Delivering hospital eye care closer to home

Your team

This programme is designed for local MDT teams to be formed across sectors to come together to work on designing and creating solutions to enable ophthalmology acute services to transition out to the wider community setting. Any sector can lead on the steer of the project area, and the formation of your project team can be based on your local needs. We are flexible to what works best for you.  

For example, your team could include colleagues from an acute hospital such as Consultant Ophthalmologist, Optometrist, Nurse/AHP and Operational Business Manager along with your ICS/System commissioner, Eye Care Liaison Officer, operational, governance or finance leads, and out-of-hospital leads such as local optometry leads or GPs with extend roles in Ophthalmology.

The team should:

• Have colleagues across sectors from clinical, operational and commissioning aspects
• Have a minimum of 6 people to ensure meaningful engagement and discussions amongst the local teams
• Have a key leader assigned in your team to co-ordinate your project
• Consider including patient excerpt/representative, data analyst and improvement support at a local level.

Your project area

As part of the application, you will be asked to outline a sub-specialty that you would like to focus on, and describe some of the challenges you are facing and where you see the opportunities for improvement to be.

In the process of forming your team, you should have backing from your system and obtain approval from a Senior Responsible Officer (e.g. Executive Director who supports your project). We also recommend notifying your regional NHS England lead.

The proposal should be something that all members of your team agree to work on. We do not expect you to have full approval to transition the service, we recognise many teams are at the early stages of wanting to build a case/explore care closer to home and influence decision making.

The core aim is to support you to create and design your local transition plan for providing ophthalmology services closer to home, that is of high quality and standard to help lead to success in securing and implementing it in practice. We anticipate some teams will move to implementation stage through this programme but it is not a requirement for all teams.

Programme schedule

You will benefit from a structured course of resources and learning sessions focused on service transformation, as well as examples of inspirational best practice and guidance. All of the sessions will be delivered remotely, with the details as follows:

• Session one: Setting the scene (27 November 2025 9:30-12:30)
• Session two: Designing the future (13 January 2026 13:00-16:00)
• Session three: Finance and funding (26 February 2026 13:00-16:00)
• Session four: The implementation plan (24 March 2026 13:00-16:00)
• Session five: Engaging on the final plan (6th May 2026 13:00-16:00)
• Session six: Evaluation and celebration (9 July 2026 09:30-12:30)

Q: Finance is the biggest challenge, so how can you support that aspect?

The programme has a dedicated session focused on finance and funding and we have an expert advisor supporting us to shape this. We are also scoping out a separate roundtable discussion with finance directors across sectors on funding models for supporting care closer to home. The conversations from this will help inform the programme. We appreciate finance is a significant challenge and we will also seek to share good practice where care closer to home has been successful.

Q: Will there be any funding given?

There is no funding allocated from NHS Confederation (we are a charity organisation). This programme offers support to explore sustainable funding models with local commissioners to allow long term improvement/ transformation to take place. There are often pockets of funding that run out after a short term and can mean transformational changes end abruptly. We want to work with local teams to create a source of funding/ commissioning that invests in their transformational work long-term.

Q: Can we consider submitting more than one subspeciality area?

We have requested one sub-speciality area to be submitted as it is an intense programme, and each sub-speciality area pathway is different. Trying to work on more than one could lead to overload or lack of progress and might get too complicated for teams. For example, one session covers process mapping which could be challenging to complete in the allocated timescales if it is more than one sub-speciality.

Q: Are we expecting community optometrists to do something radical like take on the whole cataract pathway?

We do not have any set expectations on what should be done, we will be led by your local needs/expertise. We will not be advising on what you should do locally, that is a decision you will make based on your local needs. Everything you propose needs to be safe, in line with national guidance and covered by local governance procedures. We have expert partners who have successfully transitioned services from one setting to another who can offer advice on their experience, but all decisions should be made within your local setting.

Q: What is the role of Primary Eyecare Services in this programme?

This programme is independently led by NHS Confederation. Primary Eyecare Services are a not-for-profit organisation and a member of our primary care network, working with 3500 local optometry practices across 800 neighbourhoods in England. Their role in this programme is to help facilitate the engagement of primary and community-based optometry services, share best practice and lessons learned, as well as providing clinical expertise and insights to inform the design. We will also be working with a wide range wide range of expert partners to help provide diverse perspectives and experiences.

Q: Is the programme open to Primary Care as well?

Yes. Primary and community care service providers are expected to be part of the local ‘team’ put forward in any application. This programme is being delivered jointly by NHS Confederation’s ICS, acute and primary care networks. The aim is to help shift care closer to home and out of an acute setting where it is safe and appropriate to do so. We want to encourage greater use of the expertise and capacity that already exists within community settings, including high-street opticians.

Q: Will you be joined up so teams are not caught between different messaging from other areas such as Royal College of Ophthalmologist?

Part of our work behind the scenes will be to connect with other organisations such as Royal College of Ophthalmologists, College of Optometrists and GIRFT. We appreciate there are good resources, guidance and practice shared in professional bodies and other programmes of work.

Q: IT infrastructure/communication is a significant challenge between sectors – how will you help support this area?

We will work with our digital policy lead in NHS Confederation to explore barriers and what considerations are needed. IT is a complex area which is different across systems, and we will work with the six teams to map out what systems they use. The teams will share learning with each other on this and we can seek to engage with their Chief/Director level IT leads to explore this further.

Q: Are the applications open to ICBs?

Yes, we expect ICB colleagues to be involved in all applications, but the ‘team’ will require representation from local providers (acute and primary eye care providers) to ensure it is collaborative and inclusive, but most importantly involves those who will be delivering services. For example, an example raised in the session - an ICB might want to explore providing glaucoma monitoring services into community-based settings so they will form a project team with colleagues from across acute and primary/ community care to explore this.

Q: Learning from good practice/others is valuable, how will you include this?

The programme will have guest speakers sharing their improvement journey and how they have provided eye care closer to home. We will also provide a series of good practice examples and ensure the teams on the programme have the space and time to learn from each other as well.

Q: Will the programme provide a process framework rather than any specific resources?

The programme is designed to help local teams to create the best possible case and local framework to support eye care being delivered closer to home. At the end of the programme, each team should have created their best possible plan/case to enable this as well as some teams making steps to implement it. We will also provide resources along the way (relevant to each session) as well as good practice. We will also be publishing a resource at the end of the programme based on the findings/learning that will support local systems on “how” to provide care closer to home

Q: How does the buddy system work?

The six successful teams on the programme will each be paired with a team. This pairing will be based on whether they are working on the same sub-speciality area, geographical closeness and level of progress made so far. We will try to create buddy teams that align well together but recognise not all 6 might be directly linked with a team that is working on the same sub-speciality. You will still have opportunity to learn from each team and connect on the programme as well as a closed workspace area that will let you view other team’s progress and project documents relating to the programme. We have used the buddy system before and recognise it adds lots of value to teams by enabling close working with peers. There will be dedicated time for buddy teams in the sessions to learn from each other.

Q: What is the non-member fee to apply?

Firstly, if you are not sure if you are a member, we encourage you to email acutenetwork@nhsconfed.org or primarycare@nhsconfed.org so we can advise you. 

If you are not a member and still want to apply, we would have a direct 1-1 conversation with you to discuss a fee based on the scale of the team involved and number of organisations collaborating.