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Introduction

This report summarises statistics in relation to primary care eye services (including the General Ophthalmic Service (GOS) and targeted Welsh eye care services such as the Eye Health Examination Wales (EHEW) and the Diabetic Eye Screening Wales), the Hospital Eye Service, sight impairment registration, certification and the Low Vision Service Wales and workforce. The report also includes statistics on the number of people suffering from hearing loss, using hearing aids and accessing hospital care for hearing related conditions.

These statistics help to monitor the delivery of current services and provide evidence from which current eye health and audiology policies based on and evaluated.

This report is updated every two years and contains the latest available data (not all data is available for both 2019-20 and 2020-21).

Background information is available in the quality report. All published tables and further data are available in linked spreadsheets or StatsWales tables.

Impact of COVID-19

Eye care and hearing services have been affected by the COVID-19 pandemic and the impact will be reflected in the data for the financial year 2020-21.

Following the start of the COVID-19 pandemic at the end of March 2020, routine optometry services were reduced. There was a cessation of payment claims from April to August 2020; an average payment was calculated and paid to ophthalmic contractors. See Eye health services: coronavirus for more information.  

Some data collection processes were postponed, for example local authority disability registers, and therefore no data are available for the most recent period.

Where data has been collected, statistics for all measures of activity in sensory health services in 2020-21 are markedly lower than in previous years and this should be borne in mind when making comparisons over time.

For more information about the broader impact of the COVID-19 pandemic on NHS hospital services, see the edition of the NHS Activity and Performance statistical release, published on 19 November 2020.

Main points

Overall summary

  • Most datasets for eye care and hearing services show that the COVID-19 pandemic had a marked impact in 2020-21, with activity levels falling considerably from previous years. However, workforce numbers were not affected as generally the number of eye care and hearing specialist practitioners increased slightly in 2020-21.

Primary eye care services

  • In 2019-20, over 810,000 (813,922) General Ophthalmic Service sight tests were paid for by the NHS, however this fell to just under 350,000 (348,740) in 2020-21.
  • In 2019-20, over 200,000 (201,208) examinations were carried out under Eye Health Examinations Wales (EHEW) scheme in 2019-20, however this fell to just over 80,000 (81,785) in 2020-21.
  • In 2019-20, just over 180,000 (180,756) patients were eligible for the Diabetic Eye Screening Wales (DESW) service. Around 115,000 (116,006) patients were screened with results reported by the DESW service and 30.3% of these were found to have some degree of diabetic retinopathy.

Hospital eye services

  • In 2019-20, over 100,000 (104,233) ophthalmology referrals were made for a first outpatient appointment, however this fell to around 60,000 (63,392) in 2020-21.
  • In 2019-20, there were over 310,000 (314,054) attendances to ophthalmology outpatient appointments in Welsh hospitals, however this fell to less than 190,000 (186,728) in 2020-21.

Rehabilitation (Low Vision Service Wales)

  • In 2019-20, just under 9,000 (8,993) assessments were carried out by the Low Vision Service Wales, however this fell to just over 5,000 (5,211) in 2020-21.

People newly certified as severely sight impaired and sight impaired

  • 1,618 certificate of vision impairment (CVIs) were given in 2019-20, 15 more than in 2018-19.

Workforce

  • There were 885 ophthalmic practitioners recorded on the Performers Lists as at 31 March 2020 (of these, 882 were optometrists). At 31 March 2021, there were 960 ophthalmic practitioners (of these, 956 were optometrists).
  • At 30 September 2020 there were 138 whole time equivalent ophthalmology doctors directly employed by the NHS in Wales (143 as at 31 March 2021).

National Survey for Wales

  • During January to March 2021, 72% of people reported that they have their eyes tested at least once every two years. 8% reported that they never had an eye test.

Hearing

  • At 31 March 2020, 55 patients had been waiting for a hearing aid for more than the target time of 14 weeks. This increased to 1,391 at 31 March 2021.
  • At 30 September 2020, there were 133 whole time equivalent otolaryngology doctors directly employed by the NHS in Wales. This increased to 136 as at 31 March 2021.
  • The National Survey Wales recorded that 19% of people reported having difficulty with their hearing during January to March 2021.

