Long waits for eye care have a huge impact on people’s lives.
With a new survey revealing people’s health deteriorating amid long waits for specialist eye care, Healthwatch England has called for greater use of high street optician services, including optometrists working in optician services, to help cut waiting times.
An optometrist’s role is to detect defects in vision, signs of injury, ocular diseases or other abnormalities. Optometrists often work alongside other professionals in primary eye care, supporting people with a range of eye problems and referring people for specialist care.
Expanding their role and responsibilities, such as being able to treat patients for a greater range of conditions, would help more people with the most serious eye conditions to be identified and referred for specialist care earlier.
Responses from 1,051 self-selecting people currently waiting for specialist eye care appointments suggest that the vast majority (85%) of people support the idea of optometrists being able to refer patients without seeing a GP first. Over 65% are comfortable with them helping to monitor and treat eye conditions.
The survey, which asked people to share their experiences of eye care between July and September 2024, found many people struggled while waiting for specialist care:
Of those currently waiting, 70% said they noticed some deterioration in vision.
People currently waiting for eye care reported that long waits affect their ability to continue their hobbies, 75%; mental health, 69%; ability to work, 52%; and relationships, 36%.
The most common type of support people reported needing was ‘knowing who to contact for further information’ about their care. However, only 14% of people said they knew who to contact.
Barely any people (4%) said they had been given advice and information to help them with day-to-day activities, such as working.
Eye care is the busiest outpatient speciality in the NHS in England, and with an ageing population, demand is set to grow further.
According to NHS statistics, last December nearly 600,000 people were waiting for specialist eye care, a third of whom (33%) had been waiting more than the 18-week target set by the Government.
And getting referred for specialist eye care may be a long process for some. Of those currently waiting, almost a quarter (22%) had to have multiple appointments before being referred.
The patient champion calls for optician services to take on more responsibility for managing people’s eye care and referring them for specialist treatment to help cut waiting times. Additionally, actions such as those proposed in the Optometry First model are needed to improve communications and support for people waiting for eye care.
Highlights of our research
Patients waiting for NHS specialist eye care strongly support using high street opticians’ staff more to help address the impact of long wait times.
Seventy per cent of patients report a decline in vision during their wait for care, while over half said the wait impacts work, daily activities or mental health.
Just four percent report getting information and advice to help with day-to-day activities like working.
Healthwatch England urges the Government to use community optometrists more to cut waits and the NHS to improve patient support while they wait. Clearer NHS data is also needed to ensure patients with the most serious eye conditions get help first.
Chris McCann, deputy chief executive at Healthwatch England, said: “Long waits for eye care are having a huge impact on people’s daily lives, including their ability to work, manage daily tasks, socialise or take part in hobbies such as reading.
“We know that highly skilled optometrists in the community are in every locality in England. Our survey shows overwhelming public support for better using this capacity through models such as Optometry First, where optometrists and their teams support patients before and after hospital care. This provides an ideal opportunity for them to take on more responsibility for managing people’s eye care and referring them for specialist treatment.
“There also needs to be better communication and support for those stuck on waiting lists. The positive impact of Eye Care Liaison Officers, a Royal National Institute for the Blind programme that provides vital support to those diagnosed with a condition that affects their sight, is well documented.
“We ask the NHS to ensure trusts and other commissioners and funders of eye care services support the increase and sustainability of this programme, which is not currently available to all patients.
“Lastly, the NHS should publish condition-specific data to ensure patients with the most serious eye conditions get help first.”
The NHS publishes waiting list data for ophthalmology treatments as a whole. However, providing information specific to different conditions would improve oversight of waiting times for more serious cases and help ensure resources are used effectively.
Dave’s story: “It’s like I’m just talking to a wall”
Dave, 67, from Newcastle, has been trying to get treatment for a painful cyst in his right eye for four years. Two years ago, he joined a waiting list to have the cyst examined by a specialist, but he’s not heard anything since. He’s also waiting for glaucoma and cataract treatments, but he can’t start these until the cyst is removed (because there’s a risk of infection if it bursts).
The cyst causes Dave a lot of discomfort. It’s painful and excretes fluid that then hardens and crystallizes. This makes it hard for him to open his eye and blurs his vision.
“It’s sore all the time,” Dave says. “It leaks like glue. That makes it hard to see, especially at night and makes things like going to the shops difficult because it’s like looking through a viscous liquid.
“But when I ask when I might get help, nobody ever tells me anything. It’s like I’m just talking to a wall!”
About our research
In total, 2,568 people responded to a survey about their eye care experiences, published by Healthwatch England on its website between July and September 2024:
1,766 people responded to the questions about having eye tests in the last two years.
471 people responded to the questions about currently waiting for secondary eye care.
580 people answered the questions about secondary eye care in the last two years.
