National ophthalmology workstream: hospital eye services

Foreword

Patients with ophthalmic conditions are often vulnerable and must be supported by a responsive health service. Their care should primarily be safe and timely. This document sets out how we plan and manage the delivery of services to achieve this by making the best use of existing resources and developing these effectively. This involves:

• Improving datasets and collection of data to understand demand and optimise available capacity; identifying shortfalls so that we are in a position to treat all patients safely and in a timely manner;
• Offering appropriate treatments within a suitable timeframe to ensure patient satisfaction and safety by preventing the risk of poor outcomes from treatment and/or vision loss by providing care where and when it is needed;
• Optimising current capacity - how we use the hospital eye service efficiently to manage patients with eye disease and those at risk of vision loss;
• Managing the system in a patient focussed fashion -
  • by ensuring that only those who require secondary care are referred to hospital;
  • by improving hospital appointments and flow by using new methods of working, technology and the entire workforce to capacity;
  • by focusing use of our return capacity more effectively to provide management of Long Term Conditions - by collecting data on review patients to 1) ensure care takes place within clinically safe time limits and 2) promote properly managed service re-design;
  • By discharging appropriate low risk patients via pre-determined pathways - identifying who and how we follow up and ensuring clear and adequate information to patients about their condition and how to access care should they need it.
• Maximising the workforce -
  • using the skill sets available so that staff work to maximise their competences;
  • enhancing education, training and continuing professional development so that each individual is able to develop and work for the benefit of patients;
  • ensuring that suitable patients are seen by the correct professional and, where indicated, this should be closer to home.

This report sets out significant progress that has already been achieved across hospital eye services in Scotland. It also explores future opportunities for further gain and innovation. Above all it sets out opportunities and tools for clinicians to be the architects of future change in the delivery of ophthalmic care in a modern health service. This exemplar work has already delivered benefits and there is much more to achieve.

John Connaghan
NHSScotland Chief Operating Officer

Professor Carrie MacEwen
President of the Royal College of Ophthalmologists