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Showing results for tags 'Medicine - Ophthalmology'.
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Content ArticleThe pandemic has impacted on all aspects of NHS care, with elective and diagnostic activities among those services that have been disrupted. This has led to a considerable backlog of people waiting for NHS treatment. This briefing, from the NHS Confederation, explores what lies ahead for the health service and patients, based on their modelling of referral-to-treatment waiting trajectories in 2021. It offers an outline policy framework, drawn up by their members, for starting to reduce waiting lists in an effective, equitable and efficient way.
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Content ArticleNHSX's Innovation Team has released its latest digital playbook which focuses on eye care and directs clinicians and organisations to digital tools that can support patient pathways. The resource, which is extensive and features numerous case studies, can be used by eye care specialists looking to digitally enhance their ophthalmology pathways, remote monitoring and sharing of diagnostics.
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News Article
Doctors warn NHS private sector plans risk patient safety
Patient Safety Learning posted a news article in News
Healthcare leaders have been warned by nearly 200 doctors that plans to give more work to private hospitals will “drain” money and staff away from NHS services, leaving the most ill patients at risk. In a letter, seen by The Independent, almost 200 ophthalmologists urged NHS leaders to rethink plans to contact cataract services to private sector hospitals as it “drains money away from patient care into private pockets as well as poaching staff trained in the NHS.” The doctors have called for “urgent action” to stop a new contract from being released which would allow private sector hospitals to take over more cataract services. They raised concerns NHS ophthalmology services would fall into the same crisis at NHS dentistry which would have “blinding consequences” for patients. One of the lead authors of the letter told The Independent the plans would mean there are not enough NHS staff available to carry out more complex surgeries where patients are at risk of losing their eyesight. Read full story Source: The Independent, 10 February 2022 -
News Article
Treatment disrupted as trust suffers major data loss
Patient Safety Learning posted a news article in News
A major IT incident at an acute trust is disrupting treatment for eye patients after a significant data loss, it has emerged. Sandwell and West Birmingham Hospitals Trust chief executive Richard Beeken revealed to his trust’s board that a data loss incident in December had “impacted on staff and patient care” after disrupting 20 systems across the organisation. Recovery of the full data set for patients receiving treatment at the Birmingham and Midland Eye Centre is still under way, and some have had operations postponed. Despite the incident, ophthalmologists are continuing to see the majority of patients, Mr Beeken said, telling HSJ: “[Numbers affected] are being kept to a minimum through the extraordinary efforts of the clinical team who are putting in extra hours to reassess each patient’s needs.” Scanning continues in the majority of cases and the trust is pressing on with recovery work for all historic images and patient contact details, though leaders believe the chances of 100% data recovery are “still slim”. No patient data was extracted during the incident and the information commissioner was made aware. Read full story (paywalled) Source: HSJ, 10 January 2022 -
News ArticleA woman has become blind after her monthly eye injections were delayed for four months during lockdown. Helen Jeremy, 73, said everything she enjoyed doing has "gone out of the window" after losing her eyesight. She has glaucoma and was diagnosed with age-related macular degeneration four years ago. Monthly injections controlled the condition and meant she could still drive and play the piano. However, her appointments were cancelled when the pandemic struck and her eyesight deteriorated. "I was panicking. It was terrifying. Because I'm a widow I'm on my own and it was awful," she said. "Suddenly my eyesight was basically gone. By the time of my next appointment I was told there was no point in going on with these injections because the damage had been done to the back of my eye." Thousands more people in Wales are at risk of "irreversible sight loss" because of treatment delays, RNIB Cymru warns. The Welsh Government said health boards are working to increase services. Read full story Source: BBC News, 27 November 2020
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News Article
Labour demands new NHS investment as patients wait longer for surgery
Patient Safety Learning posted a news article in News
