Ophthalmology Services

Inquiry5

The Health and Social Care Committee held a short inquiry into Ophthalmology Services in Wales, including consideration of:

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>>>Organisational reform and service efficiency: examining the Welsh Government's efforts to integrate primary and community care optometrists into the eye care service model, focusing on redesigning referral pathways to improve patient access, while also evaluating how government policies support health boards in making these changes and aligning leadership to drive improvements.

>>>Workforce expansion and training: reviewing the Welsh Government’s efforts to increase training capacity, expand roles for optometrists and other healthcare professionals, and evaluate the impact of the All Wales International Recruitment Programme on staffing shortages. Assess how workforce initiatives align with the National Workforce Plan and the effectiveness of investment in transforming the optometry workforce to reduce reliance on hospitals.

>>>Hospital and infrastructure improvements: reviewing the progress with upgrading hospital facilities and addressing outdated spaces, investigate delays in implementing digital systems like the ophthalmic EPR and eye care referral systems, and assess funding and outcomes for infrastructure improvements in primary and secondary care. Investigate the impact of delays implementing improved digital systems and their interoperability. Assess plans to meet growing demand in ophthalmology, including the use of telemedicine and AI tools to improve care.

>>>Clinical Networks and equal access to care: reviewing the establishment of clinical networks to ensure equal care across regions, addressing disparities in care delivery and waiting time performance. Evaluate the Welsh Government's approach to regional service and workforce distribution, and how clinical networks can improve collaboration between health boards and patient outcomes. Also, assess the effectiveness of new care pathways in prioritising high-risk patients and using community-based optometrists for non-complex cases. Finally, examine collaboration between health boards and third-sector organisations, such as the Eye Care Support Pathway, to ensure holistic patient support.

>>>Oversight and implementation: evaluating the Welsh Government’s oversight of strategy implementation, including leadership commitment at the health board level. Assess the role of Digital Health and Care Wales (DHCW) in accelerating IT system rollouts.. Investigate how delays and inefficiencies are being addressed, and what penalties or corrective measures are in place for missed timelines.

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Report

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>>>The Committee published its report on 28 November 2025.

>>>The Welsh Government responded to the Committee’s report on 15 January 2026.

>>>Letter from the Chair, Health and Social Care Committee to the Cabinet Secretary for Health and Social Care requesting a further response to report recommendations on 9 February 2026.

>>>Letter from the Cabinet Secretary for Health and Social Care in response to the Committee’s follow-up questions on the report recommendations on 24 February 2026.

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Follow-up work

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>>>On 30 January 2026, we wrote to stakeholders inviting comments on the Welsh Government’s response to the Committee’s report.

In particular we sought views on the following:

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***Urgency and Interim Action: The Welsh Government’s response frequently defers decisions and ties action to future governance arrangements, without setting out immediate steps to address risks such as avoidable sight loss. Do you feel the Welsh Government’s response adequately reflects the urgency of the issues identified in the Committee’s report, or are there immediate actions you believe are missing?

***Governance and Oversight: The recommendation to establish a dedicated oversight board was not accepted, with the Welsh Government deferring this until governance reforms conclude in April 2026. How concerned are you about the lack of a defined oversight structure in the period before the new governance arrangements are finalised? Do you see risks to accountability or delivery?

***Investment and Resourcing: For several recommendations – particularly on secondary care investment and workforce training – the Welsh Government either deferred decisions or pointed to other bodies such as Health Education and Improvement Wales (HEIW), without committing new resources or setting timelines. From your perspective, does the response demonstrate sufficient clarity and commitment around the investment and resourcing required for ophthalmology services?

***OpenEyes and Digital Delivery: The Welsh Government accepted the OpenEyes recommendations but only in part. Do you have confidence in the current digital delivery plans (particularly OpenEyes), or do you feel greater transparency and scrutiny are needed at this stage?

***Data, Harm Reporting, and Performance: The response supports principles such as subspecialty reporting and harm-reporting protocols but provides limited milestones, timelines, or compliance expectations. How important do you think it is for the Welsh Government to set clear milestones and expectations for data reporting and harm-reporting? Do you see gaps in what has been provided so far?

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Stakeholder responses in response to the Welsh Government’s response to the Committee’s report:

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>>>FOP01 Optometry Wales

>>>FOP02 RNIB Cymru

>>>FOP03 Health Education and Improvement Wales (HEIW)

>>>FOP04 Royal College of Ophthalmologists

>>>FOP05 Hywel Dda University Health Board

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