New NHS “Getting It Right First Time” (GIRFT) guidance, published in May, endorses a shift toward integrated glaucoma care to address rising hospital waiting lists. By moving detection, monitoring, and follow-up services into community optometry practices, the NHS aims to reduce avoidable sight loss and alleviate the burden on hospital eye services, which currently handle roughly 20–25% of all ophthalmology outpatient activity.
The Integrated Care Model
The GIRFT guidance establishes a framework where primary eye care services assume a greater role in the glaucoma patient pathway. According to the NHS, this model utilizes community optometrists for early detection, repeat measures, and risk-based monitoring. This transition is designed to provide care closer to home while freeing hospital resources for patients with the highest clinical needs.
The Royal College of Ophthalmologists previously outlined similar requirements in its October 2025 position statement. The College emphasized that for this model to succeed, local services require two-way digital connectivity for image sharing, robust governance, and clear commissioning arrangements. They specifically identified referral refinement and the follow-up of treated ocular hypertension and low-risk primary open angle glaucoma as primary targets for community-based care.
Glaucoma affects over one million people in the UK. This figure is projected to reach 1.06 million by 2030, driven largely by an ageing population.
Sector Response and Implementation Challenges
Industry bodies, including the Association of Optometrists (AOP), the College of Optometrists, and FODO, have formally welcomed the framework. In a joint statement, these organizations noted that they worked alongside the GIRFT team to ensure community services were properly reflected.
Dr. Peter Hampson, clinical and policy director at the AOP, stated that optometrists are “uniquely placed” to manage both the detection and ongoing monitoring phases of the condition. However, the sector has been clear that clinical efficacy depends on funding. The Local Optical Committee Support Unit (LOCSU) noted that while the guidance provides a “clear and credible framework,” its success hinges on whether local commissioners provide the necessary funding to support these enhanced clinical services.
Patient Perspectives on Community Care
Public sentiment appears to align with the shift toward community-based services. A survey of 900 people published by the RNIB earlier this year found that patients are generally positive about receiving eye care in community settings. Despite this trust, the report identified a need for better public awareness regarding the availability of community optometry services.
Glaucoma UK, which is currently conducting a National Patient Voices Survey, reported that patients often find the current system “unpredictable and disjointed.” The charity is seeking to gather data from 10,000 people during Glaucoma Awareness Week 2026 to further refine how these new pathways are implemented.
Pro Tip: Accessing Care
If you have been diagnosed with glaucoma or ocular hypertension, ask your local optometrist if they participate in enhanced case-finding or monitoring schemes. Early detection remains the most effective way to prevent irreversible sight loss.
Frequently Asked Questions
Why is the NHS moving glaucoma care to the community?
Hospital eye services are currently overwhelmed, with glaucoma accounting for 20–25% of outpatient activity. Shifting stable or low-risk cases to community optometrists reduces waiting lists and prevents avoidable delays in treatment.
Is community-based care as safe as hospital care?
The Royal College of Ophthalmologists states that community care is effective provided there is robust digital image sharing, appropriate professional upskilling, and strict governance protocols in place.
What should I do if I am worried about glaucoma?
Because glaucoma often progresses without obvious symptoms, regular eye examinations are essential. Visit your local optometrist for a comprehensive check-up.
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