Eye care

Primary eye care services

General ophthalmic service: sight tests and optical vouchers

Having a sight test with an optometrist at least once every two years is recommended as part of everyone’s health care routine as this may reduce preventable sight loss.

Many people qualify for a free NHS General Ophthalmic Service (GOS) sight test, including:

  • people aged 60 and over
  • children under 16 (or under 19 and in full-time education)
  • people with diabetes
  • people aged 40 and older who have an immediate family member with glaucoma
  • people eligible for certain benefits

As of 31 March 2021, 340 optometry practices were providing general ophthalmic services.

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As services in 2020-21 were impacted by the pandemic, nearly 350,000 (348,740) sight tests were paid for by the NHS. This is 57.2% fewer sight tests from 2019-20.

Number of sight tests paid for by the NHS (StatsWales)

The number of sight tests paid for by the NHS has been on an upward trend since 2002-03, with the number ranging from just under 650,000 in 2003-04 to over 810,000 in 2019-20. In the last year to be largely unaffected by the pandemic (2019-20), there was an increase of 2.4% from the previous year, and an increase of 10.8% from 10 years ago (2009-10).

As services in 2020-21 were impacted by the pandemic, nearly 350,000 (348,740) sight tests were paid for by the NHS. This is 57.2% fewer sight tests from 2019-20 and 53.0% fewer sight tests from 10 years ago (2010-11).

Note that for clinical reasons, people may have more than one sight test a year.

Sight tests data by patient eligibility is available on StatsWales.

Domiciliary sight tests

The majority of sight tests paid for by the NHS are conducted at practitioners’ premises, although a small proportion are conducted away from ophthalmic premises, including people’s homes and residential homes.

In 2020-21, nearly 8,000 (7,976) domiciliary sight tests were paid for by the NHS. Of these 89.2% were paid at the higher rate (where the patient is the first or second to be seen at an address) and 10.8% at the lower rate (third and subsequent patients visited at the same address).

This is markedly lower than the number of domiciliary sight tests in 2019-20, where nearly 30,000 (28,432) tests were paid for by the NHS. The distribution between higher and lower rates was also different in 2019-20, with 69.5% paid at the higher rate and 30.5% at the lower rate.

Time series data for domiciliary sight tests are available on StatsWales.

NHS optical vouchers processed

In 2020-21, just over 130,000 (132,366) optical vouchers were processed, 53.6% fewer than 2019-20, when nearly 290,000 (285,333) optical vouchers were processed.

Time series data for NHS optical vouchers are available on StatsWales.

Claims for repair or replacement to spectacles

There were just over 12,000 (12,246) claims for repair or replacement in 2020-21, a decrease of 66.5% from 2019-20, when just over 36,000 (36,564) claims for repair or replacement were made.

Time series data for repairs and replacements are available on StatsWales.

Eye Health Examination Wales

The Eye Health Examination Wales (EHEW) scheme offers extended free eye examinations to groups of the population that are at greater risk of certain eye diseases and to those that may find losing their sight particularly disabling, including people who:

  • have sight in one eye only (uniocular)
  • have a hearing impairment or are profoundly deaf or blind
  • have retinitis pigmentosa
  • are from an ethnic group that is Black (which includes African/Caribbean/Black British or other Black) or Asian (which includes Indian/Pakistani/Chinese/Bangladeshi/Asian British or other Asian)
  • are at risk of eye disease because of a family history
  • are experiencing eye problems that need urgent attention

There were 323 optometry practices in Wales where practitioners are accredited to provide the service (as at 31 March 2021).

For more detail about the EHEW, including the banding structure, see the quality report.

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As services were affected by the pandemic, just over 80,000 (81,785) examinations were carried out in 2020-21. This is a decrease of 59.4% from 2019-20.

Number of examinations claimed for under Eye Health Examination Wales (MS Excel)

The number of examinations for all bands have increased each year until a peak was reached in 2019-20, where over 200,000 (201,208) examinations were carried out under the EHEW in 2019-20. This is an increase of 9.1% from the previous year and an increase of 65.3% from 2015-16.

