Cataract Operations NHS Delays For Patients With Complex Health Issues

It is estimated that around 400,000 cataract operations are carried out in the UK annually. The process involves replacing the cloudy cataractous lens inside a person’s eye with an artificial one and enables patients to regain their eyesight.

Due to pressures on the NHS service, NHS-funded private healthcare providers have helped by performing the most straight forward procedures. In England, in 2016, 11% of the cataract procedures were conducted by the independent sector. This figure increased to 46% in April 2021.  However, those with more complex health issues, still face significant delays in accessing treatment that could see some patients waiting over half a year.  It is understood that this delay has, in fact, been made worse by the subrogation of NHS services to the private sector. An example of this in action is given below.

Example

An elderly woman with Parkinson’s disease and mobility problems noticed her vision deteriorating, leaving her to struggle with daily tasks. She obtains a referral to an optometrist from her GP.  The tests carried out by the optometrist include a standard eye test and a cataract assessment. The results show that she needs a cataract operation for one eye, and she is referred for surgery.

Unfortunately, because the woman’s case is complex, she is unable to have help from the private sector. Instead, the surgery will have to be carried out by the local NHS provider. This, however, comes with a waiting time that can be six months or more. This is a longer waiting list than was the case before the surgery was contracted out to the private sector because the availability of surgery appointments, and surgeons who can carry out the surgery, has in fact reduced. Statistics show the average time for a cataract procedure in Leicester has increased from 89 days in 2017-2018 to 229 days in 2021-2022.

Further, due to her living alone and the recommendation that she take eyedrops every two weeks to reduce any risk of infection, the ophthalmologist says she will require support. However, hospital staff are finding it difficult to now find a district nurse to help take care of her needs because of the decrease in the number of such personnel. Statistics show that in July 2022 there were 4,029 district nurses, compared to 6,101 full-time district nurses 10 years ago. The need for this support delays her surgery even further.

Experts have commented that the overall cataract surgery waiting times have decreased but because the funded private providers aren’t likely to help in more complex cases, those who require such surgery will have to wait even longer than they would have done in previous years.

Clinical Adviser from the College of Optometrists, Daniel Hardiman, said:

It is worth noting that any delays in surgery for cataracts don’t put a person’s sight at permanent risk. Cataracts do not cause a permanent loss of vision, so a delay in surgery wouldn’t pose any further risk of complications. However, the loss of vision experienced whilst waiting for the cataract to be dealt with can be debilitating especially for vulnerable people and those living alone.

Comment

The NHS is already experiencing many delays and long waiting lists for many of it’s services. Whilst the private sector has helped reduce waiting times for those with straightforward conditions, those with more complex needs are experiencing even further delays to have the treatment they so desperately need along with the knock-on effect of delays to supplementary care and healthcare service provision. This is especially worrying because, in most cases, the more complex the health issues, the quicker the requirement for treatment.