This report focuses on the 1,051 people who responded to the questions about waiting for secondary eye care. We use the statistics from the survey and responses to free text questions to illustrate the impact on people of waiting for eye care.
Download our report
If you need this report in a different format, please email enquiries@healthwatch.co.uk or call 030000 68 3000.
Ordering medicines when they aren’t needed can mean you end up with more than you need in your cupboard. Small changes in managing our medicines can make a big difference and help reduce medicine waste in the North East and North Cumbria.
That £20m could help fund:
535 more nurses per year
476,190 more GP appointments per year
1,574 knee replacements
What is stockpiling?
At some point, you might have thought about ordering extra medicines “just in case.” It’s a natural reaction, especially if you are worried about running out of something important. However, ordering more than you need or holding onto medicines you don’t use (known as stockpiling) can lead to problems.
Why stockpiling isn’t helpful
Wasted resources: Medicines that are not used often, go out of date and have to be thrown away. This wastes NHS funds that could be better used elsewhere.
Supply issues: If some people stockpile, it can create shortages, making it harder for others to get what they need.
Medicines safety: Holding onto medication can lead to mistakes about what to take and when, especially if your prescription changes.
When we order only what we need, we help make sure there is supply for everyone. It also helps the NHS focus on giving the best care for all. Don’t forget – if you’re worried about running out or delays, speak to your pharmacist or GP practice. They are there to help!
How you can help
We can all take simple steps to make sure medicines are not wasted, so the NHS can focus resources where they’re needed most. Here’s how:
1 Only order what you need: Check what medicines you have at home before you place an order, and only order what you need.
2 Hand back: When you collect your medicines from your local pharmacy, make sure that you only have what you need. If you return an item before you leave the pharmacy, it can be reused.
3 Stick to your routine: Order your medication when you are running low, and no earlier. You can set up notes in your calendar to help you check to see if you need to order more.
On Saturday, around 60 volunteers braved the cold to plant a variety of trees at the hospital in South Shields.
The trees were donated by NHS Forest, which is run by the Centre for Sustainable Healthcare (CSH). This initiative started in 2009 and has seen more than 100,000 trees planted on or near NHS sites.
Several types of trees were planted, including Dogwood, Field Maple, Hawthorn, Crab Apple, Bird Cherry, Rowan and Hazel.
The tree planting supports South Tyneside and Sunderland NHS Foundation Trust’s sustainability commitment as well as its aim to reduce its impact on the environment.
The trees will create a greener space for patients, visitors, and staff and play an important role by storing carbon to benefit the wider environment.
Once grown, these trees will create a natural barrier between the hospital and the John Reid Road. Helping to reduce the noise pollution and absorb emissions from the road.
In the future, many of the trees will blossom, providing an important nectar supply for insects and fruit for wildlife.
Ryan Swiers, Public Health Consultant and Sustainability Lead at STSFT, said: “We’re committed to creating a cleaner and greener environment for our staff and our patients. This work forms part of the Trust’s green plans, improving biodiversity and helping us move towards the NHS carbon reduction targets.
“I’d like to thank everyone who was involved in this project. As well as everyone who volunteered on the day. There was a real sense of community and it’s so rewarding to know we’ve contributed to something that will benefit future generations.”
Coun Ruth Berkley, Lead Member for Adults, Health and Independence (pictured with Ryan Swiers), said: “We all recognise the power of nature to improve our environment and enhance our wellbeing and this project supports our vision for South Tyneside to be a place where people live healthy, happy, and fulfilled lives. We also welcome the Foundation Trust’s commitment to sustainability, supporting our wider action on climate change.”
The project was carried out in collaboration with Choice, STSFT’s subsidiary company. Robertson Group donated boots for volunteers and provided welfare facilities on the day.
Wyn Construction excavated and prepared the ground and MES Construction dug the holes for each tree. Southern Green also who helped with the landscape strategy and planting proposals.
Around 60 volunteers helped to plant the trees, including STSFT staff and their families and STSFT volunteers. Volunteers also attended from Natural England, Ryder Architecture, P&HS Architects, Cad 21, Turner & Townsend, Jasper Kerr, Southern Green and Robertson Group.
Reforms to reduce bureaucracy, make savings and empower NHS staff to deliver better care for patients have been set out today by the Prime Minister, Keir Starmer.
NHS England will be brought back into the Department of Health and Social Care (DHSC) to put an end to the duplication resulting from two organisations doing the same job in a system currently holding staff back from delivering for patients. By stripping back layers of red tape and bureaucracy, more resources will be put back into the front line rather than being spent on unnecessary admin.
The reforms will reverse the 2012 top-down reorganisation of the NHS which created burdensome layers of bureaucracy without any clear lines of accountability. As Lord Darzi’s independent investigation into the state of the NHS found, the effects of this are still felt today and have left patients worse off under a convoluted and broken system.