Of the total examinations in 2019-20, nearly 120,000 (119,890) were Band 1 examinations (59.6%).

As services were affected by the pandemic in 2020-21, just over 80,000 (81,785) examinations were carried out. This is a decrease of 59.4% from 2019-20.

Of the total examinations in 2020-21, just over 50,000 (53,145) were Band 1 examinations (65.0%).

Further breakdowns including age band and selected symptom are available in the accompanying tables.

Diabetic Eye Screening Wales (DESW)

Diabetic Eye Screening Wales (DESW) is provided for every eligible person 12 years and over of age with diabetes who is registered with a GP in Wales. The service makes use of mobile screening units, which visit the various health board areas.

Data for 2020-21 was not available for this release.

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The number of eligible active patients in Wales has increased every year since 2013-14 with just over 180,000 (180,756) patients in 2019-20, an increase of 3.1% from 2018-19.

Number of eligible active patients in Wales (MS Excel)

The number of eligible active patients in Wales has increased every year since 2013-14 and during 2019-20, just over 180,000 (180,756) patients were eligible for the service, an increase of 3.1% from 2018-19 and an increase of 15.6% from 2013-14.

Table 1: Summary of key statistics, Diabetic Eye Screening Wales, April 2019 to March 2021
Summary of key statistics Number
Eligible active patients 180,756
Eligible active patients: new registrations 13,360
Results reported (a) 116,006
Urgent referrals to Hospital Eye Service for diabetic retinopathy 595
Urgent referrals to ophthalmology for other lesions (b) 410
No retinopathy 76,668
Any retinopathy 35,157
Sight threatening retinopathy/maculopathy 6,981
Severe retinopathy/maculopathy (c) 585

Source: Diabetic Eye Screening Wales (DESW)
(a) Some patients may have been screened more than once in the year; note that in addition to known outcomes a number of results were ungradable.
(b) If, whilst assessing an image for diabetic retinopathy, the grader observes a non-diabetic issue of concern, this may also prompt a routine or urgent referral.
(c) number of people with sight threatening retinopathy/maculopathy that is severe: note, these patients appear in both the sight threatening and severe categories.

Of the 180,756 eligible patients in 2019-20, just over 13,000 (7.4%) were new registrations.

Of the 116,006 results reported from screenings during the year, just over 35,000 (30.3%) were found to have some degree of diabetic retinopathy (a small number of the total had ungradable outcomes).

Nearly 7,000 patients (6.0%) had potentially sight threatening retinopathy, but did not necessarily require a referral to Hospital Eye Services.

Further data is available in the accompanying tables.

Hospital eye service

Referrals

Referrals statistics count the number of referrals received by Welsh local health boards for a first outpatient consultant appointment (regardless of the patient’s area of residence).

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In 2020-21, just over 60,000 (63,392) ophthalmology referrals were made for a first outpatient appointment, a 39.2% decrease from 2019-20.

Number of referrals for first outpatient appointment for ophthalmology (StatsWales)

Chart 4 is based on the referrals data published on 19 August 2021 on StatsWales. This dataset can be subject to monthly revisions so therefore the data in this stats release may not exactly match data on StatsWales in future months.  

Since October 2014, a new source of referral code was introduced to capture referrals that come directly from optometrists. This caused the number of non-GP ophthalmology referrals to rise from October 2014, so care must be taken when analysing ophthalmology referrals over time.

The number of referrals for first outpatient appointments for ophthalmology had remained broadly stable at just over 100,000 referrals per year from 2015-16 until 2020-21, which was affected by the COVID-19 pandemic.

In 2020-21, just over 60,000 (63,392) ophthalmology referrals were made for a first outpatient appointment, a 39.2% decrease from 2019-20, when just over 100,000 (104,233) ophthalmology referrals were made.

The majority of referrals are from non-GPs with 81.4% of all referrals from non-GPs in 2020-21, an increase from 78.4% in 2019-20.

