Hospital OR Local Opticians? The Future of the NHS is on the High Steet
23 July 2025
A strong vision for the future of community eye care has been laid out by Dharmesh Patel, Optometrist and Chief Executive of Primary Eyecare Services, calling for the full integration of optometry into NHS neighbourhood care models by 2035.
In a newly released essay, From Vision Checks to Vital Care, Dharmesh urges healthcare leaders, commissioners and policymakers to reimagine optometry not as a peripheral provider of sight tests, but as a core pillar of preventative, personalised and digitally connected primary care.
“This isn’t a vision built on theory, it’s grounded in evidence and current delivery,” Dharmesh states. “We have the infrastructure, the clinicians and the public trust. What we need now is system recognition, strategic investment and national frameworks to fully embed eye care in the future of neighbourhood health.”
Part of the NHS Confederation’s Reimaging the Future of Primary Care series by providers at scale, the essay sets out a clear, achievable roadmap for how high-street optometry practices can serve as the first point of contact for urgent eye conditions and long-term condition monitoring and management, all delivered in collaboration with hospitals, general practice, community pharmacy and social care. These services would be enabled by fully interoperable NHS digital systems with access to shared clinical records, AI-supported diagnostics and streamlined digital referrals.
Optometrists would work to the top of their license, supported by new workforce roles such as Neighbourhood Eye Health Coordinators to proactively target population health, tackle health inequalities and reduce unnecessary demand on hospital and GP services. Shared care arrangements, digital advice and guidance, and advanced triage tools would support right-sized referrals, keeping care close to home wherever safe and possible.
Crucially, this vision is already being delivered. In 2024, Primary Eyecare Services, a not-for-profit primary care provider at scale, delivered care to more than 800,000 patients through over 3,000 optometry practices. These services prevented more than 515,000 avoidable hospital appointments and saved 250,000 GP appointments in a single year.
These real-world results directly support the 2024 PA Consulting report, which identified the potential to save £98 million annually and avoid 1.9 million NHS appointments through nationally scaled, community-led eye care.
“We’re seeing what’s possible when optometry is trusted to do more,” Dharmesh adds. “The opportunity now is to scale what works, embed optometry into neighbourhood care and make community-based eye care the new front door to the NHS.”
At Primary Eyecare Services we are looking forward to in the months ahead setting out how we will go about achieving this vision with our partners across optometry and wider NHS.
For the full essay, see here.