Eye patients harmed after acute trust's waiting list spirals

At least 7,000 patients were not given follow up appointments at University Hospital Southampton FT, prompting trainee doctors to raise multiple concerns and write a letter of concern to trust chiefs earlier this year.

Both the trust and the Royal College of Ophthalmologists said the problems were a result of a “significant and sustained” pressure on eye services nationally, and claimed such backlogs are common across NHS trusts.

Such are the concerns that UHS has written to NHS England calling for a “national awareness message” into the current pressures facing ophthalmology.

By January, the backlog had reached 7,000 patients, including 4,500 with glaucoma and 2,500 with diabetes-related eye problems.

According to the trust, demand has outstripped capacity, due to the ageing population and increased ability to maintain better sight for longer in patients with chronic eye conditions.

A trust spokesman said doctors were seeing a 5 per cent rise in patients every year.

In response to the backlog, the trust is reviewing affected patients. So far, 38 patients have been identified as experiencing a worsening of their condition due to not getting follow up appointments. The severity of their conditions has not been made public.

The trust said it had fully addressed the age related macular degeneration backlog, and had made “significant progress” in the diabetes patients backlog.

Around 3,000 glaucoma patients are still to be notified and reviewed.

“These patients will be booked in according to their level of risk which is determined by the urgency with which the appointment was requested,” the spokesman said.

In a bid to bring down the glaucoma backlog, the trust plans to develop new referral pathways into the service, expand its clinical and nursing teams over the next three months, outsource activity to other providers, and appoint a manager to oversee the high risk patients.

For diabetes patients, the trust will develop “virtual clinics”, continue to offer appointments on Saturdays, use locum consultants, and suspend some general clinics and routine cataract surgery.

“All patients have been risk assessed to ensure those at increased risk are being seen sooner,” the spokesman said. 

Last month, Southampton City Clinical Commissioning Group said it remained concerned about the situation.

Michael Burdon, president of the Royal College of Ophthalmologists, said he believed UHS’s ophthalmology problems are being felt in the majority of acute NHS trusts.

He said UHS was “ahead of the curve” in recognising its problems.

“I don’t think most trusts have got a really good handle of the extent of this problem,” he said.

“There’s a mismatch between capacity and demand across ophthalmology in the NHS.

“More patients are being put on waiting lists that don’t tend to end up being managed appropriately, and we get a situation where there are hundreds if not thousands of patients on the lists.”

He said the capacity issues in ophthalmology are not prioritised by national chiefs because they mainly affect elderly patients and are not seen to be as important as other specialties, such as emergency care.

Unpublished research by the college suggests 230 new ophthalmology consultants are needed to deal with the rising demand.

In response to the pressures, NHS England has launched an elective care transformation programme which is reviewing ophthalmology among other services.