Wales General Ophthalmic Service (WGOS) National Clinical Lead (NCL) brief for Health and Social Care Senedd committee.
WGOS NCL, May 2025
1.0 Wales General Ophthalmic Services (WGOS) overview
Following legislative changes in 2023, 1,2 Wales General Ophthalmic Services (WGOS) replaced General Ophthalmic Services (Wales) (GOS[W]), Eye Health Examination Wales (EHEW), Low Vision Service Wales (LVSW), and many various local enhanced service pathways. Welsh Government policy 3-5 provided the platform for this change and support the delivery of care within the primary care setting to providing care closer to home and ensuring that people only attend hospital eye services when required.
WGOS is a Primary Care Optometry service delivered from both fixed location premises in the community and closer to/in homes via mobile practices. To deliver WGOS, each contractor and practitioner must be listed on the Wales Ophthalmic or Administrative list and must have completed WGOS compliance training provided by Health Education Improvement Wales.
WGOS is a tiered Service comprising of the following:
· WGOS 1: Eye examination, incorporating prevention and well-being and patient management plan
· WGOS 2: Consists of 3 bands
o Band 1 – Acute eye care and referrals for examination from another healthcare professional.
o Band 2 - Further examinations following WGOS 1 to inform or prevent a referral.
o Band 3 - Follow up examinations to WGOS 2 Band 1 and Cataract Post-operative Assessments
· WGOS 3: Low Vision assessments and Certification of Vision Impairment
· WGOS 4: Referral filtering and monitoring for glaucoma and medical retinal, Hydroxychloroquine monitoring
· WGOS 5: Independent Prescriber Optometrist Services.
2.0 Wales General Ophthalmic Services (WGOS) Governance
The National Health Service (Wales Eye Care) (Wales) (No. 2) Directions 2024 2 came into force on 01 April 2024, providing for the establishment of the Eye Care Wales Committee (ECWC), which includes Local Health Board (LHB) members to oversee the holistic delivery of the WGOS. The committee oversees three subgroups consisting of: Health Board subgroup,
Clinical subgroup and the IT, digital and data subgroup. ECCW and its’ subgroups provide oversight to WGOS including;
· Assessment of effectiveness of WGOS, including reporting from HBs on patients seen, workforce and any gaps in service
· Identification and consideration of proposals for improvements to services
· Development of clinical manuals and standard operating procedures
· Assurance from HB regarding any concerns, complaints or serious incidents
· Sharing good practice between Health Boards
The ECWC includes representation from the Clinical Implementation network (CIN), and the CIN includes members from ECWC. However, the governance of each group follows a different structure, with the CIN sitting within the NHS Wales Executive.
3.0 Wales General Ophthalmic Services (WGOS) Clinical Leadership
The Wales General Ophthalmic Services (WGOS) National Clinical Lead (NCL) plays a pivotal role in shaping and supporting eye care services across Wales. This national position is dedicated to improving patient outcomes and ensuring high-quality, sustainable optometry services by working in close partnership with Health Boards, optometry professionals, and patients. The position of WGOS NCL is hosted on behalf of the Health Boards in Wales by NHS Wales Shared Services Partnership.
At its core, the role of the National Clinical Lead is to act as a bridge between clinical practice and healthcare policy. Working closely with Welsh Government, the post supports the implementation of national strategies such as A Future Vision for Optometry Services 4 and the broader ambitions of A Healthier Wales. 5 These policy frameworks outline a shift towards integrated, preventative, and community-based care — goals which the National Clinical Lead helps bring to life through practical service development and clinical leadership.
A key responsibility of the National Clinical Lead is to work across the full spectrum of stakeholders, from front-line optometrists to senior decision-makers. This ensures that the design and delivery of services are grounded in clinical realities and reflect the principles of prudent healthcare — delivering care that is needed, avoids harm, and makes the best use of available resources. Equally important is the alignment with value-based healthcare, where outcomes that matter most to patients are achieved in the most cost-effective way.
The role also provides expert support to Health Boards, helping them to implement local service models that are consistent with national aims, yet tailored to meet the needs of their communities. By working alongside clinical colleagues, professional bodies, patient representatives, and policymakers, the National Clinical Lead helps to build a shared vision for eye care in Wales and ensures that progress is clinically informed and strategically sound.
1. WG. 2023 No. 1053 (W. 179)
NATIONAL HEALTH
SERVICE, WALES
The National Health Service
(Ophthalmic Services) (Wales)
Regulations 2023. Welsh Government. Accessed 23.9.24, 2024. https://senedd.wales/media/nj5h0rcn/sub-ld16058-e.pdf
2. THE NATIONAL HEALTH SERVICE (WALES) ACT 2006 The National Health Service (Wales Eye Care Services) (Wales) (No. 2) Directions 2024 (Welsh Government) (2024).
3. WG. Well-being of Future Generations (Wales) Act 2015. Welsh Government; 2015.
4. NHS Wales Eye Health Care Future Approach for Optometry Services (Welsh Government) (2021).
5. WG. A Healthier Wales: our Plan for Health and Social Care. Welsh Government; 2021.