Over the past couple of weeks, Declan (Vice-President) and I have been contacting College Council Regional Representatives from all four nations to find out how well eye departments have adapted to the COVID-19 enforced new way of working. Their responses have been uniformly positive. Routine appointments and operations have been postponed but urgent eye care is being maintained. In many departments, consultants are providing a first on-call service (and, in some cases, finding that they are enjoying life back in the A&E Department), and doctors of all grades have shown a willingness to support work in other areas of their hospital. These measures are an understandable and appropriate response to the acute situation we found ourselves in a few months ago. However, whilst it would appear that the NHS has avoided being overrun by COVID-19 patients, it is now equally clear that the plateau phase of the pandemic will be prolonged, perhaps lasting for a further 18 months.
This better understanding of the pandemic’s likely duration must guide our future strategy. Measures put in place to protect patients over a period of three months are not appropriate over a much longer time course. There is a risk of significant, permanent visual loss if normal ophthalmology services are not restored in the near future. The College is working hard to develop guidance on how ophthalmology services can be increased whilst minimising risk to our relatively elderly patients.
In reality, this is a period of opportunity. Whilst patient numbers are low, we have the chance to review pathways to minimise both patient time in the department and contact with other patients and staff. In the long-term, this work is likely to lead to more efficiently-run clinics and theatre lists. As part of this work, I would like to suggest that we adopt waiting room occupancy as a key performance measure. From a COVID-19 pandemic perspective, it is inappropriate to have patients sitting together. Furthermore, if a patient is waiting, there may well be a pathway bottleneck that needs to be identified and corrected.
I would like to thank you all for the work you are doing for our patients, and encourage you to begin a systematic review of the service you offer.
Mike Burdon, President, The Royal College of Ophthalmologists