Labour is demanding new investment for the NHS as part of the government’s spending review next week, after analysis shows hundreds of thousands of patients are waiting for life-changing operations. The party’s shadow health secretary, Jonathan Ashworth, will challenge Matt Hancock in Parliament on today over the latest NHS data, which reveal almost 500,000 patients are waiting for surgery on their hips, knees and other bones. Last week, NHS England published new data showing more than 1.7 million people were waiting longer than the NHS target of 18-weeks for treatment. The target was last met in February 2016. An analysis of NHS England data reveal which specialities have been hardest hit by the growing backlog of operations, which has soared since the first wave of coronavirus caused widespread hospital cancellations earlier this year. There were 4.3 million patients on NHS waiting lists for hospital treatments in September. Labour said this included 477,250 waiting for trauma and orthopaedic surgery, with 252,247 patients waiting over 18 weeks. The next worst specialty was ophthalmology, which treats eye disorders, with 444,828 patients on waiting lists, 233,425 of whom have waited more than 18 weeks. There were six figure waiting lists over 18 weeks for other specialties including gynaecology, urology, general surgery, and ear, nose and throat patients. Read full story Source: 17 November 2020 -
News Article
Nearly half of eye patients at Hancock’s local trust waiting more than a year
Patient Safety Learning posted a news article in News
The East of England has been revealed as the worst-performing region for long ophthalmology waits, with almost half the waiting list at one acute trust already breaching the 52-week milestone. Eleven per cent of the region’s 59,000 ophthalmology patients had already been waiting more than a year for treatment at the end of February, compared to 6 per cent in London, the best performing region. West Suffolk Foundation Trust — which is in health and social care secretary Matt Hancock’s local constituency — had by far the biggest problem on this measure of any trust in England, with 42% of the waiting list (660 patients) referred for treatment more than a year ago. Papers submitted to West Suffolk FT’s board meeting in April said there were “limited option[s] for independent sector capacity” and patients were reluctant to travel to other hospitals for treatment. The trust did not respond when asked to comment. Read full story (paywalled) Source: HSJ, 13 May 2021 -
News Article
NHS may ‘never catch up’ with ophthalmology surgery backlog caused by covid
Patient Safety Learning posted a news article in News
Delays due to the COVID-19 crisis have created tens of thousands of year-long waiters for ophthalmology treatment, and a surgery backlog which experts say may never be recovered. NHS England provisional data shows the number of people waiting 52 weeks or longer for ophthalmology treatment increased to more than 23,000 in December, up 57,580% on just 40 the year before. Experts say ophthalmology procedures have been hit particularly hard by the cancellation of elective work due to COVID-19 pressures. On average, roughly 130,000 ophthalmology patients completed treatment per month in England in 2019, most of which would likely have been cataract surgeries. Royal College of Ophthalmologists professional standards chair Melanie Hingorani told HSJ that many in the discipline feared “traditional” ways of working were too “fragmented” to address the size of the challenge. She said that without a “much more innovative” approach it would be “really difficult” to deal with the surgery backlog on ophthalmology and that clearing it could take “two years, maybe longer”. There remained a danger, however, she added that: “Maybe we never catch up”. Read full story (paywalled) Source: HSJ, 1 March 2021 -
News ArticleAt least three people died and more came to ‘severe harm’ after treatment delays across three specialties at one hospital trust, new reports have revealed. King’s College Hospital Foundation Trust commissioned harm reviews due to problems with a lack of capacity and poor management of waiting lists in endoscopy, dermatology and ophthalmology pre-pandemic. Most of the problems relate to the trust’s southern site, Princess Royal University Hospital, and took place before the current executive team took over. The most recent board papers revealed a review of 614 cases at the PRUH’s endoscopy service found seven cases of “serious harm”. This category includes death and the document revealed three patients had died. The review also “highlighted delays in endoscopy leading to delayed diagnoses of cancer” in 2018-19 and 2019-20. Investigators also found a dermatology patient came to “severe harm” after being lost to follow-up twice by the trust. Read full story (paywalled) Source: HSJ, 17 September 2021
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Content ArticleThis is the final report of the stocktake undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems.
