A Burden Shared

The UK’s National Health Service (NHS) is currently facing record high waiting lists of more than six million patients, many of whom are awaiting cataract surgery – and the backlog is only expected to increase between now and 2024. Although the COVID-19 pandemic was clearly a significant contributor to the situation (1), more than four million people were already waiting for treatment before the pandemic began. A step-change beyond post-lockdown resumption of procedures is needed to support the NHS in managing these unprecedented waiting lists (2) – and, despite the government’s 2021 announcement of a £36 billion funding increase over a three-year period, the NHS continues to face intense pressure (2), making it clear that funding alone is not enough. Instead, I propose adopting a shared-care partnership model to allow community-based healthcare services to provide some relief.

The backlogs are having a significant impact on patient outcomes – and not just when it comes to elective surgery. In UK emergency departments, the expectation is that at least 95 percent of patients should be seen within four hours, yet every day of 2021, more than a thousand patients across the country waited for at least 12 hours. And with research showing that, for every 82 patients spending six to eight hours in the ER, one will come to avoidable harm, these delays are having long-lasting detrimental impacts on many patients (3). Eye care is no exception. In particular, it is vital that cataract surgery patients receive quick and efficient care. The NHS guidelines recommend waiting no longer than 18 weeks before treatment, but the average wait time for cataract surgery in 2021 was nine months (4), a delay that can significantly affect patients’ quality of life. More concerningly, research suggests that delay in treatment can cause further eyesight issues and increase the risk of complications. In 2021, up to 22 patients lost their vision each month while on the surgery waiting list (5), which highlights the fact that delivering efficient, timely, high-quality care is essential to achieving better outcomes for patients.

Community ophthalmology providers
 

As waiting lists continue to grow, it is becoming increasingly clear that the NHS cannot be left to cope with this crisis alone. Instead, community-based services can step in to ease the pressures by offering elective care in local settings. Specialist providers of community ophthalmology, such as Community Health and Eyecare Ltd (CHEC), provide key eye care treatments and services in local communities. Through these offerings, CHEC supports the NHS in treating over half a million patients waiting for eyecare services.

The effectiveness of a shared-care partnership model cannot be understated. It has been suggested that community-based healthcare has been key to the fast and efficient recovery of the healthcare systems in both Denmark and the Netherlands (2), and adopting a similar model in the UK could be instrumental to clearing the NHS backlogs. Community-based care offers a wide range of services and already provides support for around 100 million patient contacts each year (6). However, despite the important role these treatment centers play, there is often a lack of recognition – and, as a result, funding – relative to the need for their services. One of the fundamental elements to facilitate increased awareness of community-based services and ensure that these services support the NHS to their maximum potential is to highlight the importance of the NHS Patient Choice Framework, which allows patients to select their provider when referred for treatment.

Local treatments, convenient solutions
 

Alongside their ability to provide systemic support, community-based services offer a number of benefits for patients. For one, adopting a shared-care partnership model can ensure that patients seamlessly access the right treatment as quickly as possible. Shared-care models, such as the partnership between CHEC and the NHS, offer patients integrated services, enabling them to access the most appropriate practitioner for their care. Additionally, community-based services provide end-to-end care. In fact, 99 percent of CHEC’s post-cataract surgery patients receive treatment in their community setting, ensuring consistency of care at every stage of their treatment.

At CHEC, we are always looking for innovative ways to offer the best possible service. The recently launched patient booking app is one of our key initiatives to support the NHS in tackling waiting lists through improved efficiency. The app allows patients on-the-go access to appointment booking, ensuring that they can be seen as efficiently as possible. The app determines how urgent an appointment is, allowing patients to book the most appropriate slot for their needs and minimizing cancellations or missed appointments. With patient experience at the heart of all we do, the app’s ultimate goal is to ensure that services are as accessible and efficient as possible.

Our answer to a recent survey finding that 31 percent of adults found it hard to access healthcare during the pandemic is the Home to Hospital service, another initiative aimed at tailoring healthcare patients’ needs (7). This free service offers patients transportation to and from their eye care surgery and appointments with local drivers who have undertaken training to support patients before and after their appointments. The Home to Hospital service also underpins broader efforts to address healthcare inequalities. A recent study highlighted that people from certain ethnic minority groups were more likely to report poor experiences at their doctors’ offices (8). By offering transport to appointments alongside other initiatives, such as translation services, we can help ensure that everyone receives the same excellent healthcare experience.

Addressing NHS backlogs will take a considerable amount of time and a concerted effort. I believe that accessible, bespoke community-based care is essential to delivering better outcomes for patients, making the NHS run smoothly, and supporting healthcare professionals. To that end, patient-oriented services such as easy-to-use booking apps and transportation services are vital to ensuring that patients receive the service that is right for them.