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New guidance designed to improve the quality of eye care and reduce waiting times for eye care services for patients in England has been published by the government.
The guidelines propose patients get access to more sophisticated diagnostic imaging before they are referred to a consultant, aiming to reduce pressure on ophthalmology services and free up vital clinical time by prioritising those who really need to be seen by a specialist.
Ophthalmology is currently the busiest outpatient speciality in secondary care and makes up almost 10% of the entire waiting list.
Improvements will also be made for patients with suspected glaucoma and cataracts, ensuring more accurate testing is available and that patients are more involved in the decisions about which treatment is best for them.
Prevent thousands of unnecessary referrals to eye services
NHS medical director Professor Sir Stephen Powis said: “Medicine and technology is constantly evolving and it is right that the NHS uses the latest clinical evidence to ensure options on the table for patients are as up to date as possible while also maximising efficiencies for the taxpayer.
“We expect these changes will prevent thousands of unnecessary referrals to ophthalmology services – giving back patients and staff alike their valuable time – as well as updating guidance for a range of other services to ensure the most effective and efficient treatment is being used for patients.”
This new guidance will require additional testing at a second appointment – a so-called two-factor authentication – to confirm a diagnosis of glaucoma or with an alternate optometrist specifically trained to undertake a more comprehensive set of tests.
For diabetic retinopathy, screening services are being asked to use an additional tool called Optical Coherence Tomography (OCT), which can take 3D images of the retina instead of 2D, improving accurate diagnosis and referral of patients needing treatment, such as intravitreal injections.
Similarly, as few as 40% (and up to 92%) of referrals for cataract surgery at some services result in the surgery actually taking place, and this intervention aims to ensure primary care staff work with patients to make sure they understand the surgery they are being referred for.
Cataract surgery accounts for 6%, or more than 450,000, of all surgeries completed a year, and was predicted to grow by 25% by 2027 and 50% by 2035 according to the Royal College of Ophthalmologists.