1.122 Access and travel emerged as the most prominent concern for consultees across the different activities: older people, visually impaired patients and those who do not drive were seen as at risk of being disproportionately affected by each of the options to differing degrees. Specific difficulties faced by those ophthalmology patients who may be unable to drive as a result of their treatment were also mentioned.
1.123 Long journey times, unreliable patient transport, poor road networks, and limited public transport were described as barriers that could lead to missed appointments, poorer outcomes and widening inequalities if not adequately mitigated.
1.124 Staff also reported significant transport challenges between Health Board sites where the services are offered, with widespread reliance on taxis to move clinicians between sites, high associated costs, and reluctance among some clinicians - particularly newly recruited international staff - to drive on rural road networks. Concerns were raised that such travel demands make recruitment and retention more difficult, and that proposals to centralise services without mitigation could worsen these issues.
1.125 Considering where ophthalmology services should be located in future, staff raised concerns about the condition, capacity and configuration of several community and acute sites. For example, it was said that:
1.126 Conversely, Withybush was seen by some staff as underused and potentially better suited for expansion; and Amman Valley Hospital was considered a preferred location for cataract services for patients, as it has easier parking than other sites.