AQW 50343/22-27
Miss Nuala McAllister
Alliance Party
North Belfast
Tabled Date: 02/07/2026
Answered On Date: 22/07/2026
Priority Written: No
Question:
To ask the Minister of Health whether there are any policies for prioritisation for patients on an ophthalmology waiting list at risk of permanently losing their sight.
Answer:
In Northern Ireland two Health and Social Care Trusts are responsible for Ophthalmology services, Belfast and Western HSC Trusts. Both HSC Trusts follow the regional Integrated Elective Access Protocol, the policy which advises that patients are assigned an appointment according to clinical priority. When a referral is received it is triaged by a consultant who determines clinical priority. Patients are wait-listed and assessed according to clinical need. If there is evidence that vision has deteriorated or, there is a risk of irreversible sight loss whilst waiting, Integrated Elective access protocol supports requesting that the patient’s referral be re-assessed. If a patient presents to their community optometrist, or GP with a concern about their vision since their initial referral, an updated referral can be sent to the HSC Trust; the referral can be re-prioritised if appropriate and the patient booked to the next available clinic. Getting it Right First Time (GIRFT) for Ophthalmology is a national clinician-led programme adopted by healthcare systems in the UK and which is designed to improve the quality of care by identifying and implementing good clinical and administrative practice, reducing variations, and enabling access to timely care and treatment for patients. Although Northern Ireland has not undertaken a funded GIRFT review for ophthalmology, the principles adopted by GIRFT are followed in the planning, delivery, and performance-management of ophthalmology locally. GIRFT focuses on core eye conditions such as cataracts, glaucoma, age-related macular degeneration (AMD) and diabetic eye conditions; although not a formal policy, its adoption by clinical leadership locally is key to transforming and improving care in ophthalmology. Patient Initiated Follow-Up (PIFU) is another process employed by the HSC Trusts to help manage waiting lists, freeing capacity to assist patients with priority conditions access timely care. My Department has recognised Ophthalmology as a speciality requiring additional support and protection for red flag and time critical patients. The elective care implementation plan specifically identifies increasing capacity in Vitreoretinal, Corneal, Glaucoma and Macular Services to address patients at risk, including those at risk of irreversible sight loss. The Belfast Health and Social Trust has recently received funding (£3.5m) to actively addressing capacity issues in high-risk sub-specialty areas. In addition, clinical and administrative waiting list validation is ongoing within the service to ensure waiting lists are accurate and those most at need are identified, recent validation work has resulted in reductions in waiting lists for general ophthalmology (~31%), cataract service (~20%) and oculoplastics (~9%). This important work frees capacity in regional ophthalmology services to assess and treat patients with sight-threatening and priority conditions. Primary care optometrists have embraced many ‘shift-left’ service developments in recent years with the aim of providing care in the right place at the right time, freeing capacity in the hospital eye service for patients with more complex eye conditions to receive essential treatment and care. Further developments in these services through the Neighbourhood Model will build on these gains and assist HSC Trusts in managing their waiting times for patients who are at risk of sight loss.
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