Moorfields Eye Hospital: building the network behind left shift
Context
Ophthalmology is the NHS’s highest-volume outpatient specialty, with almost 10 million appointments a year in England. Demand continues to rise, while delay can lead to irreversible sight loss. In August 2026, more than 620,000 patients were waiting for ophthalmology treatment.1 6
Moorfields Eye Hospital NHS Foundation Trust sees nearly 800,000 patients a year across 22 sites.4 As it prepares to relocate to Oriel, its new centre at St Pancras, the Trust is also pursuing a long-term shift of appropriate care from the acute hospital into community, diagnostic and digitally enabled settings.5 Akeso has supported this ambition through a connected programme of strategy, operating-model design, mobilisation and delivery.
Challenge
For Moorfields, left shift meant more than opening new sites. It required a network that could route patients to the right setting, operate consistently across organisational boundaries, and preserve specialist acute capacity for more complex care.
The Trust therefore needed to address three interdependent challenges:
Create accessible community capacity through diagnostic, surgical and outpatient facilities.
Connect the network through clear referral routes, digital records and the Sparc single point of access.
Build the estates, equipment, supplies, sterile services, logistics and programme-management infrastructure needed to operate at scale, while planning the move to Oriel.
Our Approach: a connected programme of work
Rather than treating each initiative as a stand-alone project, Akeso worked as an extension of Moorfields’ teams across the patient pathway and the enabling functions behind it.
Realising models of care closer to home
Akeso supported the design and mobilisation of outpatient and diagnostic facilities across the network. At their new Hoxton site, the team defined the strategic vision and operating model, identified patient cohorts suited to a community setting, and mobilised a six-lane diagnostic hub in three months. The hub created capacity for up to 2,700 glaucoma and medical-retina patients each month.
At Brent Cross, Akeso supported the design and mobilisation of an innovative research diagnostic hub in a former retail unit. The flexible layout enabled different configurations and patient flows to be tested, helping identify the most efficient and cost-effective model for community diagnostics. Patients could complete rapid eye tests in around 45 minutes, with results reviewed remotely by specialist clinicians.
Akeso also supported subsequent community locations and led the redesign and retendering of community eye-care services in Croydon, creating a model designed to widen the range of care delivered outside hospital and to be replicated elsewhere.
Reimagining access to new care models
New capacity only creates value if referrals reach it. Akeso helped Moorfields articulate the case for Sparc (Single point of access for referral and coordination), refine its delivery model and support plans for expansion. The work focused on a clearer route into specialist care for patients and community optometrists, while positioning Moorfields to provide a wider London single point of access.
Building the infrastructure for distributed care
As activity spread across more sites, Akeso supported the operational foundations needed to sustain it, including inventory and asset management, sterile services, records and referral routing. Scenario modelling and replacement planning gave Moorfields clearer visibility of capital and medical-equipment requirements across its changing estate.
For Oriel, Akeso defined and market-tested six smart-hospital services, including patient check-in, visitor management, and room and desk booking. Outcome-based requirements avoided premature commitment to a specific technology solution. The team also mapped future flows across portering, waste, linen, stores, pharmacy, catering and deliveries, giving the new centre a designed logistics blueprint rather than an inherited one.
Embedding delivery discipline
Working alongside Moorfields’ teams, Akeso brought greater discipline to a complex portfolio of more than 50 interdependent projects. The team translated the portfolio into a focused five-year roadmap, clarified priorities and dependencies, and introduced dashboards that gave leaders real-time visibility of progress, risks and delivery pressures. Akeso also provided embedded PMO and programme-management capacity across strategically important initiatives, working as an extension of internal teams while strengthening governance, reporting and the Trust’s own delivery capability. This combination of hands-on delivery support and capability transfer helped Moorfields coordinate change across the network, embedding a more accessible and diverse delivery model, rather than managing each initiative in isolation.
Impact
Akeso’s work created practical evidence that specialist eye care could be delivered in more accessible settings, while helping to establish the infrastructure needed to support a distributed network:
The Hoxton diagnostic hub was mobilised in three months and added capacity for up to 2,700 patients a month.
Capacity at pace
Better patient experience
The Brent Cross shopping centre hub reduced a typical visit from around two hours to 45 minutes.
Clearer routes into care
Community service redesign, referral-routing support and Sparc expansion strengthened the routes connecting patients and referrers to care outside the City Road main site. Sparc is now live across North Central, South West and parts of North East London and has processed more than 29,000 referrals.
Foundations for a distributed network
Capital, equipment, asset and logistics planning gave Moorfields stronger foundations for operating across multiple sites, and Oriel is set to open with a designed logistics blueprint rather than an inherited one.
Coordinated delivery
A prioritised roadmap, delivery dashboards and embedded PMO capacity supported coordinated delivery across more than 50 interdependent projects.
Throughout, Akeso delivered at pace in an environment shaped by sustained demand, a rapidly expanding network and a once-in-a-generation relocation.
This work forms part of a wider transformation led by the Trust, whose performance now sets it apart nationally. Moorfields sits in the top segment of the NHS Oversight Framework, ranked joint fourth of 134 acute and specialist trusts in England and the highest in London. Provisional figures for August 2026 show that 84% of its patients were waiting less than 18 weeks for treatment, against 72% for ophthalmology nationally.2 4 Sparc, developed by Moorfields with the Royal Free London, holds NHS England eyecare accelerator status and was named Acute Sector Innovation of the Year at the 2024 HSJ Awards.6 7
Why it matters
Moorfields’ experience shows that left shift is not simply about shifting where some care is delivered. It is about reimagining entire delivery models, across both acute and community settings. It depends on the access routes, assets, logistics, technology, capital planning and delivery discipline that allow a distributed network to function. Akeso’s work provides a transferable model for providers developing community diagnostics, care closer to home or a major estate transformation.
Contact Our Experts
Olivia Jeffery
Manager
olivia.jeffery@akeso.co.uk