Waiting times (referral to treatment)

The referral to treatment (RTT) pathway is the period of time waited from a referral from a GP or other medical practitioner until treatment starts. It includes time spent waiting for any hospital appointments, tests, scans or other procedures that may be needed before being treated.

A full definition is available in the quality and methodology section.

There are two Welsh Government targets associated with RTT, these are that: 95% of patients should wait less than 26 weeks from referral; and no patients should wait more than 36 weeks for treatment from referral.

Chart 5 shows the number of closed patient pathways for ophthalmology in each financial year since April 2012 and the length of time waited from referral to treatment.

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The number of closed patient pathways increased between 2013-14 and 2018-19. However, activity decreased in 2019-20 and fell further in 2020-21 as services were affected by the COVID-19 pandemic.

Number of closed patient pathways for ophthalmology by grouped weeks wait and year (StatsWales)

Chart 5 shows that activity had been increasing in ophthalmology services with the number of closed patient pathways increasing by 12.2% between 2013-14 and 2018-19. However, activity decreased in 2019-20 and fell further in 2020-21 as services were affected by the COVID-19 pandemic.

While activity has broadly increased since 2013-14, a higher proportion of patient pathways have waited longer for treatment, with just under a quarter (23.5%) of patients waiting 26 weeks or longer in 2013-14 compared to over a third of patients waiting 26 weeks or longer in 2019-20 (35.8%) and in 2020-21 (34.0%). 

Just over 40,000 (42,157) ophthalmology patient pathways closed in 2020-21. This is a decrease of 54.0% from 2019-20, when just over 90,000 (91,642) pathways closed.

While referral activity decreased in 2020-21, performance against both targets were relatively consistent with previous years. In 2020-21, 66.0% of pathways were closed in less than the 26 week target time, and 11,404 patient pathways closed after 36 weeks. This compares to 64.2% of pathways closed in less than 26 weeks, and 12,872 pathways closed after 36 week target in 2019-20.

However, with fewer patients being referred in 2020-21, over a quarter (27.1%) of all pathways waited longer than 36 weeks to be closed, the highest proportion on record.

Chart 5 is based on the RTT data published on 19 August 2021 on StatsWales. This dataset can be subject to monthly revisions so therefore the data in this stats release may not exactly match data on StatsWales in future months.

Further data, including information relating to open pathways (i.e. the number waiting to start treatment) are available on StatsWales.

Outpatients

An outpatient attendance is defined as a patient who attends a hospital for treatment without staying there overnight, with either a consultant or a specialist nurse. Appointments with other health professionals and telemedicine are not captured.

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The number of attendances to ophthalmology outpatient appointments in Welsh hospitals fell from around 315,000 (314,054) in 2019-20 to just under 190,000 (186,728) in 2020-21.

Number of outpatient attendances (new and follow up) for ophthalmology by year (MS Excel)

In 2020-21, the number of attendances to ophthalmology outpatient appointments in Welsh hospitals fell to just under 190,000 (186,728), from close to 315,000 (314,054) attendances in 2019-20.

Of these, just over 40,000 (42,752) were new appointments and just over 140,000 (143,976) were follow-up appointments. This compares to nearly 90,000 (86,080) were new appointments and nearly 230,000 (227,974) were follow-up appointments in 2019-20.

The number of follow-up appointments have been falling since 2017-18.

Note that the Outpatient data does not match the StatsWales data for outpatient activity, as the data presented here is on a Welsh provider basis, which includes activity provided by Welsh organisations and data submitted by English organisations with records for patients who are registered with a Welsh GP. The StatsWales data is however presented on a Welsh activity basis (i.e. the outpatient activity carried out at hospital sites in Wales, which includes activity carried out by English organisations in Welsh hospitals and excludes activity carried out in England for Welsh residents or organisations). For further information, see the quality report.

Hospital admissions

Patients are defined as being admitted to hospital if they stay at least one night (inpatients), or if they are admitted electively for treatment or care that does not require an overnight stay in hospital (day cases).

More information is available on the Patient Episode Database for Wales (PEDW) website.

