mean? We explore the debate in detail below.

Why do we need a National Eye Health Strategy

Marsha De Cordova made a compelling case for each in outlining the priorities. For instance, in speaking about the need for an eye and sight loss pathway, she highlighted that “blind and partially-sighted people are likely to experience poor mental health outcomes such as depression and anxiety in their lifetimes.”

1. Eye and sight loss pathway

She called for “non-clinical community support” to complement the work of community optometrists, ophthalmologists and rehabilitation officers.

Through the merger of Fight for Sight and Vision Foundation, we will fund scientific research and projects that deliver social impact.

• Read why we’re backing calls for a National Eye Health Care Strategy

2. Better collaboration between primary and secondary care

Unifying primary and secondary care is vital because “demand for eye care services will increase by 40% over the next 20 years,” said Marsha De Cordova. She added, “Some of the burden on hospitals from that increased demand could be eased by more investment in high street optometrists and by changing the way services are commissioned.”

Technology may also provide a solution to community-based care. “Improved IT connectivity for two-way transfer of patient and clinical data would enable better patient care, and improved use of clinical skills and facilities in primary care, enabling more patients to be seen and treated closer to home.”

3. An expansion of the workforce

The third area highlighted was the shortage of ophthalmology professionals. A quarter of the profession is nearing retirement age, and there is a significantly uneven distribution of services across England. Nearly 80% of eye care units already do not have enough consultants to meet current demand.

• Read more on staff shortages and NHS delays

4. Intelligence and data

Better data is essential because “for too long, population data has not been used effectively to pinpoint the location of need and the places where opportunities for change can be found,” said Marsha De Cordova.

She added that a strategy would focus on ‘robust’ data collection to inform decisions and service delivery. “Without that data, we do not know whether public expenditure on eye health is meeting people’s needs.”

In addition, she highlighted the need for more significant investment in eye health research. “The UK government should increase spending on eye research, which gets a fraction of the investment it desperately needs,” said Marsha De Cordova, echoing some of the core findings of our Time to Focus report.

• Find out more about the research we’re funding to save sight and change lives.

5. Improving awareness of eye health

Finally, Marsha de Cordova pointed to the need for better awareness of services. “Two million people each year turn up to try and get a GP appointment for a problem that could be dealt with by a community optometrist,” she said.

She concluded by pointing to the fact that England is the only country in the UK without an eye health strategy. “Why will the Government not commit to an eye health strategy for England? When will the Government publish their overdue workforce plan? Will there be a focus on ophthalmology?”

Support for the Westminster Halls Debate

During the debate, support was evident for Marsha De Cordova and the need for her bill:

Dr Rupa Huq, Labour MP for Ealing and Acton, said:

“Some of these problems are intrinsic to our health service, such as the lack of joined-up-ness that she talked about between primary and secondary care, the fact that services are a postcode lottery and the pre-existing backlogs that were worsened by Covid.”

Dr Huq celebrated the work of Judith Potts, who persuaded the World Health Organisation to recognise Charles Bonnet Syndrome as a condition in the 11^th edition of the International Classification of Diseases.”

Dr Matthew Offord, Conservative MP for Hendon, supported the need for a strategy, saying:

“I never actually heard the Minister say that she would agree to an eye strategy. That was surprising considering that, during the debate, we learned that over 2 million people currently live with sight loss, and 350,000 people are registered blind or partially sighted. We also learned that age-related macular degradation is a leading cause of blindness. That can be averted with more accessible healthcare provision. We also learned that more people suffer from macular degradation than dementia.”

Karin Smyth, Labour MP for Bristol South, said:

“Living with sight loss from birth, and as many others find out, sight loss can be devastating—it affects work, how we travel through the world and how we interact with those around us. There is not only the physical impact, but the effect on our mental health, and on confidence, which is crucial for how we live our life.”

A full version of the debate transcript is available via the government website.