Patients left waiting after specialist trust closed outpost centre 20 miles away

Patients from north Kent have had to travel to other parts of the county or into London for cataract surgery and some other ophthalmic treatments since Moorfields Eye Hospital Foundation Trust closed its ophthalmology unit at Dartford’s Darent Valley Hospital last October.

Moorfields has declined to say why it closed the unit but stressed it had worked to make the transfer as seamless as possible. It also gave a year’s notice — alerting Kent and Medway Clinical Commissioning Group’s predecessors in September 2019. 

Uniquely for an NHS provider, Moorfields operates a large network of eye centres at other sites spread around London and the south.

When the unit closed, patients were given the choice of going to Maidstone and Tunbridge Wells Trust, one of Moorfields’ other sites in London or, if appropriate, community providers. However, 68 patients — with conditions other than cataracts — could not be transferred immediately because of a lack of capacity at an appropriate service. The CCG said they were monitored by Operose Health, which runs North Kent Community Ophthalmology Service, to ensure they did not require urgent treatment, but 62 ended up waiting longer than 52 weeks for treatment.

This may have been compounded by the impact of covid-19 — which has triggered long delays for ophthalmology services nationally, with the number of people waiting 52 weeks or longer for ophthalmology treatment rising to more than 23,000 in December 2020, from just 40 the year before.

Of the 2,800 patients being treated at the Moorfields’ site at Darent Valley, 1,411 opted to transfer their service to another provider in Kent. 

The CCG described Maidstone and Tunbridge Wells as the “closest provider geographically” for patients who were previously seen at Darent Valley. However, getting from Darent Valley to either Tunbridge Wells Hospital or Maidstone Hospital takes at least two hours by public transport and involves several changes. 

But 18 months after the initial decision to close the Moorfields unit, Kent County Council’s health overview and scrutiny committee has not yet discussed the service changes.

Shane Mochrie-Cox, a HOSC member from Gravesend in north Kent, called for Kent and Medway CCG to explain to committee members “why there was a delay in bringing this before HOSC, what engagement they had with patients in making this decision and how they can put right this delay to patients’ health and wellbeing”.

He added: “This seems to be a decision that has detrimentally affected patients from accessing services and could be a barrier to health.”

In a statement, the CCG said it had been due to present to the Kent County Council HOSC last October about the “interim arrangements” for ophthalmology. However, the meeting had been postponed and a new date has yet to be set.

It added: “Following the change of eye care service provider, the CCG and MTW are about to undertake engagement with existing and new patients about their experience of using ophthalmology services. Further engagement is planned later this year.”

According to MTW board papers, the preferred long-term solution for the service is for operations to take place at a day surgery suite at Medway FT. A statement from MTW said: “In replacing Moorfields Eye Hospital as the local provider, we worked with Kent and Medway CCG to deliver an interim solution to provide eye care services for patients in the north Kent area.

“They are currently seen as outpatients at the eye unit at Medway Maritime Hospital with our diabetic macular oedema service currently operating at Sevenoaks Hospital. Any surgical procedures take place at Maidstone Hospital or Tunbridge Wells Hospital, depending on the treatment required.”

Moorfields Eye Hospital chief David Probert said in a statement: “We gave NHS Kent and Medway CCG formal notice in September 2019 and Darent Valley Hospital notice in March 2020, with services stopping in September 2020. We have worked hard with Maidstone and Tunbridge Wells NHS Trust and NHS Kent and Medway CCG to make this transfer of services as seamless as possible for patients, overcoming the challenges the pandemic has given us all.”