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There were just over 6,000 (6,077) cataract admissions in 2020-21, a decrease of 69.9% from 2019-20.

Number of admissions (inpatient and day case) for hospital eye care in Wales, by principal diagnosis and year (MS Excel)

Chart 7 and the following refers to eye related admissions by principal diagnosis.

Admissions in 2020-21 were affected by the COVID-19 pandemic, but the scale of the impact was different depending on the principal diagnosis.

There were just over 6,000 (6,077) cataract admissions in 2020-21, a decrease of 69.9% from the previous year where there were over 20,000 (20,199) admissions. Diabetic retinopathy also fell markedly (by 67.4%) from 347 to 113 admissions.

However, decreases in other principal diagnoses were not as pronounced, with a fall of 23.4% for age-related macula degeneration, from 7,644 admissions to 5,856; and a fall of 35.7% for glaucoma, from 829 admissions to 533.

Eye care measures

New monthly data on both open and closed patient pathways for ophthalmology, outpatients who waited, or have been waiting within their target date or within 25% beyond their target date at the end of each month, has been published on StatsWales. Data is available from April 2019 onwards.

A patient can be categorised as Health Risk Factor R1 if they are at risk of irreversible harm or significant adverse outcome if their target date is be missed.

The latest open pathway data shows that, at the end of June 2021, just over 120,000 (122,406) patient pathways, where the patient was assessed as Health Risk Factor R1, were waiting for an outpatient appointment. Nearly all of these patient pathways (122,229) had a target date allocated.

47.0% of patient pathways, where the patient had been assessed as R1, were waiting within their target date or within 25% beyond their target date.

The latest closed pathway data shows that, during June 2021, just over 20,000 (20,157) appointments were attended where the patient had been assessed as Health Risk Factor R1. Of these, just over 17,000 (17,036) had a target date allocated.

61.9% of appointments attended, where the patient had been assessed as R1, had waited within their target date or within 25% beyond their target date.

Further information is available through the Eye care measures for NHS outpatients publication.

Low Vision Service Wales

The Low Vision Service Wales (LVSW) aims to help people with visual impairment to remain independent by providing low vision aids such as magnifiers, and by appropriate education, referral, and rehabilitation training. ‘Low vision’ is a term used to describe a sight problem that cannot be corrected by glasses, contact lenses, or medical treatment.

Referrals are from a range of professionals and from individuals themselves.

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The number of Low Vision Service Wales assessments fell from 8,993 in 2019-20 to 5,211 in 2020-21 (42.1% decrease).

Number of Low Vision Services Wales Assessments (MS Excel)

Just over 5,000 (5,211) Low Vision Service assessments were carried out in 2020-21, a decrease of 3,782 (42.1%) since 2019-20, when just under 9,000 (8,993) assessments were carried out.

Further data of assessments by age group, conditions reported, ethnicity and other characteristics are available in the accompanying tables. Data relating to visual acuity recorded at assessments and referrals are also available.

Sight impairment

Certificates of Vision Impairment (CVI)

The Certificate of Vision Impairment (CVI) is used to record patients with sight impairment as severely sight impaired or sight impaired. With patient consent and when signed by a consultant ophthalmologist, the CVI is the formal notification to local authorities to assess the needs of the individual for services and register them as sight impaired or severely sight impaired. A copy of the CVI is also sent to Moorfields Eye Hospital who collate and analyse the data for new registrations each year.

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1,618 CVIs were issued in 2019-20, a slight increase from 1,603 in 2018-19.

Number of CVIs given across Wales by age band and financial year (MS Excel)

The total number of CVIs given has been on a slight upward trend since 2014-15 and in 2019-20, 1,618 new CVIs were issued. Of these, 852 related to patients aged 80 years and over (53.1% of all CVIs with a recorded age), 439 were for patients aged between 60 and 79 (27.3%), 236 were for patients aged between 20 and 59 (14.7%) and 79 were for patients aged 19 or below (4.9%). 

