NHS 10 Year Plan - Lutra Health Response

This week, the UK government released its long-awaited 10-Year Health Plan for England: Fit for the Future - a bold framework for transforming health and care across the country. The plan acknowledges what those of us working in the system already know: the current model is under unsustainable pressure, and a fundamental shift is required.

At Lutra Health, we strongly welcome this vision and believe it can unlock enormous potential, especially in eye care. But if this plan is to be more than aspiration, we must ensure that the strategy translates into meaningful delivery, especially at the community level where most patient journeys begin.

Our entire mission is to provide the digital tools to connect patients, optometry and ophthalmology, thus enabling more care to be delivered by optometry.

A System at Breaking Point

Across England, hospital eye departments are buckling under the weight of demand. Delayed follow-ups, long waitlists, and fragmented handovers between community and secondary care are putting patients at risk and clinicians under strain.

This isn’t a new challenge. Over 640,000 patients were waiting for ophthalmology appointments as of early 2025, making it the second-largest outpatient backlog in the NHS. Many of these are chronic conditions, where time-sensitive monitoring is critical to avoid permanent vision loss.

And yet, we already have a highly trained, under-utilised workforce in place: community optometrists. These professionals are equipped to monitor stable eye conditions, triage new cases, and even co-manage patients with hospital specialists, provided they have the right tools, pathways, and support.

The 10 Year Plan Sets the Right Direction

The NHS plan rightly identifies three urgent shifts:

1. Move more care closer to home
   
   
2. Empower the workforce to operate at the top of their license
   
   
3. Use data, technology, and digital infrastructure to integrate care
   

Each of these goals directly supports what’s needed in ophthalmology:

• Closer to home: Many routine and stable follow-up appointments can safely happen in community optical practices, reducing unnecessary hospital visits and freeing capacity for more complex cases. Some can even be done remotely, with hospital-based clinicians or higher certified optometrists reviewing data such as visual fields, retinal images, OCTs without congesting overburdened hospital eye services.
  
  
• Workforce enablement: Optometrists are highly skilled but often underused. With appropriate governance and shared care agreements, they can manage more patients directly, without compromising safety.
  
  
• Digital infrastructure: Currently, there is no standardised, scalable system for referrals, shared records, or outcome tracking across eye care settings. This digital disconnect undermines safety and efficiency.
  
  

In short, the plan points in exactly the right direction. But as ever, the challenge lies in execution.

What Will It Take to Deliver?

Transforming vision care under this 10-year plan requires more than high-level commitments. It demands ground-level infrastructure that connects the entire patient journey. Here are four essentials we believe must be prioritised:

1. Integrated Digital Pathways

Patients move between community, secondary, and sometimes even tertiary services, yet their records rarely follow them. Lutra Health is working to bridge this gap, enabling:

• Structured digital referrals from optometrists to ophthalmologists
  
  
• Shared access to test results, images, and notes
  
  
• Real-time triage tools to flag high-risk cases earlier
  
• Feedback loops so community clinicians know the outcomes of their referrals

This isn't a luxury, it's a patient safety imperative.

2. Shared Care Models with Clear Governance

The NHS plan emphasises "team-based care" and the need to empower professionals. But this will only succeed if clinical governance keeps pace.

We need robust, standardised shared care frameworks that:

• Define scopes of practice clearly
  
  
• Provide appropriate training and audit mechanisms
  
  
• Protect clinicians with indemnity support
  
  
• Reimburse fairly for the work being done
  
  

Eye care has already pioneered some of this with schemes like MECS, glaucoma monitoring, and post-op cataract pathways, but scaling this nationally requires a more unified, supported approach.

3. Investment in Local Capacity

Shifting care to the community won’t work if practices are expected to absorb new workload without support.

The NHS plan references a commitment to expand diagnostic capacity - community optical practices are already distributed across the country, ready to act as local eye health hubs. Targeted investment in equipment, workforce development, and digital tools will go much further than building new brick-and-mortar capacity from scratch.

4. Patient-Centred Design

Finally, reform must work for the people who matter most; patients. That means:

• Clearer communication about where and how they’ll be seen
  
  
• Minimising duplication (e.g., re-testing or repeating history)
  
  
• Improved access, particularly for those with mobility, language, or socioeconomic barriers
  
  
• Faster escalation for urgent or sight-threatening issues
  
  

We believe that patients don’t care about system boundaries, as long as they can access timely, seamless, high-quality care. The system should reflect that.

Lutra Health: Building the Infrastructure for Modern Eye Care

Our goal is providing the tools to enable the shift from hospital to community care. 

We’re developing a universal eye care record that:

• Captures structured data from community eye exams
  
  
• Supports clinical decision-making and risk stratification
  
  
• Offers advice & guidance between optometry and ophthalmology
  
  
• Enables safe, digital referrals with embedded imaging and diagnostics
  
  
• Tracks shared care across settings with full visibility
  
  
• Surfaces high-risk cases early and ensures appropriate prioritisation

A Call for Action, Not Just Aspiration

We welcome the NHS’s 10-year vision. It’s thoughtful, ambitious, and grounded in the right principles.

But transformation doesn’t happen through strategy documents alone. It happens when clinicians are supported to deliver care differently, when digital tools remove friction instead of adding it, and when patients experience tangible improvements in access and outcomes.

In eye care, we have an opportunity to be at the forefront of this shift and we’re ready to support any health systems keen to drive change.

Get in touch to learn how we’re supporting ICBs, provider collaboratives, and community optometry networks to deliver joined-up, modern eye care.