Changes to primary eye care funding in Wales will disadvantage vulnerable patients, AOP says

Proposed changes to funding for primary eye care services in Wales could have “unintended consequences” that disadvantage vulnerable patients, the AOP has warned.

Patients who receive sight care and low vision services in their homes are at risk of losing access if the latest healthcare reforms proposed by the Welsh Government go ahead in their current form, the association said.

Under the current proposals, the fee for domiciliary services will be cut from £38.27 to £26 per patient.

The fee for annual low vision assessments, which often includes providing aids that support a patient’s independence and referrals to services such as GPs, will be reduced from £80 to £53.

The AOP emphasised that proposed funding cuts will see the number of domiciliary services reduced by 30%, leaving the estimated 30,000 people who rely on domiciliary services in Wales with “poor or inadequate choices.”

An AOP survey of optometrists providing sight care in Wales saw 40% say they were worried that giving care to patients in their homes will be more difficult under the proposed changes.

In the same survey, 52% said they are either unsure of the benefits of the new proposals or believe they will have little effect on reducing pressure on other healthcare services, such as hospitals and GPs.

The survey of AOP members working in Wales was conducted in May 2023.

The AOP is now calling on the Welsh Government to halt changes that could threaten vital services for elderly and housebound patients.

As it stands, changes could come into force as early as autumn 2023.

Adam Sampson, chief executive of the AOP, said: “There is no doubt in my mind that that the Welsh Government’s intentions are good. We all want patients to be able to access timely care and for the backlog to be cleared. But looking at the detail of the proposal, there are a number of unintended consequences that will have a significant impact on some of the most vulnerable patients in Wales.

“Crucially, we are urging the Welsh Government to rethink the funding cuts to the domiciliary service and the low vision service. Optometrists are telling us the existing services will disappear, particularly in rural areas, because members simply will not be able to afford to deliver them.”

Sampson added: “For patients who have no other way of accessing care outside their home, these proposed changes will limit patient choice and access to healthcare, with potentially devastating consequences to their quality of life.”

AOP members have also raised concerns over the proposed decrease in the value of NHS sight test vouchers, with 44% saying they are concerned about services for specific groups, particularly those on low incomes who are eligible for the vouchers.

Over 60% said these patients would be negatively impacted, facing increased costs and less choice on the glasses they can buy.

The issue of voucher values was also raised by optometrists OT spoke to in May.

Stephen Evans, optometrist-owner of Swansea’s Stephen Evans Optometrists, also a Hakim Group independent practice, said that a focus on vouchers needs to remain a priority.

“The vouchers for glasses have to be contributions towards glasses, rather than it being mandatory that you have to supply a pair of eyeglasses for the lower voucher values,” he said, adding: “I just don’t think that is sustainable.”

The proposals remain under review as part of nationwide consultation in Wales, which closed on 19 June. The AOP has submitted its response to the Welsh Government.