Three steps to sustainable patient care: RCOphth publishes position on the independent sector and the delivery of NHS cataract surgery

  • 10 Nov 2021
  • RCOphth

The Royal College of Ophthalmologists (RCOphth) has today defined its position on the provision of NHS cataract surgery and training by the independent sector in a new statement Three Steps to sustainable patient care: RCOphth view on the independent sector and the delivery of NHS cataract surgery

Action needed to ensure sustainable patient care

The statement describes the growing role played by Independent Sector Providers (ISPs) in delivering cataract surgery in England and outlines how the RCOphth will work with ISPs and others to ensure the delivery of a sustainable comprehensive ophthalmology service with a well-trained workforce. The statement sets out the RCOphth commitment to:

  1. Rapidly increase access to surgical training in the independent sector
  2. Level the playing field for cataract providers to ensure equitable patient access and stability for the whole service
  3. Safeguard patient safety and standards of service delivery.

The growing role of the independent sector

There has been a huge shift over the last five years in what type of provider delivers NHS funded cataract procedures. In 2016, just 11% of NHS cataract procedures in England were delivered by ISPs. But by April 2021 there was almost a 50/50 split, with 46% by ISPs and 54% by NHS trusts and treatment centres.

An important part of this changing picture is that NHS ophthalmology units, despite developing innovative solutions, have struggled to provide capacity for cataract procedures because of a lack of investment in appropriate infrastructure and workforce at the national and local level.

The RCOphth recognises that ISPs have helped to increase much-needed capacity to deliver patient care, particularly during the pandemic. However, this growing role has also presented new challenges that must be addressed to ensure a well-trained workforce and a sustainable comprehensive ophthalmology service to meet the growing patient demand.

The landscape for how NHS funded cataract surgery is delivered in England has shifted dramatically. This has helped to increase the capacity to deliver timely patient care, especially given the under-resourcing of many NHS eye units and the disruption to services caused by the pandemic. But this shift has not come without difficulties. Ophthalmologists in training are struggling to get the access to surgical sessions they need to become experienced surgeons. Patients with more complex needs can only be managed by the NHS ophthalmology service, further complicating patient access to care. The financial viability of NHS eye care units to deliver ophthalmology services and comprehensive out-of-hours care is also being threatened. It is crucial that we all now take stock, whether we work in the traditional NHS setting or the private sector and together work towards a sustainable ophthalmology service into the future.

RCOphth President Professor Bernie Chang

View the pdf: Three Steps to sustainable patient care: RCOphth view on the independent sector and the delivery of NHS cataract surgery

The RCOphth welcomes views or comments, please email [email protected]