In 2019 the Welsh Government introduced the ‘Eye Care Measures’ for NHS Outpatients after concerns were raised by RNIB Cymru that ophthalmology services across Wales were struggling. Patients were waiting far too long for both first appointments and for follow-up appointments. Because appointment targets were focused only on new patients, those already in the system and in need of ongoing treatment were delayed, regardless of clinical risk. This caused significant numbers of patients with treatable conditions to permanently lose their sight.

The Eye Care Measures allows for priority to be directed to the most urgent cases to ensure that patients with the highest levels of risk are treated in a safe and medically appropriate timeframe. All new and follow-up patients should be categorised based on their clinical need and given an individualised target date for when they should be seen.

However, the 2025 RNIB Cymru briefing for Senedd Cymru Health and Social Care Committee Ophthalmology Inquiry has reported the following key points:

• The number of ophthalmology patients waiting beyond their target date has more than doubled in the past five years.
• More than 80,000 patients at the greatest risk of permanent sight loss are waiting too long for sight saving treatments.
• Wales has the lowest numbers of Consultant Ophthalmologists per capita in the UK and in Europe (only North Macedonia has fewer).
• An electronic patient record and referral system (EPR) intended to give hospital ophthalmologists and community optometrists access to shared clinical information was launched in 2021. To date, there has been no public ministerial commitment and there is nothing in place for the implementation of EPR.
• The National Clinical Strategy for Ophthalmology was published by NHS Wales Executive in 2024. To date, there has been no commitment from the Welsh Government to make significant investments needed to implement the recommendations of the Strategy.

 

Eye Care Measure Data – January 2025

Health Board	Patients assessed as being at highest risk of irreversible harm waiting for an appointment	Patients assessed as being at highest risk of irreversible harm waiting beyond target date	% Patients assessed as being at highest risk of irreversible harm waiting beyond target date
Wales	161,902	80,826	49.9%
Betsi Cadwaladr	43,258	23,255	53.8%

 

The RNIB report concluded “While we wait and hope for a commitment and investment from the Welsh Government to support these plans to improve our eye care services, more than 80,000 people are sitting at home, anxiously awaiting their fate, hoping for an eye clinic appointment that could save their sight.”.