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The time it takes for things to be adopted by the NHS should never be underestimated. I developed a simple algorithm, published in 2012, that showed that those with diabetes found to have no diabetic eye disease on 2 successive screenings were at very low risk and could be safely seen after two years rather than at annual intervals. This was then replicated in 7 more datasets, checked by teams at Public Health England, signed off by the Minister in 2017. It is now being rolled out in England, started in 2023. Things move slowly. I was told that it had been rolled out in Norway before it was rolled out in UK.

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