Eyesight in 20,000 people put at risk from delayed follow-ups

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Delayed glaucoma follow-ups for more than 500 people at 43 separate hospital trusts
GIRFT report calls this a “major concern” and cause of loss of vision
GIRFT finds variation in treatment across ophthalmology specialty, England’s highest volume specialty

Tens of thousands of patients have had their follow-up treatment for glaucoma delayed over the past year, risking their sight, a new study has revealed.

The Getting It Right First Time report on ophthalmology found 43 of the 120 providers of NHS-funded ophthalmology work visited for the study had had follow-up treatment delays affecting 500 or more patients over the past year. This equates to more than 20,000 patients.

The report said: “This is of major concern as the 2017 British Ophthalmological Surveillance Unit study highlighted glaucoma as the most common reason for loss of vision.”

Only 11 per cent of trusts reported no delay in patients getting a follow-up appointment for their glaucoma.

Ophthalmology is the highest volume outpatient specialty in England and cataract surgery is the most common operation.

In his introduction to the report, GIRFT chair Tim Briggs said: “Our ophthalmology leads have found a huge desire within the NHS for change, and in particular for ways to address shared concerns around capacity, timeliness and quality of care.”

The report noted the findings of the most recent workforce census, which found a national shortage of 230 consultants across England. The GIRFT team also noted this was a driver behind ophthalmology’s £25m locum spend.

In a study published by Nature using the BOSU’s research, the authors said: “It is recognised that loss of vision impacts negatively on both physical and mental health — those with sight loss are more likely to suffer falls, depression, and to become dependent on social services at an earlier stage.”

It added: “The solutions lie in making collection and reporting of the intended follow-up date of out-patient appointments compulsory, optimising capacity in ophthalmic outpatient departments and empowering patients to challenge delays.”

Recommendations in the GIRFT report included:

Streamlining processes so that routine cataract surgery takes no longer than 30 minutes;
Implementing “failsafe prioritisation” for glaucoma and medical retina conditions, with an annual risk audit; and
“Improv[ing] the quality, depth and accuracy of data collected nationally about ophthalmology services and clinical outcomes.”

GIRFT also recommended Health Education England and professional bodies work together on training “non-medical ophthalmology health care professionals”.