Compared to 2018-19, the total number of CVIs marginally increased by 15 (0.9%) in 2019-20. There were falls in patients aged 19 or under (25.5%) and those aged 60 to 79 (4.6%). There were increases in other age groups however, 8.3% for those aged 20 to 59, and 5.1% for those aged 80 or over.

Further breakdowns of data, including cause of sight impairment and broad ethnicity, can be found in the accompanying tables.

Registers of severely sight impaired and sight impaired people

People with sight impairment are registered by local authorities following certification of their sight impairment by a consultant ophthalmologist.

The data are based on the Local authority registers of disabled people statistical release.

For more detail about the sight impairment registration see the quality report.

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At 31 March 2019, just over 13,000 (13,137) people were registered with a sight impairment; 50.6% were registered as sight impaired and 49.4% were registered as severely sight impaired.

Total number of sight impaired people in Wales as at 31 March (MS Excel)

The Vale of Glamorgan was unable to provide data for 2017-18 and 2018-19, and Caerphilly was unable to provide data for 2018-19; Chart 10 therefore excludes these local authorities. No data was collected in 2020 due to the COVID-19 pandemic.

At 31 March 2019, just over 13,000 (13,137) people were registered with a sight impairment. Of these 6,653 (50.6%) were registered as sight impaired and 6,484 (49.4%) were registered as severely sight impaired.  

Further data is available in the accompanying tables.

Workforce

The majority of ophthalmic practitioners work in primary care, in ophthalmic practices and are counted using the performers list. Ophthalmic practitioners can also be directly employed by the NHS, typically working in hospital locations and these data are sourced from the Electronic Staff Record (ESR) (NHS).

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As at 31 March 2021, there were 960 ophthalmic practitioners on the performers list, up from from 885 ophthalmic practitioners recorded at 31 March 2020.

Number of ophthalmic practitioners (MS Excel)

Chart 11 shows the number of ophthalmic practitioners (Optometrists and Ophthalmic Medical Practitioners) over time. Data for 2020 onwards is not comparable to previous years due to a change in data source. More detail is provided in the quality and methodology section.

For the period up to 2019, the number of ophthalmic practitioners showed a broadly upward trend and ranged from 711 in 2009 to 875 in 2018 and 2019.

As at 31 March 2021, there were 960 ophthalmic practitioners on the performers list, an increase from the 885 ophthalmic practitioners recorded at 31 March 2020.

Nearly all practitioners were optometrists (956), with 4 ophthalmic medical practitioners recorded in 2021.

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At 31 March 2021, there were 143 WTE ophthalmology doctors directly employed by the NHS, up from 138 WTE at 30 September 2020.

Ophthalmology staff directly employed by the NHS (whole time equivalent numbers) (StatsWales)

Chart 12 shows the whole time equivalent (WTE) number of ophthalmology doctors directly employed by the NHS over time. Data are as at 30 September each year, except for 2021 which is as at 31 March. This is based on the staff directly employed by the NHS statistical release.

The number of WTE ophthalmology doctors directly employed by the NHS has remained broadly consistent since 2009 at close to 140 WTE.

At 31 March 2021, there were 143 WTE ophthalmology doctors directly employed by the NHS in Wales. This is a slight increase from 138 at 30 September 2020.

National Survey for Wales

As part of the survey that was undertaken during the period January to March 2021, two questions were asked on eye care. The results are summarised as follows:  

  1. How often your eyes are tested?
    35% of people reported that they have their eyes tested at least once a year, 37% every two years, 17% less than every two years, and 8% say they have never had their eyes tested.
  2. Who you would ask for help with eye pain / redness?
    47% of people say that they would ask an optometrist/optician, 43% said that they would ask a GP, 6% said that they would ask a pharmacist, 3% said that they would ask friends/family/colleagues, 2% said that they would ask a hospital and 1% would ask NHS Direct.

More information can be found in the National Survey for Wales publication.

Hearing loss

Hospital hearing service

Hearing aid waiting times (Diagnostic and therapy waiting times (DATS))

This data is part of the DATS waiting times dataset which provides a snapshot of the number of people waiting for services at the end of each month.

