Preventing Avoidable Sight Loss: How Community-Based Glaucoma Care is Delivering the NHS Vision
23 July 2025
As the NHS looks to the future, the integration of community-based services into neighbourhood care models is no longer a vision – it’s a necessity.
Glaucoma, a leading cause of irreversible sight loss, affects over 700,000 people in the UK. Yet nearly half remain undiagnosed due to its symptomless progression and long hospital waiting times, which can stretch up to 72 weeks in some areas.
Primary Eyecare Services is already delivering on the NHS 10 Year Plan’s ambition to bring care closer to home. Through a network of over 3,000 high street optometry practices, we are transforming glaucoma care by offering early detection, repeat testing, and shared care services that reduce pressure on hospitals and improve patient outcomes.
A Model That Works
Recent research from Primary Eyecare Services evaluated the outcomes of Glaucoma Enhanced Referral Services across 11 Integrated Care Boards (ICBs) in England between 2021 and 2024. The study reviewed 14,376 patient cases, with a mean age of 65.2 years and found that nearly half (49.2%) were safely discharged to routinely follow-up, avoiding unnecessary referrals to secondary care. With a deflection rate of approximately 50%, the service has the potential to significantly reduce the burden on hospital eye services, improve waiting times and deliver cost savings to the NHS, the findings advocate for wider adoption and consistent commissioning across England.
The study highlights that 50.8% of patients were referred to secondary care, with 45.3% routed routinely to glaucoma services, 4.1% urgently and 1.4% to other specialties. These outcomes demonstrate the effectiveness of filtering referrals and reducing false positives, aligning with NICE and GIRFT guidelines.
Our Glaucoma Repeat Readings Service supported a further 8,991 patients, using precise equipment to confirm or rule out high intraocular pressure findings. These services are delivered by clinicians in accessible optometry practices (key neighbourhood/community settings), ensuring timely intervention and reducing unnecessary referrals.
This model is not only clinically effective, it’s scalable. According to Fight for Sight, glaucoma diagnoses are expected to rise 17% by 2032. Yet only 24% of hospital eye units believe they have sufficient consultant capacity to meet current demand. Community optometry offers a sustainable solution.
Aligning with the NHS 10 Year Plan
The NHS 10 Year Plan calls for neighbourhood care, moving services out of hospitals and into the community. Primary Eyecare Services exemplifies this shift. In the past year, our services prevented over 515,000 hospital appointments and saved 250,000 GP visits. We are already operating in hundreds of neighbourhoods and the opportunity to scale nationally is clear.
As Dharmesh Patel, Chief Executive of Primary Eyecare Services, writes in his NHS Confederation essay, “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.”
A Call to Action
The integrated glaucoma model is one of four key pathways recommended for national rollout in PA Consulting’s 2024 report, “Key Interventions to Transform Eye Care & Eye Health.” It is a proven, patient-centred approach that supports prevention, personalisation and digital integration, core pillars of the NHS’s future.
As we look ahead, the message is clear: community-based eye care is not just a complement to hospital services, it is the new front door to the NHS. Now is the time to scale what works, embed optometry into neighbourhood care, and ensure every patient has access to timely, high quality glaucoma services, wherever they live.
Resources
See here our research poster ‘Outcomes of Glaucoma Enhanced Referral Services (GERS) based in Primary Care Optometry in England 2021 – 2024’
See here for the PA Consulting Analysis