A routine audit identified significant booking errors in Orthoptic services, leading to seven moderate‑risk incidents involving young children. Review showed urgent patients were not being prioritised. All waiting patients were triaged, urgent cases escalated, and emergency meetings held with booking and governance teams. Updated SOPs improved booking processes and non‑responder management, supported by monthly audits and meetings. Long‑wait breaches dropped dramatically, with urgent 18‑week waiters reduced to zero. Communication with the booking team strengthened, 850 dormant cases were actioned, and all affected children reviewed. The successful approach is now being used to address long waiters in Ophthalmology.

After joining Queen Elizabeth Hospital in January 2025, Briony rebuilt an Orthoptic service that had been absent for a year, leaving hundreds of patients waiting. With only one part‑time colleague, she established an Orthoptic Casualty Service, telephone follow‑ups, and joint optometry‑orthoptic clinics to reduce delays and improve access. She created a new stroke‑vision screening pathway, strengthened the strabismus surgery process, and built a support network with neighbouring hospitals. She also led extensive team training to improve paediatric assessments. Within a year, the department transformed into a functional, responsive service equipped to meet regional demand and improve patient care.

The Orthoptic stroke service improvement project aimed to meet BIOS stroke KPI targets without reducing out‑patient capacity or harming patient experience. Previously reliant on a single specialist, the service met only 18% of in‑patient KPIs and none for out‑patients. A lean review exposed heavy admin burdens and delays that pushed patients into long out‑patient waits. Training two additional clinicians and trialling new models led to a daily ward‑based Orthoptist receiving referrals directly at huddle and assessing patients same day. Five‑month evaluation showed KPI adherence rising to 83%, waits dropping from 38.9 to 3.5 days, throughput increasing 150%, and strong patient feedback. The model is scalable to other services.

Judith led the development of an innovative partnership between Alder Hey and Primary Eyecare Services, enabling community optometrists to provide sight tests, ocular assessment and spectacle dispense for children who fail vision screening. She established service specifications, governance, failsafe processes and fee agreements aligned with the NHS Three Shifts. The new pathway reduces long waits, improves access and offers care closer to home, with PES managing referrals via Opera and monitoring WNBs. Children receive timely assessment while remaining under Alder Hey governance, and the Trust retains financial benefit. Judith’s leadership has been central to delivering this transformative model.

Julie developed an innovative pilot to address a six‑month backlog of school‑nurse vision screening referrals for children with SEN or autism, who were waiting far longer than the six‑week departmental standard. Recognising that busy clinics were unsuitable for these children, she created a dedicated “Super Saturday” clinic with full access to the waiting area, quiet breakout rooms and streamlined joint orthoptic–optometry assessment. Fifty‑six patients were seen in one day, eliminating the backlog and identifying significant refractive errors and squints. Parent and clinician feedback was overwhelmingly positive. The success of the pilot has led to plans for regular monthly SEN screening sessions.

Safiah was nominated in recognition of her exceptional innovation in creating a dedicated IIH management pathway that transforms how patients with suspected or confirmed IIH are assessed and monitored. She led a full redesign of referral and diagnostic processes, uniting multidisciplinary teams to deliver timely, standardised and coordinated care. A major achievement is embedding enhanced orthoptic practice—including visual field assessment, optic nerve evaluation and OCT interpretation—into core IIH management, enabling earlier escalation of deterioration. Safiah also drove regional alignment through shared documentation and processes, improving equity and reducing variation. The pathway has already delivered shorter waits, safer monitoring and stronger cross‑specialty collaboration, showcasing outstanding orthoptic leadership.

Helga has shown outstanding leadership in developing an Orthoptic‑led TED service for NHS Ayrshire & Arran, transforming care for patients with Thyroid Eye Disease. With only 15% of patients previously seen on time, her model has the potential to achieve full compliance by delivering timely, evidence‑based assessment outside pressured ophthalmology clinics. She has written comprehensive competencies and an SOP progressing through governance and intended for BIOS adoption, while advancing her own practice through structured training. Helga has built strong multidisciplinary pathways and created a TED database to support audit and regional integration. Her compassionate, expert approach has already improved patient experience and is reshaping the TED pathway locally with clear national potential.

Ciara introduced an initiative expanding the role of Advanced Orthoptists to undertake consenting, theatre assistance and post‑operative reviews for strabismus surgery, addressing national Ophthalmology capacity pressures. Developed in response to workforce shortages and aligned with AHP role expansion policy, the project introduced orthoptic‑led pre‑assessment, independent consenting, theatre support and slit‑lamp‑based post‑operative clinics. Robust governance, BIOS competencies and consultant‑supervised training ensured safety. Outcomes include reducing paediatric pre‑assessment waits from 208 to 6 weeks, cutting adult surgical waits, releasing 270 consultant appointments and supporting 63 theatre lists. Strong patient feedback and successful regional spread demonstrate a scalable, resilient model that strengthens Ophthalmology services.

Roddy has delivered Scotland’s first orthoptic‑led eyelid dystonia Botox clinic for two years, providing autonomous care for patients with blepharospasm and hemifacial spasm. Developed in response to ophthalmology capacity pressures, the service ensures timely treatment for a low‑priority but high‑need patient group. Roddy completed structured training, theoretical learning and competency assessments under consultant supervision, ensuring safe extended‑scope practice. All patients retain the option to decline non‑medical injection, yet all have consented, with excellent feedback. Annual audit shows the model is efficient, cost‑effective and safe, demonstrating a scalable advanced orthoptic role that relieves Ophthalmology pressure without compromising care.