16 June 2023

FODO’s response to Welsh Government consultation

FODO's members provide most primary eye care services in Wales and will play key roles in ensuring the proposed WGOS reforms are a success.

The FODO Board is currently finalising the FODO response to the Welsh Government consultation, Proposals to reform the ophthalmic services delivered in primary care in Wales, which will close on Monday 19 June.

We wanted to take this opportunity to thank all Welsh members for helping shape our response and to provide a final update before the consultation closes.

A reminder about why reforms are necessary

The Welsh Government is spot on when it says that eye care services in Wales must change if we are to meet population needs safely.

The government is also correct that there are simply not enough ophthalmologists to meet current and future eye health demand. Today people in Wales wait too long to see an ophthalmologist, putting their sight at unnecessary risk.

The government is also right that providing more eye care closer to home is the only way to help tackle avoidable sight loss due to capacity limitations and long waits in secondary care. There is no question or other option; change is urgently needed in Wales.

FODO's position

The Welsh Government recognises that primary eye care is a major health care asset, with a long history of working in partnership with NHS Wales and government. It has consistently delivered timely and high-quality care to patients innovating with PEARS over 20 years ago.

The Welsh Government recognises that primary eye care has the workforce and infrastructure to do more, but that the NHS has not taken full advantage of this.

The proposed reforms are about expanding primary eye care, reducing pressure on GPs and hospitals, and, most importantly, preventing sight loss due to the delays in hospital care patients currently experience.

Put simply, much of what the Welsh Government is proposing aligns fully with Principles and priorities for primary eye care, and therefore commands the full support of FODO and its members.

However, there are two elements of the proposals FODO cannot support when we know these will have detrimental impacts on the poorest and most vulnerable in society.

The first is cutting patient voucher values (a patient benefit, not a practice benefit). This would see the most claimed vouchers cut to a level where practices are unable to meet patients' needs at anything but the most basic level and, even then, cross subsidising from clinical fees to plug this new funding gap. 

The second is the genuine yet unaddressed concerns raised by domiciliary eye care providers.

We will set out these concerns in our detailed submission. Neither of these issues is unsolvable. It is hoped that sensible discussions between Optometry Wales, Welsh Government and NHS Wales will find a way forward before the reforms start to be implemented later this year. 

Working together with everybody focused on serving patients' best interests will result in the genuinely transformational change Welsh people urgently need, and which FODO members of all sizes and disciplines in Wales are looking forward to playing their full and enthusiastic part in delivering.

Optometry Wales FAQs

Optometry Wales (OW) has today published a new set of FAQs. We encourage all members in Wales to read them in full, especially if you are planning to respond to the consultation.

FODO would also like to take this opportunity to thank the OW Board members for their hard work in analysing a mammoth volume of information since the consultation opened in April.

OW Board colleagues are volunteer clinicians who have given a lot of their personal time to serve the sector, especially since April. As clinicians always focused on patients' best interests, the OW Board has also shown candour in these FAQs about previous shortcomings, while looking forward to and remaining focused on helping deliver essential changes to protect and serve patients.

We are confident that FODO members in Wales will support them in this approach and the efforts they are making to get things right for all patients.

What members should do next

With clinical manuals not yet published, many of you have told us that it has been difficult to respond to the public consultation in any detail. Whilst we agree, we hope there is now enough information available from our previous newsletters and OW FAQs, for members to make informed responses to the consultation both about the benefits and any potential negative effects on patients.

If you do wish to respond to the consultation, but do not feel you can answer all the questions without more detail, there is still time to answer questions where you think you can add value. Welsh Government would welcome all feedback. Read the OW FAQs and take part here.

At the same time, if you are still struggling to respond, FODO has developed a comprehensive response on behalf of all members in Wales and we will capture all the feedback you and other members have provided. You can still send your feedback to us by emailing [email protected] before 8pm on Sunday 18 June.

The importance of speaking up

Finally, we understand that some people might feel nervous about speaking up because they have heard that any challenge might result in the Welsh Government pulling all reforms and their patients having to continue suffering from current systems failures.

The Welsh Government is unlikely to do that. Public consultations are not negotiations, they are about due process and ensuring policymakers understand the full range of views and can, if in the public interest, review and refine proposals.

If you are concerned about any specific aspect of these reforms, such as cuts to patient benefits or certain changes to domiciliary care, simply make this clear in a response to the Welsh Government or to FODO in a constructive and supportive way and we will pass it on. There is so much to be supported in these proposals, that we will be keen to show balance on your behalf and welcome the many aspects which are clearly positive for the people of Wales.