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A total of 3,451 patients were waiting for an adult hearing aid at 31 March 2021; with 1,391 waiting over the target time of 14 weeks, significantly higher compared to previous periods.

Number of people waiting for an NHS adult hearing aid, as at 31 March (StatsWales)

Chart 13 shows the total number of patients waiting for an adult hearing aid and those waiting over the target time of 14 weeks, based on the position as at 31 March of each year. The chart is based on the DATS data published on 19 August 2021 on StatsWales. This dataset can be subject to monthly revisions so therefore the data in this stats release may not exactly match data on StatsWales in future months.

The number of patients waiting for adult hearing aid had been on an upward trend from 2010, reaching a peak in 2017 with a little under 5,000 patients waiting. Since then, the number has decreased, with 3,345 waiting as at 31 March 2020.

The large majority of patients waited less than the target time of 14 weeks over the course of the time series, and the last year which was largely unaffected by the pandemic (as at 31 March 2020), 55 patients were waiting longer than the target waiting time.

Data for 2021 is affected by the COVID-19 pandemic. At 31 March 2021, 3,451 patients were waiting for an adult hearing aid, a small increase (3.2%) from the previous year. However, 1,391 patients were waiting over the target time of 14 weeks, a considerable increase when compared with all previous years.

Hospital admissions

Chart 14a shows admissions for diagnoses relating to hearing loss by any mention of diagnosis (i.e. where the patient was additionally diagnosed with a hearing problem), and Chart 14b is by primary diagnosis.

The two charts together show that for the vast majority of these admissions, the primary diagnosis was not hearing related but the patient was diagnosed with an additional hearing problem. Where there was any mention of a hearing problems, the most common cause has been ototoxic hearing loss over the course of the time series. Where the primary diagnosis was hearing related, the main cause of admission has been evenly split between ototoxic hearing loss and conductive hearing loss.

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In 2020-21, there were just under 6,000 (5,814) admissions for patients with any mention of hearing loss related diagnosis, down from just under 7,000 (6,950) in 2019-20.

Number of admissions (inpatient and day case) for hearing loss in Wales, by any mention of diagnosis and year (MS Excel)

The number of admissions for patients with any mention of hearing loss related diagnosis had been increasing every year until 2018-19, since then admissions have decreased and in 2020-21, there were just under 6,000 (5,814) admissions. The large majority of admissions have been for ototoxic hearing loss throughout the time series, and in 2020-21 there were just under 5,000 (4,980) admissions where this diagnosis was mentioned.

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In 2020-21, there were 133 admissions for patients where the primary diagnosis was hearing related, down from 334 in 2019-20.

Number of admissions (inpatient and day case) for hearing loss in Wales, by primary diagnosis and year (MS Excel)

The number of patients admitted to hospital where the primary diagnosis was hearing related has varied from year-to-year but has tended to be between 300 and 400 every year since 2009-10; however the effects of the COVID-19 pandemic led to only 133 admissions in 2020-21.

The most common primary diagnosis was conductive hearing loss, bilateral, half (66) of all patients having this diagnosis.

These data, and data for further procedures, can be found in the accompanying tables.

Registers (hearing impairment)

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At 31 March 2019, just over 12,000 (12,286) people were registered with having a hearing impairment.

Number of people registered with a hearing impairment, by age range (MS Excel)

The Vale of Glamorgan was unable to provide data for 2017-18 and 2018-19, and Caerphilly was unable to provide data for 2018-19; Chart 15 therefore excludes these local authorities. No data is available for 2020.

The registers data is based on the local authority registers of disabled people statistical release.

The number of people registered as having hearing impairment has been on a slight downward trend since 2016 and the latest data shows that at 31 March 2019, just over 12,000 (12,286) people were registered with having a hearing impairment. Of these around three quarters (9,545) were aged 65 or over and a quarter (2,585) were aged 18 to 64. 

Further data is available in the accompanying tables.

Workforce

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At 31 March 2021, there were 136 WTE otolaryngology and 1.7 audiovestibular doctors in the NHS.

