Chamber and committees

Established in 2014, the National Eyecare Workstream was set up to influence and embed change in the way that eyecare services are delivered in Scotland. The workstream focuses on using capacity and capabilities differently within and across Primary and Secondary Care, drawing together the different strands of work that contribute to building a sustainable service.

Throughout its duration, the National Eyecare Workstream has supported extensive data collection and analysis of hospital eyecare services, including future capacity and demand for cataract surgery. In 2018, taking into account population growth and demographic change, demand for cataract surgery was forecast to grow by up to 47% to 2035.

More recently the Royal College of Ophthalmologists has projected an increase in demand of 25% in the next 10 years and 50% over the next 20 years.

The National Eyecare Workstream has been working with Health Boards to streamline each stage in the cataract pathway to ensure maximisation of all available resources across the country.

In May 2021, the National Eyecare Workstream commissioned the Centre for Sustainable Delivery (CfSD) to deliver a Short Life Working Group (SLWG) to focus on improving efficiency and productivity within cataract only theatre sessions in line with the latest guidance from the Royal College of Ophthalmologists. This SLWG has supported several new and innovative pathway developments, including high volume cataract surgery in ring-fenced sessions and delivering one cataract every 30 mins. In parallel with this, the National Eyecare Workstream is undertaking clinically-led peer reviews which supports new and efficient ways of working and shares best practices across the country across a number of ocular sub-specialties, including cataracts.

A number of ophthalmic surgeons are now undertaking immediate sequential bilateral cataract surgery to prevent patients having to travel twice for surgical intervention enabling both cataract surgeries to be performed on the same day, one after the other. In a number of Health Board areas, non-medical staff have been upskilled to pre-assess and list patients for cataract surgery freeing-up ophthalmologists’ time to undertake duties only they are qualified to do e.g. perform cataract surgery.

The National Eyecare Workstream has also undertaken a workforce review across the entirety of NHS eye care services in Scotland. This was required to support workforce and service planning, and to ensure ongoing workforce sustainability. The final report, published in 2023, is available here: https://www.nhscfsd.co.uk/media/pjwntap4/national-ophthalmic-workforce-review-may-2023.pdf

In addition, our National Treatment Centres (NTC) programme provides additional protected elective capacity and infrastructure to meet the needs of the aging population, which is projected to grow by 25-30% between 2015 - 2035. We have allocated an additional £2.6 million to National Treatment Centre (NTC) Highland to deliver thousands of additional orthopaedic and ophthalmic operations every year, with approximately 61% of the additional funding intended to support ophthalmic procedures.

This is part of our wider investment of £110 million to address long waits for planned care, which includes over £12 million funding for ophthalmology services.

A number of Health Boards also have additional cataract slots at Golden Jubilee National Hospital.

Cataract surgery remains one of the most frequently performed surgical interventions across NHS Scotland. However, our health service has experienced unprecedented pressures over the past few years including the long-term impacts of the pandemic, seasonal and staffing pressures and unprecedented levels of inflation across the public sector. This has inevitably disrupted the NHS’s ability to carry out routine procedures, meaning longer waits for many patients.

The Scottish Government is committed to delivering reductions in waiting times, and has this year allocated an additional £12 million funding to NHS Boards for ophthalmology services.

The Scottish Government have not received reports of any extended delays for patients contacting NHS 24. We monitor NHS 24’s performance closely and remain satisfied that it continues to meet its statutory and clinical obligations.

NHS 24 has taken significant steps to improve performance, including increasing staffing levels to 1,556.9 WTE (2,199 headcount) as of March 2025 – an increase of 48.3% over the past decade. The service has also revised its key performance indicators to better capture unmet demand and identify risks where callers may have made multiple unsuccessful attempts to access 111.

The Scottish Government remains committed to supporting NHS 24’s efforts to improve service delivery and ensure that the 111 service continues to meet the needs of the public.

The Scottish Government continues to work closely with NHS 24 as it trials and implements new approaches to service delivery.

NHS 24 is also collaborating with key partners, including the Scottish Ambulance Service, to explore improved models of joint working. These efforts aim to enhance efficiency and ensure the 111 service remains responsive, effective, and aligned with the needs of patients across Scotland.

