Br J Ophthalmol doi:10.1136/bjophthalmol-2012-302067
  • Global issues

Better value eye care for the 21st century: the population approach

  1. JA Muir Gray2
  1. 1Moorfields Eye Hospital, London, UK
  2. 2Department of Health, London, UK
  3. 3NHS Leed PCT and Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK
  1. Correspondence to Aeesha NJ Malik, Moorfields Eye Hospital, London, EC1V 2PD, UK; aeeshamalik{at}
  • Received 21 May 2012
  • Revised 28 November 2012
  • Accepted 6 December 2012
  • Published Online First 15 January 2013


Health services globally and in the UK face challenges from increasing need and rising expectations to inequalities and financial constraints. The UK government has recently published a Public Health Framework for the first time. This has included preventable sight loss as an outcome measure for the nation's public health reflecting increasing recognition of eye health issues in the broader public health agenda. This presents a real opportunity to improve eye care services at a population level. However, the chief executive of the National Health Service (NHS) has set his own challenge to the NHS to find £20 billion in efficiency savings in the next 3 years in order to maintain services within the available healthcare budget. We have reviewed national routine healthcare data in order to understand the current financial expenditure, activity and outcomes in ophthalmology. Our results have found a wide variation in expenditure in healthcare and activity across the country. We discuss a population based, value-orientated approach to dealing with healthcare issues which will provide a sustainable framework for the future.

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