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Clinical commissioning groups (CCGs) are responsible for commissioning all secondary care ophthalmology services and are also able to commission primary care services (i.e. minor eye services, glaucoma monitoring, referral, refinement and post cataract assessment) in the community to reduce secondary care demand for services and better meet identified needs.
We would expect services to be commissioned in line with National Institute for Health and Care Excellence guidance where it is available or best available evidence and for patients to receive treatment, in line with their clinical priority, without any undue delay at any stage of their referral, diagnosis or treatment. Where urgent referral pathways do not exist all patients in England have a right to start consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions. National guidance is also clear that all follow-up appointments should take place when clinically appropriate.
Getting It Right First Time (GIRFT) is a national clinical improvement programme, working with frontline clinicians to identify and reduce unwarranted variations in service delivery and clinical practice. The GIRFT programme looked at what can be done to ensure ophthalmology patients do not suffer unnecessary delays in follow-up care. NHS England advise the GIRFT report into ophthalmology, which will contain recommendations for service improvement, is due for publication shortly.