• Five trusts either take steps to reduce complications or dispute data in response to findings of national ophthalmology outcomes audit
  • Overall rates of posterior capsule rupture have reduced over the nine years audit has been running
  • Surrey and Sussex Healthcare Trust, which has nearly double national average rate, disputes data

Several trusts have taken action after recording high rates of complications for cataract surgery, while others have disputed the figures, an HSJ  investigation has found.

The latest results from the national ophthalmology database show a national rate of one complication – posterior capsule rupture – of 1.2 per cent, but one trust had a rate of almost double this at 2.1 per cent.

The five trusts with the highest proportion of PCRs in 2017-18, adjusted for case complexity, ranged from 1.5 to 2.1 per cent.

The five trusts with the highest rate of PCRs

Surrey and Sussex Healthcare Trust - 2.1pc

East Cheshire Trust -1.7pc

Yeovil District Hospital Foundation Trust - 1.7pc

Aintree University Hospital FT - 1.7pc

Chesterfield Royal Hospital FT - 1.6pc

Yeovil District Hospital and Aintree University Hospital foundation trusts said they had made improvements since receiving the results.

Yeovil said it had improved consultant supervision of less senior staff and had brought a locum onto the staff to increase continuity of care.

A spokeswoman told HSJ: “Greater scrutiny and supervision, coupled with changes to the team to improve the continuity of care, has brought about a reduction to our PCR rate this year, which we would expect to see reflected in the next set of adjusted figures when these are published.”

Aintree said it “recognised the hospital’s PCR rate was higher than average” but it had made changes in response and internal audit had shown an improvement. The spokesman did not explain what changes had been made.

Surrey and Sussex Healthcare Trust disputed the findings and blamed its 2.1 per cent score on a data issue. It said only 20 per cent of its cataract procedures had been included in the total and so was “not representative of our overall performance”.

A spokeswoman said its unadjusted PCR rate was 0.2 per cent, adding: “We have internal processes to provide assurance on the quality of our care and have recently introduced additional software to improve our participation in this audit in the future.”

An East Cheshire Trust spokesman said it had submitted the minimum amount of data required for inclusion in the audit – 50 cases – and that its unadjusted PCR rate was 0.7 per cent, if measured over three years.

Chesterfield Royal Hospital FT said the result was a “snapshot” but that it “welcome[d] the audit as a positive opportunity to continue to improve”.

A spokeswoman said: “We undertake more than 1,600 cataract operations each year and – as the audit indicates – we also have an above average case complexity ratio. We will examine the results taking all these factors into account.”

The NOD release comes ahead of the report from the Getting It Right First Time programme on ophthalmology, which is expected shortly.

Cataract surgery is the highest volume NHS surgical procedure with more than 410,000 performed annually, costing around £450m.

The NOD study said, since the first national cataract audit in 2010, there had been a 38 per cent reduction in PCR complications, equivalent to 3,400 fewer a year. It said this reduction had yielded a saving of £2m a year.


HSJ Provider Summit

The HSJ Provider Summit, taking place at the Crowne Plaza, Stratford-upon-Avon from 22-23 April 2020, unites 120+ board members from provider trusts across the country with those shaping national policy, to share best-in-class initiatives in delivering cost-effective and high-quality care for their local populations.

Held under the Chatham House Rule, attendees will co-develop solutions to their local challenges with colleagues from across the country. The summit is free to attend for board-level NHS leaders.