The current system also penalises hardworking staff at NHS England and DHSC who desperately want to improve the lives of patients but who are being held back by the current overly bureaucratic and fragmented system.
Health and Social Care Secretary, Wes Streeting, said: “This is the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction and most expensive NHS in history.
“When money is so tight, we cannot justify such a complex bureaucracy with two organisations doing the same jobs. We need more doers and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline.
“NHS staff are working flat out but the current system sets them up to fail. These changes will support the huge number of capable, innovative and committed people across the NHS to deliver for patients and taxpayers.
“Just because reform is difficult does not mean it should not be done. This government will never duck the hard work of reform. We will take on vested interests and change the status quo, so the NHS can once again be there for you when you need it.”
Sir James Mackey, who will be taking over as Transition CEO of NHS England, said: “We know that while unsettling for our staff, today’s announcement will bring welcome clarity as we focus on tackling the significant challenges ahead and delivering on the government’s priorities for patients.
“From managing the COVID pandemic, the biggest and most successful vaccine campaign which got the country back on its feet, to introducing the latest, most innovative new treatments for patients, NHS England has played a vital role in improving the nation’s health. I have always been exceptionally proud to work for the NHS – and our staff in NHS England have much to be proud of.
“But we now need to bring NHS England and DHSC together so we can deliver the biggest bang for our buck for patients, as we look to implement the three big shifts – analogue to digital, sickness to prevention and hospital to community – and build an NHS fit for the future.”
Incoming NHS England chair, Dr Penny Dash, said: “I am committed to working with Jim, the board and wider colleagues at NHS England to ensure we start 2025 to 2026 in the strongest possible position to support the wider NHS to deliver consistently high-quality care for patients and value for money for taxpayers.
“I will also be working closely with Alan Milburn to lead the work to bring together NHS England and DHSC to reduce duplication and streamline functions.”
Work will begin immediately to return many of NHS England’s current functions to DHSC. A longer-term programme of work will deliver the changes to bring NHS England back into the department, while maintaining a laser-like focus on the government’s priorities to cut waiting times and responsibly manage finances. It will also realise the untapped potential of the NHS as a single payer system, using its centralised model to procure cutting-edge technology more rapidly, get a better deal for taxpayers on procurement and work more closely with the life sciences sector to develop the treatments of the future.
The reforms to deliver a more efficient, leaner centre will also free up capacity and help deliver significant savings of hundreds of millions of pounds a year, which will be reinvested in frontline services to cut waiting times through the government’s Plan for Change.
The changes will crucially also give more power and autonomy to local leaders and systems – instead of weighing them down in increasing mountains of red tape, they will be given the tools and trust they need to deliver health services for the local communities they serve with more freedom to tailor provision to meet local needs.
The number of people working in the centre has more than doubled since 2010, when the NHS delivered the shortest waiting times and highest patient satisfaction in its history. Today, the NHS delivers worse care for patients but is more expensive than ever, meaning that taxpayers are paying more but getting less.
Too much centralisation and over-supervision has led to a tangled bureaucracy, which focuses on compliance and box-ticking, rather than patient care, value for money and innovation. In one example, highlighted by Dame Patricia Hewitt’s 2023 review, one integrated care system received 97 ad-hoc requests in a month from DHSC and NHS England, in addition to the six key monthly, 11 weekly and three daily data returns.
The review also revealed the challenges caused by duplication – citing examples of tensions, wasted time and needless frictional costs generated by uncoordinated pursuit of organisational goals that do not take account of their wider effects.
Substantial reform, not just short term investment, is needed to deliver the government’s Plan for Change mission to get the NHS back on its feet and fit for the future, and this announcement is one of a series of steps the government is taking to make the NHS more productive and resilient so that it can meet the needs of the population it cares for.
NHS England’s new leadership team, Sir Jim Mackey and Dr Penny Dash, will lead this transformation while re-asserting financial discipline and continuing to deliver on the government’s priority of cutting waiting times through the Plan for Change.
These reforms will provide the structure necessary to drive forward the three big shifts identified by government as crucial to building an NHS fit for the future – analogue to digital, sickness to prevention and hospital to community.
Since July, the government has already taken significant steps to get the NHS back on its feet, including bringing an end to the resident doctor strikes, delivering an extra two million appointments seven months early and cutting waiting lists by 193,000 since July.
Responding to today’s announcement, Healthwatch England Chief Executive Louise Ansari said: “We know people want better access to and experience of care for everyone, in particular those facing health inequalities, including disabled people, carers, and those on low incomes.
“During the forthcoming period of change for NHS England, it’s important that everything possible is done to ensure that patients’ care is not disrupted and that the progress the NHS has been making in some areas is not reversed.
