A view of the sector

In total, IHPN members operate more than 150 sites delivering ophthalmology services in England, working in every commissioning area. These include standalone community ophthalmology centres, high-flow cataract hubs, outreach clinics and diagnostic centres – with members also operating some virtual pathways and working in partnership arrangements with local NHS health centres as well. For optometry, members operate more than 1,300 local practices and home visit teams.

During 2025, our members treated more than 400,000 NHS ophthalmology patients and delivered more than 1.4 million optometry appointments. Since April 2021, independent providers have delivered treatment to remove more than 2 million patients from NHS ophthalmology waiting lists.

Data from IHPN members shows that more than 3,000 clinicians are directly employed in the sector. Every year, the sector also delivers training to more than 1,000 clinical staff, along with placements for more than 250 trainee surgeons and vocational support for more than 1,000 trainee optometrists.

Clinical need

Independent sector providers deliver more than half of all cataract procedures carried out for NHS patients in England – but while cataract surgery is the biggest ophthalmic procedure by volume, IHPN members also deliver a significant range of other activity. This includes treatment for the most common causes of avoidable sight loss and visual impairment, including:

• glaucoma,
• ocular hypertension,
• posterior capsular opacification,
• age-related macular degeneration,
• diabetic eye disease,
• dry eye,
• lid lesions,
  and a range of other general ophthalmic conditions.

Services are delivered through a mixture of outpatient, day-case and diagnostic models, with surgery undertaken in dedicated clinical environments and outpatient care provided through both community and hospital-style settings, all of which are CQC registered.

Within optometry, services provide timely assessment and treatment for conditions such as:

• red eyes,
• dry eyes,
• flashes and floaters,
• foreign bodies.

These services are delivered by accredited optometrists in community settings, often with same-day or next-day access – and data shows that less than 15% of these patients are referred onward, with up to 80% treated and discharged within community practices. Optometry providers also offer many diagnostic, continuing care and follow-up services, including glaucoma referral refinement, monitoring of ocular hypertension, and cataract post-operative care.

A core strength of the independent sector is the ability to place services closer to patients. Pathways delivered in community settings – in line with the NHS 10-Year Plan’s ambition to deliver care closer to home and reduce reliance on hospital-based services – improve accessibility, reduce travel burden and free acute hospital capacity for more complex work. National coverage of provider locations means services are typically closer to patients, easier to access, and provide patients with a genuine choice of provider.

Demand for ophthalmology continues to rise, driven by an ageing population, chronic disease prevalence and increased referral rates. The impact of eye disease is significant to individual patients, and the cost of treating and supporting patients who don’t access early treatment, or who experience more significant vision loss, is borne not only by secondary care but also by primary and social care, as well as weighing on the families and carers of patients with declining vision.