Imran Rahman launched CHEC (Community Health and Eyecare) in 2012, while serving as a consultant ophthalmologist leading the cataract and corneal transplant units at Blackpool Victoria Hospital, UK. Since then, CHEC has worked in partnership with the NHS to increase patient choice and capacity to improve access to timely, locally based care.
In 2017, Rahman left the NHS to focus on CHEC full-time. CHEC is now one of the UK's leading providers of community healthcare. Here, he tells us how his drive to improve the healthcare sector is as strong as ever.
What led you to create CHEC, and how has the organization grown?
When I left the NHS in 2017, I had become frustrated with the inability to change processes in the healthcare sector. I could see waiting lists increasing, and understood community care could not only help to improve the wellbeing and lifestyle of eye health patients, but could also unlock further capacity for the NHS. I set up CHEC in Preston and we’ve grown exponentially ever since.
In 2023, having established a highly functional “hub and spoke” operating model made up of hospitals and community clinics, we expanded our model to also begin offering gastroenterology, as well as ophthalmology. The levels of service we’re able to provide in gastroenterology are unchallenged, and we’re now considered specialists in this field too.
By the end of this year, we’ll have expanded our portfolio significantly, to over 35 hospitals, and approximately 105 community clinics, in areas where accessibility to NHS treatment is particularly challenging, where social deprivation limits equity of access and where there is evidence of increasing sight threatening eye disease. Our expansion to hard-to-reach places and people aims to relieve local waiting lists for outpatient, elective, and diagnostic services.
What do you see as the key ophthalmology challenges in the UK?
The whole ophthalmology sector could operate much more efficiently if there was clearer dialogue between primary, secondary, and independent services, and less resistance from all parties around working together.
There’s regular commentary that independent sector providers are undertaking too much work, placing acute ophthalmology departments at risk. However, there is little factual evidence of this. These are areas where independent providers can support and reduce sight threatening problems. What I believe the independent sector has done successfully is remove some of the longest waiting times, allowing the NHS to capitalize on the extra capacity this has given to reduce their backlogs. Ultimately, patients want a provider that offers them quick, accessible, safe care, with positive outcomes, free at the point of service.
With technology advancing as it is, there is no reason for waiting lists to continue rising. Community care should be exactly that – all services within one community, working together for the people who live there. It’s an ambition of mine to help achieve this, but much needs to change to do so. In particular, there needs to be closer collaboration with the NHS and independent sector to maintain low waiting times and improve patient safety in an agile way, using technology fit for future generations and truly placing patients at the center of discussions.
What obstacles have you faced in your career?
When you’re a medical student you get taught how to communicate efficiently, think critically, interpret and relay good and bad news, and how to handle emergency situations – things you don’t get exposure to in any other degree. But a medical degree doesn’t tell you how to cope with institutionalized issues, such as racism, which – at the time I was looking for my first job – was rife.
During one of my earliest job interviews I was told I might never become an ophthalmic surgeon because of my name. On another occasion, when working with a senior registrar who was Nigerian, he explained he had come across challenges he didn’t want to repeat out loud. I decided that, should I ever become a consultant, I would do the right – and obvious – thing, and recruit and reward based on talent, not race.
It sounds simple. We live in a different world today, but to have those issues presented to you in the earliest days of your career sets a certain type of tone. I’ve built a culture at CHEC which makes it an open, honest, welcoming place to work – we take an incredibly strong stance against bullying of any kind. As long as our people are taken care of, I feel like we can take on any other challenge that comes our way.
What's your vision for the future of CHEC?
Our ultimate ambition is equity of access to high quality, efficient, and safe healthcare. This is why the mobilization of our community clinics is so important to us right now. We’re aiming for each of our hospitals to have at least four community sites supporting it, so patients are offered a choice of convenient locations closer to home with short wait times. This reduces travel time – and therefore expenditure – and being placed in hard-to-reach areas with a standardized level of service helps reduce healthcare inequalities.
This also supports our Net Zero agenda. Up to 3.5 percent of carbon emissions from the NHS are related to patients and staff coming to hospitals and going to appointments. Our community hub and spoke model is designed to reduce carbon emissions as well as support local care delivery
What advice would you give to other practitioners with ambitions to make a real difference to healthcare delivery?
One piece of advice I received when I was thinking about starting CHEC was to do the best you can for patients and everything else will follow. Whether it’s your reputation, a great team, awards – none of it will come your way if you don’t prioritize the patient every step of the way. Acknowledge and accept you will make mistakes, but minimize the risk of that whenever you can by planning methodically and to great detail. At CHEC, we don’t instigate anything until we’ve fully understood the risk element beforehand, centered around a clinical governance structure.
And finally: never stop learning. My parents instilled in me a great love of education, to the point it is still habitual. Learn from your team, learn from your peers, learn from industries with synergies and surround yourself with the best people. Combine all that and you’re sure to leave your mark.
