Our verdict on the 10-Year Plan for the NHS

Here are the key takeaways and our initial thoughts on the Plan.

The 10-year plan in relation to Eye Care

The Plan comes at a critical moment for eye care services, which are under severe pressure. Waiting lists and delays to treatment remain extremely high, increasing clinical risk and the danger of people losing their sight unnecessarily. We were therefore pleased to see ophthalmology specifically named as one of the priority specialisms of the Government’s ambition to tackle elective care waiting lists, and to deliver more eye care in the community, both of which we have campaigned for.

Speaking in Parliament on the morning of the Plan’s launch, Health Secretary Wes Streeting responded to a question on eye care by saying:

"We will support more eye care services being delivered in the community, helping to create capacity within secondary eye care services too.

Patients can be assured that optometrists have the training to manage a wide range of eye conditions safely in the community.

We will also support improved I.T. connectivity between primary and secondary care, which has been shown to improve the referral and triage of patients and enable the better use of technology to support local services.

Of course there are still challenges, ophthalmology is one of the largest outpatient specialties, representing 8 per cent of the total NHS waiting lists, and the Royal College of Ophthalmologist’s workforce census found that 76 per cent of units do not have enough consultants to meet demand.

We will address those issues. We are working both across the public sector and the independent sector to make sure people receive the care they need when they need it. Lots done, but as she [Marsha de Cordova MP] rightly says, so much more to do. "

Introduction of Neighbourhood Health Centres and bringing care into the community

The Plan sets out how the NHS will establish neighbourhood health centres in every community. These will deliver both hospital-based services, such as diagnostics, as well as wider support. RNIB wants to find out if these centres would include opticians and convey public health messages such as encouraging people to attend routine eye tests.

However, moving appointments closer to home won’t help if blind and partially sighted people can’t access them. For example, local community health centres can be closer but still difficult to get to, if they aren’t served by accessible public transport. We’ll be pressing for good signage and wayfinding at these centres, with properly trained staff who truly understand sight loss. We will look to work with the Government to ensure all new centres are developed with accessibility in mind.

Whilst there was only limited mention of social care, we were pleased to see the Plan contains multiple references to rehabilitation, forming an essential element to the creation of neighbourhood health services.

We have long called for the better integration of health and social care services. The plans outlined, alongside the ongoing Casey Commission, show some promising signs for the future. It will be vital to ensure vision rehabilitation services are brought into these locations to ensure a smoother transition from secondary to social care for blind and partially sighted people.

However, we know there are numerous challenges to secure the properly trained staff needed to deliver the required level of support for blind and partially sighted people. Any reform to the way vision rehabilitation is delivered must be made where the speciality of these professionals is protected and retained.

Greater rollout and use of the NHS App

A significant expansion in the use and functionality of the NHS app was announced so that it can come to serve as the ‘front door to the NHS’ in a drive to digitally transform working practices. For example, to track prescriptions, send out appointment reminders and test results, provide mental health support, and allow patients to review performance data on different health providers.

RNIB welcomes this increased investment in transforming the NHS from analogue to digital. We hope this will improve digitally enabled blind and partially sighted people’s access to their healthcare, providing that the NHS app’s end-to-end journey, core functionality and future updates are designed and tested for accessibility. However, we are also clear that non-digital pathways need to be maintained for individuals who cannot access the NHS app or digital services.

We were encouraged to see a focus on inclusion as a core driver of the NHS app outlined within the Plan. Accessibility by default will be key to meeting the UK Government’s ambitions for inclusion. We also welcome the efforts made to encourage more people to develop the digital skills needed to engage with the NHS app, including through the use of libraries. We will continue to highlight the importance of ensuring those delivering these services are fully aware of how to support people with sight loss and have an understanding of how assistive technologies can be used to benefit people with sight loss.

RNIB stands ready to support the development of the NHS App to ensure its accessibility for blind and partially sighted people. We are clear this needs to be accessible from inception and suited to the needs of people with sight loss.

Mental Health

We welcome the focus on mental health support as part of the Government’s plan to focus on prevention. We believe eye health professionals, as well as the wider health care workforce, should be adequately trained to ensure they are prepared and ready to have conversations with patients about mental health to help normalise the emotional impact of sight loss.

We further welcome the commitment to recruit 8,500 mental health staff for both children and adults, as supporting good mental health in childhood is crucial for later in life. However, it’s important that all qualified mental health professionals placed in schools receive training to ensure they are equipped to support children and young people with a vision impairment.

Single Patient Record

In another effort to increase productivity and streamline services, the Government has said it will introduce a Single Patient Record which will bring together all a person’s medical records into one place, likely to be rolled out from 2028. This will come to serve as a patient passport, ensuring seamless care no matter where they are in the NHS.

We hope that improving NHS digital systems in this way will allow NHS healthcare providers to better record, flag and share patient’s reasonable adjustments, including their communication needs. This means that blind and partially sighted people would only need to share their requirements once, e.g. needing large print, and have a higher likelihood of receiving them.

Importantly, this could provide the opportunity for a person's certificate of vision impairment (CVI) to be readily available within the NHS App to ensure they can share it with social care departments and get the benefits that it can bring them.

The Accessible Information Standard

Today’s plan emphasises the importance of patients being in greater control of their healthcare. But patient empowerment will only be achieved if peoples’ rights to accessible health information become a reality. Delivering this is vital to ensuring that everyone can access the health information they need in a format that works for them. It was therefore disappointing to see no specific commitment to fully implement the refreshed Accessible Information Standard (AIS). We believe the plan must reinforce the AIS across the NHS, with accountability and staff training to ensure compliance.

Upon the publication of the Plan, Vivienne Francis, RNIB’s Chief Strategy and Public Affairs Officer, said:

“We welcome the ambition of the 10-Year Health Plan for England, particularly its focus on prevention, innovation, patient empowerment, and moving care closer to the heart of communities. If designed inclusively, these goals could significantly improve access to timely eye care and patient information.

“In particular, we are delighted to see the priority given to tackling the ophthalmology waiting lists, and the move to delivering more eye care in the community, both of which we have campaigned for.

“Today’s Plan comes at a critical time for eye care. Waiting lists remain unacceptably high putting people at risk of avoidable and needless sight loss. For this plan to succeed, it must include action to tackle the backlog and guarantee that digital healthcare tools, like the NHS App, are fully accessible. Blind and partially sighted patients must have access to alternative formats like braille or large print through a single electronic record across health and social care.

RNIB is poised to support the delivery of the NHS Plan through the implementation of the eyecare support pathway.”

Read the ‘Fit for the Future’ plan in full.

Read what blind and partially sighted people wanted the plan to include.