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Content ArticleDecision support tools, also called patient decision aids, support shared decision making by making treatment, care and support options explicit. They provide evidence-based information about the associated benefits/harms and help patients to consider what matters most to them in relation to the possible outcomes, including doing nothing. NHS England has just published a suite of eight decision support tools that will help people with their healthcare professionals in clinical consultations, about their treatment choices for their condition through shared decision making. NHS England has worked with patients, patient charities health professionals and research teams over several months to develop the tools in line with NICE guidance on shared decision making standards.
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Content ArticleIn this research paper published in the Nature journal Eye, Foot and MacEwen determine the frequency of patients suffering harm due to delay in ophthalmic care in the UK over a 12-month period. They found that patients were suffering preventable harm due to health service initiated delay leading to permanently reduced vision. This was occurring in patients of all ages, but most consistently in those with chronic conditions. Delayed follow-up or review is the cause in the majority of cases indicating a lack of capacity within the hospital eye service.
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Content ArticleThe National Patient Safety Agency (NPSA) issued guidance on preventing delay to follow up for patients with glaucoma [NPSA/2009/RRR004]. This followed evidence of harm to patients with glaucoma suffering visual loss after delays to follow up appointments. This came to light from incidents reported by staff in the NHS relating to glaucoma. This paper provides background information and a checklist for organisations to help implement actions in the accompanying guidance to prevent harm from delayed follow-up appointments for patients with glaucoma. It presents details of incident data and litigation data. This work was supported by an interactive event in March 2009 with input from ophthalmic surgeons (and the Royal College of Ophthalmologists), nurses, service managers and patient representatives.
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Content ArticleCataract removal and implantation of an artificial lens is the most common surgical procedure undertaken by the NHS. Insertion of an incorrect intraocular lens was the most commonly reported never event in England between April 2016 and March 2017. A never event is a serious incident that is entirely preventable. Read the Healthcare Safety Investigation Branch's report on the insertion of an incorrect intraocular lens.
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Content ArticleThe database of people with diabetes who are eligible for diabetic eye screening (DES) in England is available on GP registration systems. Local screening services can access it electronically through the GP2DRS IT system, or by requesting a copy from the GP practice. Eligible individuals remain on the local service register until they are no longer part of the local service cohort – for example if they have moved away from the area or died. These individuals then become ‘off register’ and should be managed in accordance with the consent and cohort management guidance. People with diabetes may not need to attend routine digital screening while under the care of ophthalmology or being seen in surveillance clinics, but they remain eligible unless they meet the ‘off register’ criteria. Each year, local screening services will recall many individuals for screening who are no longer registered with a GP in England and are ‘untraceable’. Many of these individuals may no longer live in England. Providers should use this guidance to manage untraceable individuals. It’s only applicable in cases where an individual is no longer registered with a GP in England.
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Content ArticleLack of timely follow-up for glaucoma patients is a recognised national issue across the NHS. Research suggests that around 22 patients a month will suffer severe or permanent sight loss as a result of the delays. In this Healthcare Safety Investigation Branch (HSIB) report, the reference case patient saw seven different ophthalmologists and the time between her initial referral to hospital eye services (HES) and laser eye surgery was 11 months. By this time her sight had deteriorated so badly, she was registered as severely sight impaired. The HSIB investigation identified that there is inadequate HES capacity to meet demand for glaucoma services, and that better, smarter ways of working should be implemented to maximise the current capacity. The report highlights that there are innovative measures implemented by some trusts that have reduced the risk, but this good practice is yet to be implemented more widely.
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Content ArticleThe need for social distancing midst the COVID-19 pandemic has forced ophthalmologists to innovate with telemedicine. The novel process of triaging emergency ophthalmology patients via video consultations should reduce hospital attendances. However, the safety profile of such services were unknown. This study, published by EClinicalMedicine, demonstrates comparable patient safety of video consultations at one-month follow-up to in person review and found the service to be acceptable to patients and to reduce the risk of COVID-19 transmission. Authors propose that video consultations are effective and desirable as a tool for triage in ophthalmology.
