The Royal College of Ophthalmologists has drawn attention to pressure building in ophthalmology services – there has been a 30 percent increase in eye clinic outpatient appointments over the past five years.
The increasing demand for eye clinic appointments is driven largely by patients with chronic eye diseases who require long-term ‘return’ or ‘follow-up’ appointments for repeat monitoring and regular treatment procedures.
These follow-up appointments are more likely to be postponed or simply be lost in the system for months, and sometimes years, to accommodate new referrals in already oversubscribed clinics.
The National Reporting and Learning System (NRLS) identified nearly 500 incidents describing loss or deterioration of vision (130 severe harm and 350 moderate harm) from such delays between 2011 and 2013.
The Royal College of Ophthalmologists is carrying out a national study to identify patients who have come to harm due to hospital initiated delays for follow up appointments. This study has not yet formally reported but preliminary results indicate that at least 20 patients per month suffer severe visual loss.
Whilst many hospitals are taking positive action to deal with these delays and to find ways to meet the demand on the limited capacity available in eye services, the response to this problem is variable amongst regions and across the devolved nations.
Verita has significant experience in ophthalmology departments, ranging from investigations of post-merger inefficiencies, the investigation and control of serious incidents, complaints and never events as well as full-service reviews. We have a highly developed and well-tested methodology for mapping processes and flows through departments. It looks at process steps, what activities go into populating these steps and outputs. This uncovers where the bottlenecks sit in services and what causes them, providing a sound, quantified basis for taking corrective actions – an efficiency optimization methodology. Our expertise in patient safety and quality underpins every recommendation that we make.