Protecting patient choice and strengthening information sharing across public health and independent services could improve NHS eye care services.
This is according to a new report from the Independent Healthcare Providers Network (IHPN), which warns that patients risk facing longer waits for NHS eyecare because of local differences in how services are commissioned and referrals managed.
The report – Protecting sight, expanding capacity: The independent sector’s role in building a sustainable NHS eyecare service – shows patient access to timely treatment can increasingly depend on where they live, with some areas making full use of available NHS and independent sector capacity while others operate more restrictive referral and commissioning arrangements.
New figures highlighted in the report show that independent providers are delivering more than 140,000 NHS ophthalmology appointments every month, and more than 400,000 NHS ophthalmology patients were treated by IHPN members during 2025.
It also shows that independent providers have helped remove more than two million patients from NHS ophthalmology waiting lists since April 2021, with IHPN members operating more than 150 ophthalmology sites across England, alongside over 1,300 community optometry practices and home visit teams.
However, the report highlights ongoing challenges in how eyecare is organised, including inconsistent access to patient choice, short-term contracting arrangements and referral pathways that can make it harder for patients to access available services.
It also calls for greater consistency in clinical quality, transparency and data sharing across NHS and independent providers, including participation in national clinical audits and outcomes reporting.
The report also raises concerns about the growing use of single points of access (SPOAs) to manage NHS eyecare referrals. While these can help ensure patients are directed to the most appropriate services and reduce unnecessary appointments, IHPN warns that poorly designed systems risk adding delays, restricting patient choice and leaving available treatment capacity unused.
Consequently, the IHPN is calling for these systems to be designed around patients’ clinical needs, with clear safeguards to ensure people retain their right to choose from the full range of qualified NHS-funded providers.
The report makes four recommendations to improve NHS eyecare services including protecting patient choice to ensure patients can access the full range of qualified NHS-funded providers, such as through SPOAs, with safeguards against unnecessary restrictions on referrals, and improving demand and capacity planning, giving commissioners a clearer picture of where patients need treatment and where capacity is available.
But it also calls for more stable contracting arrangements, enabling providers to maintain clinical capacity, invest in services and support workforce development, and to strengthen common standards for quality and data, to ensure consistent clinical audit, outcomes reporting and information sharing across NHS and independent services.
The report highlights the importance of better integration between community optometry and hospital eyecare, including more streamlined referral routes and carefully designed SPOAs, to ensure patients reach the right service without unnecessary delays.
It adds closer collaboration, consistent standards and more effective use of capacity across the whole health system will be essential to ensuring patients can continue to access timely, high-quality care.
David Hare, chief executive of the Independent Healthcare Providers Network (pictured), said: “Real progress has been made in reducing NHS eyecare waiting times, with independent providers playing an important role. But with demand set to grow significantly, we cannot afford to be complacent.
“Patients should not face longer waits simply because of where they live, particularly when there is capacity available to treat them. Changes to referral pathways, including single points of access, must improve access to care rather than restrict patient choice.
“We need a more joined-up approach across NHS and independent providers, with consistent standards of quality and care, to ensure patients get the treatment they need and avoid preventable sight loss.”
