What engagement has the Welsh Government had with ophthalmology providers regarding reducing ophthalmology waiting times on both one-off procedures and chronic ongoing disease management?
Ophthalmology waiting times lengthened during the covid pandemic, due to the potential infection control issues related to the nature of the assessments and treatments. NHS Wales is now delivering improvements in the reduction in the number of pathways over 2 years. These have reduced from 9,300 in March 2022 to 2,385, a 74% improvement as of June 2023. Performance against the eye care measures however remains challenging with 49.3% of patients being seen within their due date. This is a decrease of 0.3% since March 2022.
I have therefore provided additional financial support to health boards to commission additional capacity from private providers if necessary. Health boards have used this additional funding to fund optometry staff to undertake reviews of patient pathway and referrals to identify patient pathways suitable for community enhanced services.
Health boards are being encouraged to redesign services and pathways through the use of primary and community eye care services to support chronic disease management.
I am concerned about the performance against the eye care measures and raised this in the Ministerial Ophthalmology Summit in November 2022. I was very clear on my expectations that we cannot do more of the same and expect different results. Health board must look to work differently, making use of the technology available to them and working together across health board boundaries and regions. The summit report can be found here. A follow up summit is being planned.
Following the summit. I commissioned a National Clinical Strategy for Ophthalmology to identify how the Pyott report recommendations will be completed and requested details on:
- demand, capacity, activity and backlog positions
- workforce and training in ophthalmology
- Infrastructure and pathways required to ensure services become most sustainable
- Actions required to reduce long waiting times.
The Pyott report can be found here
The clinical strategy will set out what the long-term blueprint for eye care, support the case for additional investment where required to ensure services are fit for purpose. I expect a report and recommendations by the end of January 2024, with follow up reports and further work through to March 2024.
The Ophthalmology Clinical Implementation Network (CIN) is focusing on the shorter to medium term improvements and the implementation of the Getting it Right First-Time (GiRFT) reviews of Glaucoma and Cataract.
Powys Teaching Health Board are consistently the strongest performer against the eye care measures. Their current performance shows that 77.4% of patients were waiting within target date or within 25% beyond target date for an outpatient appointment. This is against the target of 95%. The health board continues to work with its commissioning NHS Trusts in England to see as many patients as possible whilst also strengthening their workforce and introducing new equipment. This includes the introduction of optical coherence tomography (OCT) scanners in Welshpool, Llanidloes and Machynlleth to support the repatriation of patients back into Powys.
The Welsh Government continues to work with health boards including Powys to explore all viable options to reduce waiting times within ophthalmology. This includes ensuring that strategic planning and operational delivery are focused on delivering optimum, clinically agreed pathways as well as utilising additional resources to treat as many patients as possible such as utilising community services and advanced practitioners to manage both acute and chronic ophthalmic conditions.
Last year I launched “the programme for transforming and modernising planned care”. The plan includes radical changes to the way in which patients access the care that they require. Reducing waiting times requires new innovative solutions, which include redefining services so that those who are at the greatest risk of sight loss or irreversible harm are seen as a priority.
Officials are undertaking a deep dive into local plans and progress during September. Ophthalmology specific meetings have been escalated within health boards and will focus on addressing the backlogs across the waiting lists, ensuring they our maximising the use of the new ways of working.
The Welsh Government remains committed to reducing waiting times for the people of and to reducing the risk of sight loss and irreversible harm.