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Overstretched eye clinics at breaking point, RNIB warns

Delays in diagnosis and treatment causing sight loss; budgets cut to save money

Caroline White

Thursday, 14 November 2013

Patients are going blind because eye clinics across England are overstretched and have reached breaking point, says the Royal National Institute of Blind People (RNIB).

Rising demand and inadequate funding are key factors driving the crisis, but the lack of capacity could lead to hospital trusts facing many more clinical negligence claims, it warns.

RNIB bases its conclusions on the results of a survey on current and future capacity sent to staff in eye clinics across England, and a Freedom of Information request to all CCGs on the evidence they use to commission eye care services.

By September 2013, 172 responses had been received from a range of eye health professionals, including 91 ophthalmologists and 59 ophthalmic nurses. RNIB also looked at which local authority Joint Strategic Needs Assessments (JSNAs) included information and data on eye care and sight loss.

Staff working in ophthalmology units voiced serious concerns about the ability of clinics to meet demand. Over 80% said their eye department had insufficient capacity to meet current demand, with 94% reporting that future capacity would fail to meet rising demand.

An ageing population and demand for services across a broad range of conditions were cited as the main reasons for the increase in case load.

Almost 40% of staff said that patients are “sometimes” losing their sight unnecessarily due to delayed treatment and follow up care caused by capacity problems. A further 4% said they believed this loss of sight is happening “often.”

RNIB's Chief Executive, Lesley-Anne Alexander described the findings as “shameful.” She said: “Nobody should lose their sight from a treatable condition simply because their eye clinic is too busy to provide care in a clinically appropriate timescale.”

She criticised hospital managers for ignoring “the capacity crisis,” which she said was often done to save money, but which was risking patients' sight putting staff on course for burnout.

Without their sight, people risk losing their jobs and their independence. They are also at higher risk of falls and accidents which require further NHS health and social care, says RNIB.

"RNIB believes these shocking results should act as a wake-up call to commissioners and to hospitals. They should be aware that if they do not act soon, they could be at risk of clinical negligence claims," Ms Alexander emphasised.

Over half the staff who responded to the survey said the problems are so significant that they have to run extra clinics in the evenings and at weekends to keep up with demand. Staff described their working conditions as “chaotic” and “running from one crisis to another.”

RNIB is calling on NHS England to undertake an urgent inquiry into the quality of care in ophthalmology and proposes that a national clinical director within NHS England should be appointed to address unacceptable variation in eye care provision.

CCGs must undertake an independent assessment of the eye care needs of their local population and provide sufficient funding to eye clinics so they can meet rising demand for services, and the National Institute for Health and Care Excellence NICE must prioritise the production of its eye health clinical guidelines and Quality Standards, it says.

RNIB Report: Saving money, losing sight

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