I understand that the Royal College of Ophthalmologists has recently written to Stephen Kinnock MP, Minister of State for Care, calling for a review into the use and oversight of independent sector providers for NHS-funded cataract surgery in NHS England.

NHS Scotland continues to make best use of existing NHS resources and capacity. Our National Treatment Centres (NTC) programme provides additional protected elective capacity and infrastructure for ophthalmic activity and a number of Health Boards also have additional cataract slots at Golden Jubilee National Hospital.

While NHS Scotland makes limited use of the independent sector, in certain circumstances limited use of alternative providers, including independent sector providers, may be required in response to capacity constraints.

The Scottish Government commissioned Centre for Sustainable Delivery (CfSD) is working with NHS Boards to ensure that they are able to continually identify new ways to increase capacity, and to respond to demand through service innovation and redesign.

In January 2022, Scottish Government commissioned CfSD to establish the Scottish National Cataract Short Life Working Group. This multi-professional group developed a 'Blueprint for Success' to deliver higher volume cataract surgery in operating theatres across Scotland; the aim being to deliver a minimum of 8 procedures per core 4-hour session or a minimum of one procedure every 30 minutes. The adoption of these minimum standards to deliver higher volume activity will reduce variation and waiting times for planned care across NHS Scotland.

The Blueprint for Success can be accessed here: https://www.nhscfsd.co.uk/media/5sofmknr/cataract-surgery-blueprint-2022.pdf

Furthermore, our additional investment of £110 million in 2025-26 has been targeted to specialty areas and NHS Boards where it can have the greatest impact against the longest waits, including for ophthalmology.

Finally, Our National Treatment Centres (NTC) programme provides additional protected elective capacity and infrastructure for ophthalmic activity. NTC capacity is a national resource and allocations are based on the latest Waiting Times management information available to Scottish Government at the time of decision. This approach ensures the NTCs are targeting the longest waiting patients that meet the clinical criteria for NTCs and allocations of activity have been determined on this basis.

There is no centralised public record that provides the exact number of people buried in unmarked graves in Scotland. National Records Scotland (NRS) collects data on all deaths in Scotland, but it does not publish statistics specifically on unmarked graves.

The Scottish Government is responsible for setting the strategic policy direction for NHS Scotland and its workforce. Operational matters, including the staffing of individual services, are the responsibility of each NHS Scotland Health Board.

At a local level, the Health and Care (Staffing) (Scotland) Act 2019 places duties on Health Boards to ensure that at all times suitably qualified and competent individuals are working in such numbers as are appropriate for the health, wellbeing and safety of patients, the provision of high-quality care and the wellbeing of staff.

The Scottish Government works with a stakeholder group (which includes NHS Education for Scotland, the British Medical Association, the Academy of Medical Royal Colleges and various Health Board representatives including regional workforce planners) to undertake annual reviews of the number of specialty training places (for resident doctors) needed across all specialties in order to meet anticipated future service demand and consultant need.

Workforce statistics, including statistics on certain roles within ophthalmology services across NHS Scotland, can be found at: NHS Scotland workforce | Turas Data Intelligence.

The Scottish Government does not hold this information.

Public Health Scotland (PHS) uses the national waiting times data mart to collect electronic patient records covering the waits that patients experience waiting for treatment as an inpatient or day case under the Treatment Time Guarantee. This data source can be used routinely to identify the specialty of treatment. However, although the records are designed to collect coded information on the procedure that is planned for the patient, this information is often either incomplete, lacking in essential detail and/or its accuracy cannot be assured. In addition, for patients who have completed their wait the procedures that was planned may not always reflect the procedure actually performed after they were admitted for treatment. The latter is not captured through the national data mart. Consequently, PHS is not currently able to report accurately on waiting times to this level of detail.

More detailed information on the procedures that is planned or undertaken for a patient will be held locally by NHS boards.

The information requested is not held centrally by the Scottish Government. More detailed information on cancellations and rescheduled appointments will be held locally by NHS boards.