RNIB calls for improved ophthalmology services across Wales

RNIB Cymru has welcomed the publication today of the Health Inspectorate Wales (HIW) review of Ophthalmology Services in Wales.

Whilst highlighting some examples of good practice and progress to improve services, the review also evidences the need for continued work and development in several areas, in particular the need to ensure that capacity within the services is able to meet existing and growing demand.


RNIB Cymru is calling for consistency across Wales to ensure that patients are able to access the services they require at the right time and in the right place to avoid people losing their sight, or suffering unnecessary damage to their eyes.


The HIW review concentrated on Ophthalmology Services for ‘Wet’ Age-related Macular Degeneration (AMD). Wet macular degeneration, which usually occurs in people over the age of 50, is a chronic eye disease that causes blurred vision or a blind spot in your visual field. It is generally caused by abnormal blood vessels that leak fluid or blood into the macula, the part of the retina responsible for central vision.


‘Wet’ AMD is the leading cause of irreversible blindness in Wales. There is no cure and the aim of treatment is to preserve remaining vision, which makes early diagnosis, treatment and monitoring essential.


However, the HIW review points out: ‘The main issue for eye care services across Wales is insufficient capacity in secondary care to meet current demands. This issue is not restricted to macular degeneration services.’


Though HIW ‘saw some excellent examples of co-operation between primary and secondary care’, it also ‘heard that poor working relationships between primary and secondary care in some health board areas have hindered efforts to improve joint working.’


Ceri Jackson, Director of RNIB Cymru said:

“As the review says, despite the challenges facing services, many patients do continue to benefit from treatment, and along with HIW we would also like to acknowledge and praise the commitment and hard work of multidisciplinary teams across Wales who at times are working in difficult conditions.


“But it is disappointing to see that issues on which RNIB Cymru has called for action many times in recent years have yet to be addressed.


“Referral to treatment targets; the expansion of the use of optometrists; and, the consistency of services across Wales have been matters of concern which RNIB Cymru has raised over several years, and whilst these issues remain many patients are losing their sight.


“HIW’s review highlighted such matters as a lack of investment resulting in a ‘significant deficit in the capacity to deliver safe and timely care’; the need for ‘more attention to workforce planning’ in order to address the issue of the ‘recruitment and retention of medical and non-medical staff’; and ‘health boards demonstrating little understanding of capacity and demand’, matters which were to be addressed with the implementation of The National Ophthalmic Implementation Plan launched by the Welsh Government in January 2015, the purpose of which was ‘to improve patient experience and deliver sustainable services’, and a requirement that health boards understood and measured demand and capacity.


“It is the resolving of such issues, and others which the HIW review has highlighted, which will indeed provide a better experience for patients, and ensure services are sustainable. But most importantly, it would provide patients with the early diagnosis and treatment which is essential for reducing the risk of severe vision loss, and may well prevent them from losing their sight.”

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