The Rise of Independent Prescribing by Optometrists in Wales 2020-2024: Number of Practices, Drugs and Costs

To evaluate the growth and prescribing patterns of community-based independent prescribing (IP) optometrists managing acute eye conditions in Wales between 2020 and 2024, a period that saw the introduction and subsequent commissioning of National Health Service (NHS) funded acute eye care with prescribing in primary care optometry throughout Wales.

Monthly prescribing data from NHS Wales Shared Services Partnership were analysed for all IP optometrists in Wales from 1st February 2020 to 31st January 2024. Data included drug name, British National Formulary classification, quantity, cost and health board location. Descriptive and correlational statistics were used to assess prescribing activity, regional distribution and cost trends.

The number of active IP optometry practices increased from eight in February 2020 to 68 in January 2024, with 20,980 prescriptions (49,162 items) issued at a total cost of £339,426. Corticosteroids, anti-infective agents and ocular lubricants were the most frequently prescribed drug classes. Ocular lubricants accounted for 34.0% of the total spend. Regional variation in prescribing activity was observed, with positive correlations between the number of active practices and both prescription volume and cost. Generic prescribing accounted for 47.0% of prescriptions, lower than national averages.

NHS commissioning of IP services in Wales has significantly expanded the role of optometrists in managing acute eye conditions in primary care. The findings highlight the potential of IP optometry to reduce pressure on general medical practice and hospital eye services. Further research is needed to evaluate clinical outcomes, cost-effectiveness and the broader therapeutic use of ocular lubricants in acute care.