Diolch yn fawr. 'The Future Approach for Optometry Services in Wales', published in March, is ambitious and it's transformative, changing the way eye health services are delivered. Aligned to 'A Healthier Wales', and underpinned by the key principles of prudent healthcare, the approach supports our overall aims, which are: to improve access for citizens; to move delivery of services from secondary care to primary care in order to address the backlog in patient appointments and delay in follow-up appointments in hospitals; to reduce demand on hospitals and GPs; and to reform general ophthalmic service contracts.

As Members know, waiting times are significant. Patient numbers waiting for their first hospital eye health appointment, and subsequent follow-up, continue to rise. This increasing demand remains a challenge not just across Wales, but across the United Kingdom and Europe as well. Ten per cent of outpatient appointments are for eye clinics and cataract surgery accounts for about 6 per cent of all surgery in the United Kingdom.

Current capacity to provide specialist hospital eye services is extremely limited due to limitations on personnel. The Royal College of Ophthalmologists 2018 census reported that an extra 230 consultant posts were required across the UK to meet rising demand for services. So, unfortunately, a significant numbers of posts remain unfilled. I'm afraid that the completion of trained doctors each year is on average 74 across the UK. Therefore, there is a significant shortfall of trained doctors to fill current and future hospital posts. In Wales, thankfully, we have had an increasing number of people in primary care to add to the optometry workforce. So, by 31 December 2018, 875 practitioners were able to deliver NHS sight tests, and that's 34 more than in the previous year and a 19 per cent increase since December 2008.

Further upskilling to enable optometrists to work at the top of their licence in their practices, with the appropriate equipment, means optometrists are in an ideal position to support hospitals to address demand and transform patient pathways. Over the past five years, increasing numbers of optometrists have gained additional higher qualifications in medical retina, glaucoma and independent prescribing. Optometrists with these higher qualifications can diagnose, manage and treat more patients in primary care, improving patients' access to care closer to home. This approach will significantly reduce the demand for a hospital opinion and intervention, and we know that is already reducing demands on GPs.

Last year, the then Minister for health announced £4.8 million funding to develop and implement a national electronic patient record and an electronic referral system across primary and secondary eye health care. To support this digitisation, health boards received £3.5 million in additional funding to replace equipment that had come to the end of its life. Introduction of these new digital systems will help to address the demand problems in hospitals, through shared care and monitoring of stable patients within primary care, providing a better experience and improved outcomes for citizens. The digitisation fund and the shift in emphasis complements the patient pathways, implementing and delivering services seamlessly across the patient journey between primary and secondary care. This is a significant move, enabling optometry practices to be the first port of call in primary care for patients with an eye problem.