Delivering Hospital Eye Care Closer to Home
Supporting teams to move ophthalmology services out of hospitals to community/primary care settings, including high-street opticians.
Eye Care Closer to Home: From Policy to Practice
This session will explore what it really takes to move ophthalmology services out of hospitals into community and neighbourhood settings.
Improvement
Cross-sector partnerships
A key challenge for health services is how to practically provide care closer to home rather than in an acute hospital, to help reduce waiting lists and improve access and experience for patients.
Ophthalmology, or hospital eye services, are a key area in which patient experience can readily be improved by making use of and building upon existing resources outside of hospitals such as community and primary care services including high-street opticians.
Our programme, launched under the NHS Confederation and continued as the NHS Alliance, is supporting multidisciplinary teams across a neighbourhood, acute and ICS footprint to understand, plan and create the infrastructure and processes to move ophthalmology care closer to a home via optometry practices in local neighbourhoods.
The programme
Running for eight months, from November 2025 to July 2026, the programme includes six virtual learning sessions, with up to six teams selected across England.
Through the programme, teams will receive extensive support to design and create solutions to move services for their chosen sub-discipline of ophthalmology from a hospital setting into the wider community.
We support them to:
- Identify, plan and agree the scale of transition
- Work together with peers and experts to create a robust implementation plan
- Create a final blueprint for service transition
Having launched in November 2025, we will be sharing outcomes from the programme as it progresses.
Participating teams
- Team Hertfordshire and West Essex: Urgent eye care - reducing attendances at A&E for minor conditions.
- Team North East and North Cumbria: Glaucoma - standardising pathways for patients with ocular hypertension (HT) and chronic open angle glaucoma (COAG).
- Team Humber and North Yorkshire: Glaucoma - improving processes for monitoring, managing and following up with patients with glaucoma or suspected glaucoma.
- Team North West London: Medical retina conditions - improving processes for monitoring and managing lower risk conditions including ocular naevus, age-related macular degeneration (AMD), vein occlusion, and hydroxychloroquine (HCQ).
- Team North West London: Children and young people's services - integrating pathways.
- Team Surrey Heartlands: Glaucoma - improving processes for monitoring, managing and following up with patients in community settings.
- Team Leicestershire & Northamptonshire: Glaucoma - improving processes for monitoring, managing and following up with patients in community settings.
- Team Birmingham and Solihull: Children and young people's services - improving screening.
Expert partner
Primary Eyecare Services is a not-for-profit primary eye care provider at scale. They operate in 800 neighbourhoods working with multiple Integrated Care Boards across England, delivering high quality eye care services. They collaborate with Local Optical Committees, NHS commissioners and NHS trusts to provide locally accessible eye care to patients at scale. Their services are provided in neighbourhoods via local opticians, from the smallest independent practices to the largest chains.
This programme is also being supported by the Q community, which is hosted by the NHS Alliance. Q is diverse membership community collaboratively accelerating the improvement of care in the UK and Ireland. The community learns together, supports each other and shares insights and approaches to address health system challenges. By leveraging the knowledge and experience of the community and partners, Q has a ‘whole world’ view of health and care in the UK and Ireland.
Meet the team
Programme ambassadors
Cecilia Fenerty
"A recently retired Consultant Ophthalmic Surgeon, Cecilia worked at Manchester Royal Eye Hospital (MREH), UK from 2002 to 2024, both as lead for Glaucoma Services and latterly as Medical Director. Her practice comprised a specialist tertiary referral service for complex adult and paediatric glaucoma.
She holds an Honorary Chair position at the University of Manchester and her research interests are mainly clinical, including diagnostic and treatment methods for glaucoma in adults and children and the impact on deprivation on glaucoma patients and their condition.
Nationally, Cecilia has held a number of roles: NICE Fellow (National Institute for Health and Care Excellence) for Glaucoma, and was part of the NICE Guideline Development Group for the Glaucoma Guidance of 2009 and 2017; Royal College of Ophthalmologists External Advisor; Expert Advisor to the Medicines and Healthcare Regulatory Authority (MHRA); and Advisor for the Parliamentary and Health Service Ombudsman. In 2011 she Chaired the UK and Eire Glaucoma Society and is a founder member of the UK Paediatric Glaucoma Society and has been a Trustee of the national charity Glaucoma UK for 4 years. Cecilia has no commercial affiliations or interests."
Lisa Gibson
“Since qualifying as an optometrist in 2005, Lisa has worked for a range of organisations in various roles. She has a vast experience of the delivery of commissioned community services having worked within primary eyecare companies since 2015 in the North East and Nationally. Through leadership and communication, she ensures that services are provided effectively and efficiently.”
Lisa has been involved with the NHS Confederation's programme to support teams to move ophthalmology services closer to home.
