Effective eye care and sight loss services are a key component of efficient local health and well-being services.
The UK Vision Strategy offers straightforward and comprehensive advice and guidance to help commissioners and commissioning groups through all stages of the eye care commissioning process that covers:
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Assessment of current services and working across professional boundaries, employing their clinical expertise and knowledge of the local population
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Design, specification and commissioning of services to meet need
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Identification of investment priorities to reduce inequality, improve patient experience and achieve cost savings
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Resources include key data sources, policy documents and guidance on developing effective Joint Strategic Needs Assessments (JSNAs) - all essential for an effective eye health commissioning.
Find out more about effective eye care commissioning.
Commissioners can save the sight of patients by understanding the urgency of wet AMD
Our new report highlights how Commissioners can help prevent unnecessary sight loss in wet AMD patients by improving the wet AMD pathway and understanding the urgency of diagnosis and treatment.
Wet AMD - or wet Age-related Macular Degeneration - is an eye condition that affects 40,000 older people every year. As wet AMD can develop very quickly, resulting in loss of central vision, urgent referral to a hospital eye clinic is vital.
The report, Don't lose sight! Don't delay!, is part of RNIB's Save our Sight (SOS) campaign.
Wet AMD can lead to sight loss in as little as three months. This is why it's vital that patients are diagnosed in the hospital clinic within seven days, and that treatment commences within the next week, in line with Royal College of Ophthalmologists guidance.
The report reveals that the time taken from first contact to diagnosis varies greatly, with 69 per cent of cases being diagnosed outside of the recommended seven days (1).
Other key findings from the report highlight:
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There are clear gaps in commissioning - both capacity and understanding wet AMD.
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Patient feedback is often not collected, limiting opportunities for service improvement.
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Preventable delays were caused by GPs or optometrists not adhering to agreed referral procedures, for example making general referrals to a retinal clinic, rather than highlighting suspected urgent wet AMD cases
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One third (34 per cent) of patients felt that there was a lack of information and support at the time of diagnosis.
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A lack of low vision services for supporting patients where treatment is not successful.
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Over referral of patients who don't have AMD is also an issue, putting pressure on Ophthalmologists' capacity to treat urgent cases.
Actions for Commissioners
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Reduce health inequalities by basing commissioning decisions on robust sight loss data collected as part of the Joint Strategic Needs Assessment.
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Create clinical commissioning teams with a good mix of staff across primary and secondary care, including social care and eye care professionals.
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Involve the public, patients and patient groups - such as RNIB - in decisions about commissioning eye care services.
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Fund tools, such as Ocular Coherence Tomography (OCT) in the community to help optometrists and GPs identify potential wet AMD patients.
Download the report
Don't lose sight! Don't delay! report (Word, 490KB)
(1) Royal College of Ophthalmologists guidelines (PDF, 370KB)