Tackling the NHS glaucoma clinic backlog issue

Abstract

Background/Objectives: to determine whether mass case review, carried out by glaucoma sub-specialist consultants, for patients for whom there was insufficient clinic capacity, could aid reduction of the glaucoma clinic appointment backlog. Subjects/Methods: patient hospital notes were reviewed by a glaucoma fellowship trained consultant and a decision was made as to whether the planned review was appropriate. Decisions were made with respect to timing, clinic-type and necessity for follow-up, together with an assessment as to whether visual field testing was required. Results: in a 3-year study a total of 9290 cases were included in the study. After consultant review, 5521 (59.5%) patients were kept within the hospital eye service (HES) and an additional 1350 (14.5%) had their next appointment delayed, 384 (4%) were discharged to specialist community glaucoma optometrists and 2035 (22%) were discharged to their standard community optometrists. Overall, therefore 26% of patients were discharged from the HES. Of the planned 9290 appointments, simultaneous visual field testing had been planned for 5393 patients (58%), but after consultant review only 65% (n = 3482) of these were considered necessary, reducing the number of required visual field tests by 35% (n = 1911). Conclusions: the authors suggest that ophthalmology departments experiencing significant clinic appointment backlog issues, consider utilising trained glaucoma sub-specialist consultants to review planned follow-up management of patients within a backlog deficit.