Otolaryngology and Audiovestibular staff directly employed by the NHS (whole time equivalent numbers) (StatsWales)

Chart 16 shows the whole time equivalent (WTE) number of Otolaryngology and Audiovestibular doctors directly employed by the NHS over time. Data are as at 30 September each year, except for 2021 which is as at 31 March. This is based on the staff directly employed by the NHS statistical release.

At 31 March 2021, there were 136 WTE otolaryngology and 1.7 audiovestibular doctors in the NHS. For otolaryngology doctors this is a slight increase from at 30 September 2020 where there were 133 WTE doctors, but a slight decrease for audiovestibular doctors from 1.8.

National Survey for Wales

As part of the survey that was undertaken during the period January to March 2021, seven questions were asked on hearing. The results are summarised as follows:  

1. Do you have any difficulty with your hearing?

  • No: 81%
  • Yes: 19%

2. Do you usually wear a hearing aid? Asked of people who have difficulty hearing.

  • Yes, most of the time: 17%
  • Yes, some of the time: 12%
  • No, but have tried one: 7%
  • No: 64%

3. How many hearing aids do you usually wear? Asked of people who usually wear at least one hearing aid.

  • One: 40%
  • Two: 60%

4. Did you get the hearing [aid/aids] you wear free through the NHS or did you pay for [it/them] privately? Asked of people who usually wear at least one hearing aid.

  • Free through the NHS: 77%
  • Paid privately: 21%
  • Both NHS and privately: Results based on < 30 people, not shown

5. Nowadays, do you ever get noises, such as ringing or buzzing, in your head or ears that last for more than five minutes?

  • Yes: 15%
  • No: 85%

6. Do you get these noises some of the time, or most or all of the time? Asked of people who say they have tinnitus.

  • Some of the time: 64%
  • Most or all of the time: 36%

7. How much do these noises worry, annoy or upset you when they are at their worst? Asked of people who say they have tinnitus.

  • Not at all: 29%
  • Slightly: 40%
  • Moderately: 23%
  • Severely: 8%                                                                                    

More information can be found in the National Survey for Wales publication.

Quality and methodology information

Referral to Treatment definition

The referral to treatment times statistics show data on the waiting time from referral by a GP or other medical practitioner to hospital for treatment in the NHS in Wales. Data on Welsh residents treated or waiting for treatment outside of Wales is not included in the release.

A patient is defined to have been treated, or their pathway closed if either, following consultation with a hospital specialist, no hospital treatment is necessary or if treatment begins. This could include:

  • being admitted to hospital for an operation or treatment
  • starting treatment that does not require a stay in hospital (for example, medication)
  • beginning the fitting of a medical device
  • starting an agreed period of time to monitor the patient’s condition to see if further treatment is needed
  • it is determined that the patient does not need treatment or has died

‘Patient pathways’ are counted, rather than patients, as the same patient can have more than one referral for treatment.

Optometry workforce

Figures for optometry workforce refer to the position at 31 December each year for 2019 and all years prior, and refer to the position at 31 March for 2020 and all subsequent years. This is because they are sourced from different systems.

For the period up to 2019, figures are sourced from NHS Digital’s publication and reflects practitioners who were authorised by local health boards (LHBs) to carry out NHS funded sight tests, based on data derived from the Central Ophthalmic Payments system.       

Data collection from that source ceased, so for 2020 onwards, data has been sourced from the performers list (Ophthalmic List and Ophthalmic Supplementary List), a register of all ophthalmic practitioners able to practise in Wales, maintained by NHS Shared Services Partnership.

Due to the change in data source and reference period for 2020 onwards, data for 2020 onwards are not directly comparable with previous years.

Well-being of Future Generations Act

The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators ('national indicators') that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. The 46 national indicators were laid in March 2016.

Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.

Further information on the Well-being of Future Generations (Wales) Act 2015.

The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.

We want your feedback

We welcome any feedback on any aspect of these statistics which can be provided by email to stats.healthinfo@gov.wales

Contact details

Statistician: Sabir Ahmed
Telephone: 0300 025 5101
Email: stats.healthinfo@gov.wales

Media: 0300 025 8099

SFR 303/2021

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