Jayne Mason
"Jayne brings twenty-five years’ experience of working with clinical teams to improve delivery of health care and has a strong reputation for bringing system partners together to respond to wicked issues that cross organisational boundaries.
She brings a mix of diligence, flexibility, resilience, attention to detail and a professional no nonsense business manner with a sense of humour.
Jayne’s commissioning expertise, training and development skills, and prioritisation of relationship building create the perfect combination to lead teams through a transformation journey."
She has been involved with the NHS Confederation's programme to support teams to move ophthalmology services closer to home.
Programme design and facilitation team
Ruth Rankine
Ruth Rankine is director of the Primary Care Network at NHS Alliance, the national membership organisation which represents the whole of the NHS in England, Wales and Northern Ireland. She also leads on neighbourhood health and community care. She joined the Alliance in December 2019 to set up the PCN network, expanding it to become the Primary Care Network reflecting the need for inclusivity across the whole of primary care. Ruth was the Confed’s covid vaccination programme lead during the pandemic and led national influencing activity as well as speaking on TV and radio on behalf of our members. In her role in the Confed, Ruth has also strengthened links into ICSs through the establishment of primary care focused forums with our partner ICS network.
Prior to joining the Alliance, Ruth worked in a range of strategy and operational leadership roles in the NHS and Government. She was Deputy Chief Inspector for general practice, online services and military health at the Care Quality Commission and Director of Strategy and Planning at NHS Direct where she led the organisation’s national response to the bird flu pandemic.
Ruth began her career in the NHS in the North East, moving to the NHS Executive where she worked in a variety of policy roles. She undertook a range of secondments to NHS organisations latterly as Director of Urgent and Emergency Care Transformation in Leeds. She was then appointed as Principal Private Secretary to the NHS Chief Executive and Permanent Secretary in the Department of Health where she worked on a range of high-profile national policy issues, gaining cross government exposure to No 10 Downing Street.
Ruth held the position of vice-chair of Carers First, a charity for carers which expanded from a local to a national organisation delivering services across 7 areas of the country.
She holds a Bachelor’s degree in Business Studies and Languages. Ruth lives in Kent with her husband Andy and spaniel Millie.
Sonia Nosheen
Sonia joined the NHS Alliance in January 2023 and is the Assistant Director for the Acute Network. Her previous work experience has been working in acute hospitals for 15 years across various roles such as patient safety manager, quality improvement, transformation manager and operational business manager.
Sonia leads on supporting and leading some of the Acute Network’s portfolio of work, supporting members to be represented and involved in policy change, implementation and developments.
Sonia has a master's in Improvement Science and Innovation from Lancaster University and degree in Health and Social Care is passionate about quality improvement. She is a QSIR Associate, Advanced Improvement practitioner and proud to be a John's Campaign Ambassador. In her spare time, she enjoys drawing digital art and visual concepts.
Follow Sonia on Twitter at @Sonia_Sparkles
Dharmesh Patel
Dharmesh is an optometrist by background and is chief executive of Primary Eyecare Services, the largest optometry not for profit lead provider of enhanced eye care services in England. With a strong clinical pedigree as well as wide-ranging expertise in service design and procurement he remains actively involved in the role of primary care in its whole entirety.
Dharmesh was the inaugral chair of the Greater Manchester Primary Care Provider Board (2015-2023) and remains active on the board as chair of the optometry provider sub board. The board brings community pharmacy, dentistry, general practice and optometry together to act as a unified voice within NHS Greater Manchester.
He is also the former chair of both the Greater Manchester Local Eye Health Network.
Richard Everitt
“Richard has spent most of his career in the private sector working in senior commercial roles for blue-chip companies. He first moved into the public sector in 2013 when he joined Herefordshire CCG leading a transformation programme to modify and improve services at Wye Valley Trust.
This paved the way to his role at NHS England as the Senior Programme Lead for optometry within the central policy team. Over a 5-year period he managed all optometry related matters within primary care and led workstreams including IT connectivity, the development of the COVID Urgent Eyecare Service (CUES), plus the design and implementation of the Special Schools Eye Care Service.”
Richard has been involved with the NHS Confederation's programme to support teams to move ophthalmology services closer to home.
Jen Morgan
Jen leads on Q’s system wide change work including developing strategies and delivering programmes for learning and improving at scale.
She has been involved with the NHS Confederation's programme to support teams to move ophthalmology services closer to home.
Anindita Ghosh
Anindita creates inclusive and inspiring learning environments to enable participants to learn by doing to support large scale change.
She has been involved with the NHS Confederation's programme to support teams to move ophthalmology services closer to home.
Tarnia Mason
Tarnia leads on Q membership recruitment processes and collaborative change through grant programmes including Q Exchange and Supporting Q Connections. She also works on Q’s local system-focused offers.
She has been involved with the NHS Confederation's programme to support teams to move ophthalmology services closer to home.
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