Chamber and committees

The Scottish Government recognises that long waits can have an impact on health and wellbeing. Waiting well | NHS inform on NHS Inform provides patients with information to support their health and wellbeing while waiting for health and social care services. This includes information on physical and mental health, as well as advice about practical issues like money worries.

We know many people are still waiting too long and this is not good enough. We are determined do more and our Budget will provide a record £21.7 billion for health and social care, with more than £110 million allocated to health boards to help tackle the longest waits for procedures and operations.

The funding has been assigned to specialty areas for the year ahead where it can have the greatest impact against the longest waits. This includes more than £12 million for ophthalmology.

I have met with all NHS Boards to discuss long waits across all planned care specialities including ophthalmology.

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.

The Minister for Public Health last met with Royal College of Ophthalmologists in July last year.

Scottish Government officials meet the College of Optometrists both bilaterally and as part of other groups/forums as and when required for policy development and implementation purposes. The next scheduled bilateral meeting with the College of Optometrists is on Friday 3 October 2025.

The number of ophthalmology trainees recorded as of July 28, 2025, and from 2015 has been provided in the following table.

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.

There is an extensive programme of work already in progress to support NHS Boards to reduce waiting times for all planned care procedures, including cataract surgeries.

This year, we have allocated more than £110 million to health boards to help tackle the longest waits for procedures and operations and this includes an investment of more than £12 million for ophthalmology.

The Centre for Sustainable Delivery’s (CfSD) National Eyecare Workstream also works with Scottish Government to support optometrists in the care for patients with cataract. In January 2022, we commissioned CfSD to establish the Scottish National Cataract Short Life Working Group to address current challenges in cataract surgery in Scotland.

This multi-professional group co-developed an agreed set of principles for delivering higher volume cataract surgery in operating theatres on a sustainable basis and assist in future proofing cataract services.

This work has led to the publication of Improving the Delivery of Cataract Surgery in Scotland: a Blueprint for Success which can be accessed here: https://www.nhscfsd.co.uk/media/5sofmknr/cataract-surgery-blueprint-2022.pdf.

The Scottish Government has confirmed that the replacement of the Edinburgh eye pavilion is a strategic priority, and the 2025-26 Budget provides the necessary funding to allow the development of the business case.

NHS Lothian has been asked to progress the business case and development of the design and timeline will form part of this work, which will take time. During an update to stakeholders in March, NHS Lothian advised an estimated timeline of 6 years.

It is usual for the business case process, construction and commissioning to take a number of years and there will be greater clarity on timeline once the business case process is complete.

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 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.