New fast track cataract service

27 February 2001

Long waiting times for cataract surgery are to become a thing of the past at the West Suffolk Hospital thanks to the introduction of a new fast track cataract service and appointment of a fourth Consultant Ophthalmologist and two specialist nurses.

During the year the ophthalmology outpatient clinics saw 3,500 new patients and booked 25,000 patient visits. This represented a 10% increase in activity and resulted in patients having longer to wait to see a consultant and for treatment.

Consultant Ophthalmologist Mr Tony Vivian and his colleagues have been looking closely at the patient's journey from GP referral through to the cataract operation, discharge and follow-up treatment.

"The aim was to speed-up the whole process but not at the expense of compromising our high-quality patient-focused service," said Mr Vivian.

"Over the next 12 months the new fast track cataract service, which will be operational from 5 March, will reduce the total waiting time from GP referral to operation to just six month. Patients are currently waiting up to 14 months.

A single pre-assessment clinic, one month prior to surgery, will replace two visits to the outpatient clinic. All patients referred to the new service by their GP will receive an information pack explaining what a cataract is and what to expect during and after the operation.

During the pre-assessment clinic specialist cataract nurses will measure the eye, book the date the patient will come into hospital and answer any questions or concerns the patient may have. An Ophthalmologist will see every patient to confirm the diagnosis and suitability for surgery and obtain their consent. Two specialist cataract nurses, Sister Sophie Pettifer and Sister Andrea Allen have been appointed to run the clinics.

"This is a quality initiative. The specialist nurses will spend more time with patients answering their questions and relieving anxieties and patients will leave the clinic with a date for their surgery. The nurse run clinics will also give consultants time to see more patients," said Mr Vivian.

The new system, and the appointment of Mr Andrew Ramsey, who joined the trust as the fourth Consultant Ophthalmologist on 27 February, will help to reduce patient waiting times. Mr Ramsey was previously a Specialist Registrar at Moorfield Eye Hospital in London and has a special interest in medical retina and diabetic eye disease.

Mr Vivian and his colleagues are now exploring the possibility of direct referrals to the West Suffolk Hospital by optometrists (opticians) who currently refer to GPs. If discussions are successful, this would help to further reduce waiting times.

Today cataract operations involve a tiny incision that does not require stitches and patients enjoy the benefits of restored sight almost immediately. The vast majority are carried out in the day surgery unit and patients need only one follow up appointment to check there are no problems.

Looking to the future it is hoped that by 2003 the day surgery unit will be extended to include an ophthalmology unit with two dedicated ophthalmology operating theatres and an outpatients department. This will improve the environment for patients and staff and enable the Trust to continue to meet the ever increasing demand for cataract surgery.

The Trust has also improved the management of glaucoma patients. Glaucoma is an insidious disease of the eye marked by increased pressure within the eyeball and gradual loss of vision. It is a treatable condition if caught early and patients with the disease should be seen as quickly as possible. Mr Kerry Jordan lead consultant for glaucoma and his team will now see and treat all glaucoma patients supported by the two new outpatient sisters and an orthoptist.

Patients with glaucoma make regular visits to the hospital. The development of electronic patient records will allow clinicians to retrieve results of previous field scans more easily so progress can be carefully and accurately monitored.