Ensuring patients have equitable access to community ophthalmology (eye) services in NW London

Across NW London a range of different community eye health services are being provided to patients through contracts with local providers. At the moment the way local people access and how GPs refer patients for this kind of treatment varies across eight boroughs: Brent, Ealing, Hammersmith & Fulham, Harrow, Hillingdon, Hounslow, Kensington and Chelsea and Westminster. This has led to inequality and inequitable access for patients

Community eye services allow patients to be seen away from the hospital for review and regular monitoring of eye conditions. This includes identifying patients who have conditions including cataracts (which can affect patients vision) and raised eye pressures which could be a sign of glaucoma. The services help support patients by picking up degenerative eye diseases early. Community services also help with the management of some minor eye conditions (e.g. red eye, non specific irritation to the eye and foreign body and emergency contact lens removal.  

There are a range of different community services in place across NW London, along with a range of hospital eye services.  This can cause some confusion about where a patient should be referred to.  When this happens it is possible that a patient could be referred to the wrong service which may cause a delay in their care.

There is data that shows that in some of our boroughs there is a higher rate of sight loss than the London average.  This suggests that there may be inequalities in how eye health is delivered across NW London.

Review of current services

We have reviewed how we currently provide community eye health services.  This review highlighted that there is inequity in patients being able to access these services.  Some patients access eye health services through their GP and the hospital eye service, whilst other patients are able to access eye health services through dedicated community services. 

What we would like to improve for patients and GPs

Our aim is to ensure that community eye health services are easy for GPs to refer into, providing the same level of access and equitable provision for all patients in NW London.

To make improvement to access and equitability we are exploring a single specification for an optometry led community service in NW London.

Next steps

As part of this service development work we want to hear from current patients and service users.

The new service specification will focus on understanding data from current services and information on local health inequalities and their impact on service delivery and transformation, as well as current evidence of best practice care pathways.

We have arranged a series of online and face to face drop in sessions to help build into the development process. Find out more and how you can attend.


We want to find out from you about how the current service is working for residents and what might make it work better. This will help the NHS design and improve how services work for patients and clinicians as well as reducing the differences between our boroughs.  This survey should take no longer than 10 minutes to complete.  We look forward to receiving your feedback. Please click here to complete the survey.

Questions and comments

If you have any questions and comments please email nhsnwl.communications.nwl@nhs.net

Closing date

The closing date for the engagement is 9 June 2023 so please make sure you complete the survey, attend one of the events or provide feedback by this time.

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