Moorfields made a strategic decision not to specialise only in tertiary ophthalmology, as some other trusts had done, as this was not seen as a sustainable option for maintaining single hospital status. There was therefore a need to grow the general ophthalmology and primary care services to provide enough ‘bread and butter’ income to help sustain tertiary sub-specialty services.

Moorfields’ primary care service was for patients with low-risk eye conditions which, with correct diagnosis and reassurance, would not require further visits – the so-called ‘see-treat-discharge’ model. General ophthalmology services covered the general conditions usually needing follow up and/or longer-term care.

The first site, at Bow Hospital, kick-started the growth of the primary care, and later more general ophthalmology, creating market share not only to enable consultants to sub-specialise at City Road but also to secure future sustainability.

It met commissioner and patient expectations to improve a poor service, bring good ophthalmic care close to patients’ homes and provide a financially sustainable service.