Standards for Virtual Clinics in Glaucoma Care in the NHS Hospital Eye Service

  • 14 Jan 2021
  • Professor Paul Foster, Dr Aachal Kotecha, Mr Simon Longstaff

Chronic eye disease management is a challenge facing the United Kingdom (UK) National Health Service. The UK population is increasing, with annual growth estimates of 0.7%.
Predictions estimate that the UK population will have reached approximately 72 million by 2031 (Department of Work & Pensions, 2005). Furthermore, as with most Western
countries, the UK is an increasingly ageing population. The increasing prevalence of glaucoma in the elderly population and advances in diagnostic technologies used by primary
care providers means that the number of new glaucoma suspect referrals to secondary NHS care are increasing (Edgar et al., 2010, Ratnarajan et al., 2013); however, the chronicity of
these conditions means that patients often require lifelong NHS eye service care. As such most hospital eye departments have significant capacity problems with ophthalmology outpatient services (Chalk and Smith, 2013, Smith, 2013).

Most recognise that there is a need to redesign the relevant patient pathways to improve current capacity, reduce overdue review intervals and enhance patient experience of ophthalmology services. One solution is to adopt a ‘virtual clinic’ for managing stable patients. A virtual clinic is one in which the face-to-face clinician consultation is removed. In a synchronous model, the patient and clinician interact in real time, for example, via webcam. In the asynchronous model, the interaction occurs at different times. In a glaucoma asynchronous virtual clinic, technicians gather quantifiable data for clinicians to make value decisions. In this type of model, clinicians can review considerably more patient data than intraditional clinics.