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Risk to eye patients as NHS England’s Next Steps plan removes 18-week referral to treatment for elective surgery from the list of priorities for the next 12 months

31 March 2017

NHS England have published Next Steps on the Five Year Forward View which recognises what has been delivered so far and sets out the priorities for the next stages of the plan. In the Next Steps document, the 18-week waiting time target (RTT) for elective surgery has been removed from the list of priorities over the next 12 months.

It is important to acknowledge the achievements to date and recognise the pressures the National Health Service is under due to an ageing population with multiple co-morbidities and resource intensive new treatments.

Ophthalmologists are contributing constructively by developing new ways of delivering care to improve efficiency and patient experience as demonstrated in The Way Forward (TWF) about transformation of services and the Common Clinical Competency Framework (CCCF) providing standards and guidance for the knowledge and skills required for non-medical eye healthcare professionals.

The Royal College of Ophthalmologists (RCOphth) is concerned that the Next Steps plan is a ‘trade off’ between providing the patient services needed to meet the demand and timely access to surgery based on clinical need. Ophthalmologists deliver highly effective surgical procedures that are life changing for those who receive them.  The 18-week RTT removal means that more patients may need to wait longer to benefit from such surgery and in fact the full benefit may not be realised due to the delay.

Professor Carrie MacEwen, RCOphth president commented, ‘We welcome clarity of the approach to the next stage of the FYFV and fully acknowledge that the NHS is under unprecedented pressure. However, it is recognised that treatable vision impairment, when not addressed, is a contributing factor to increased levels of depression and anxiety, risk of falling and dependence.’

The Way Forward research anticipates an increase of around 50% in the number of cataract operations needed over the next 20 years. Cataract surgery is one of the most cost efficient surgeries in the NHS, with nearly 400,000 routinely performed in England alone.

Professor Carrie MacEwen continued, ‘The proposed measures in the Next Steps plan for ophthalmology will have a wider financial and social care impact on local community and health services; as well as the possibility of increasing the numbers of people going to accident and emergency care. Removing the 18-week referral to treatment time will mean that waiting times for such surgery are likely to increase and with it the anxiety of patients.’