The Department of Health and Social Care has announced a £20 million investment to roll out e-referrals to all optical practices with NHS contracts in England, to support direct referrals to secondary services including NHS Online when it launches in 2027.
DHSC has shared hopes that this will allow “millions” of people to benefit, with the potential impact on reducing unnecessary referrals simply by directly being passed on to a specialist.
All optical practices with an NHS contract will be granted access to the e-Referral service and National Care Record Service by April 2028, DHSC outlines, giving optometrists a view of eye care records to support their clinical decisions. Funding will further be used for training and supporting practices to use the new systems.
“In areas where digital referral systems are already in place, GP referrals for eye care have already fallen, demonstrating the potential of this national roll-out to reduce unnecessary demand across the wider health system and free up GP appointments for other patients,” DHSC reports.
The announcement accompanies new GIRFT guidance on Glaucoma. Joanne Creighton, Glaucoma UK chief executive, said: “The publication of the GIRFT guidance is an important step for glaucoma care at a time when services are under real pressure. Improving early detection, strengthening referral pathways and making better use of digital systems all have the potential to create a more joined-up and less stressful experience for patients.”
Earlier this year, NHS England listed glaucoma, cataracts, and macular degeneration among initial focuses for the new NHS Online service. Peter Thomas, consultant ophthalmologist and Moorfields Eye Hospital’s director of digital development, highlighted the success of the trust’s single point of access system for eye referrals, linking GPs and optometrists with specialists online. “With our single point of access service, we’ve been defining how a virtual hospital can support better eye care,” he said. “We’ve used technology to improve the capability and efficiency of the system, and which allows clinicians in the community and hospital services to work more closely together to streamline care. The impact is clear – patients are being seen more quickly in more appropriate settings, and the pressure on NHS services is being reduced.”
Wider trend: Digital eye care
The digital eye care programme is continuing to be rolled out across Wales, with the Welsh Government issuing an update on its current status by health board for the OpenEyes national EPR and OPERAi national electronic referral system for eye care. All health boards have now implemented both systems either in full or in part, the government states, promoting real-time sharing of clinical information, along with consistency in national referral and triage processes.
Teams from Moorfields Eye Hospital NHS Foundation Trust and the University College London Institute of Ophthalmology have developed an AI tool capable of predicting patients at risk of developing retinopathy, following use of a common autoimmune medication, said to be widely prescribed to treat rheumatoid arthritis, lupus, and other autoimmune conditions. Trained using more than 8,000 eye scans from 409 patients in the US and UK, the HCQuery algorithm works by analysing retinal images captured using optical coherence tomography, a standard part of screening for hydroxychloroquine patients. It correctly identified 100 percent of patients with retinopathy up to 2.74 years earlier than doctors, according to Moorfields, also achieving 91 percent accuracy in ruling out patients without the condition.
Moorfields spin-out Cascader has announced its partnership with Specsavers focused on harnessing the potential of AI innovation to improve patient care in optometry. Cascader, a spin-out from Moorfields, UCL and Topcon Health, is focused on building clinical-grade AI for ophthalmology. A mission statement from its website outlines its work to use AI “to enable safe, evidence-based decisions in high-volume, high-risk eye conditions” and to use oculomics for early detection of systemic disease.