“Going forward, any changes in structures need to have improvements in patient access to and experience of care at their heart.”
Smoking causes one in four of all cancer deaths in England and kills up to two-thirds of its long-term users, claiming around 80,000 lives a year in the UK.
While smoking rates have declined in recent years, 11.9% of the population – 6m people in the UK – still smoke. The latest statistics from NHS England show that in 2022-23 there were an estimated 408,700 hospital admissions due to smoking. This means that almost every minute someone is admitted to hospital because of smoking.
It is estimated that smoking costs the country £21.3bn a year in England. This includes an annual £18 billion loss to productivity, through smoking related lost earnings, unemployment, and early death, as well as costs to the NHS and social care of £3bn.
On average, you could save around £2,500 per year by quitting smoking; three-quarters of smokers wish they had never started.
Just a few statistics that should make smokers think twice about quitting on No Smoking Day.
When you stop smoking, there are almost immediate improvements to your health:
after just 8 hours harmful carbon monoxide levels in your blood will have reduced by half
after 48 hours your senses of taste and smell are improving
after two to 12 weeks circulation will have improved
after three to nine months lung function increases by up to 10%
after one year the risk of heart attack will have halved compared with a smoker’s
after 10 years the risk of death from lung cancer will have halved compared with a smoker’s
after 15 years the risk of heart attack is now the same as someone who has never smoked.
Evidence shows that once people have got past the short-term withdrawal stage of quitting, they have reduced anxiety, depression and stress and increased positive mood compared with people who continue to smoke.
Where can I find help to stop smoking?
Getting free expert support from your local stop smoking service is proven to give you the best chance of quitting successfully. Some are now able to offer free vape starter kits too.
NHS Better Health offers a range of free quitting support including the NHS Quit Smoking app, Personal Quit Plan, 28-day email programme, local stop smoking service look-up tool, as well as advice on stop smoking aids including information on how vaping can help you quit smoking.
Launched last year by North East and North Cumbria Integrated Care Board (ICB), the Big Conversation heard from almost 5,000 women as part of a programme aiming to make the region a driving force for better women’s health.
The new report – published by the region’s independent Healthwatch network – used a regionwide survey and a series of focus groups to better understand what matters to women about their health.
More than half the respondents pointed to mental health as a key concern, with healthy ageing, bones, joints and muscle health also highlighted. More than four women in ten said that menopause, cancer screening, menstrual and gynaecological health should be high priorities.
The six focus groups who took part included one with women from ethnic minorities in South Tyneside, facilitated by Healthwatch South Tyneside.
Claire Riley, the ICB’s chief corporate services officer and lead for women’s health, said: “We can look at the data and see what services women are using, but there’s no substitute for asking women what they want. We want to make a sustained difference to women’s health, and that means doing more listening.
“Our NHS provides many fantastic services, but we can do better in understanding women’s needs. Many women have told us that they don’t always feel they are listened to or their needs taken seriously. We want to change that, and the Big Conversation will help us understand women’s concerns better.”
The report proposes a new ‘Women’s Promise’ to detail the level of care, dignity and support women can expect, as well as a directory of women’s health services and more options to see a female health professional, get a second opinion or escalate concerns if needed.
New ‘women’s health MOTs’ can provide regular check-ups, screening and a place to raise concerns, while more training in women’s health issues can help GPs and healthcare professionals to raise standards of care.
Samantha Allen, the ICB’s chief executive, said: “I welcome this report and I’m keen to learn from what women have told us. We have made progress in some areas with women’s health hubs, working to improve menopause care and support, and training more primary care staff in contraceptive fitting.
“But we know there is a lot more to do such as better support for conditions like poly-cystic ovary syndrome and endometriosis, more options for postnatal contraception and helping more women in deprived areas get hormone replacement therapy when they need it. If we can make things better for girls and women, everyone benefits.”
Lindsay Graham of North East and North Cumbria Healthwatch Network added: “We’re grateful to every woman who contributed to this project, enabling us to get a brilliant understanding of what is important to women and challenges they face. Listening to these experiences has shown us how much needs to change. This report will help ensure that women’s voices lead to real improvements in healthcare and we’d like to thank the ICB for welcoming our recommendations.”
The region’s NHS kicked off its women’s health programme last year by opening women’s health hubs in Sunderland, Gateshead and North Cumbria, while the ICB also signed up to the Menopause Workplace Pledge to better support the many NHS staff who are affected by menopause symptoms. In addition, Newcastle Hospitals NHS Foundation Trust is investing in a fourth mobile breast screening trailer, to improve access to screening in rural areas.
NHS England’s new leadership team, Sir Jim Mackey and Dr Penny Dash, will lead this transformation while re-asserting financial discipline and continuing to deliver on the government’s priority of cutting waiting times through the Plan for Change.
