Cataract Surgery Redesign: Meeting Increasing Demand, Training, Audit and Patient-Centered Care

Figures & data

Table 1 Number of Cataract Surgeries Performed in the Three Study Periods

	Before Redesign (BR) March 2018–August 2018	Redesign Period (RP) September 2018–February 2019	Post Redesign (PR) March 2019–August 2019
Total cataract cases	1033	1291	1659
Cases performed in QMH within normal hours	973	1000	1547
Cases performed in QMH outwith normal hours (supplementary weekend lists)	36	12	0
Cases outsourced (waiting list initiatives)	24	279	112*
Cases outsourced to Golden Jubilee Hospital	199		0
Consultant cases	823	892	1324
Trainee cases	150	108	223
Anterior vitrectomies (% of total cases)	13 (1.33)	5 (0.50)	8 (0.48)

Notes: *All within March 2019, the month immediately following completion of the rebuild. Arrangements for these breeched cases was made during the redesign period and in the post-redesign period, there was no further outsourcing required.

Table 2 Economic Analysis of the Redesign

Redesign Costs	In Pound Sterling (£)
Cost of building work	565,250
Microscope	112,850
Hand pieces	38,000
Instruments and Trays	22,000
Total	738,100
Recurring annual costs
Nursing staff theatre	60,408
Nursing staff Clinic	29,860
Cost of outsourcing 415 cataracts (12 months)	180,110

Figure 1 NHS Fife cataract referral form.

Figure 2 Post-operative visual acuity outcomes for QMH department (all surgeons) compared to Doctor X.

Figure 3 Cataract surgery procedures performed in calendar years 2009 to 2018 by NHS Board in Scotland, United Kingdom. From: Scottish Government. National Ophthalmology Workstream: Hospital Eye Services Progress, Priorities & Practical Actions for a Safe, Sustainable Service across Scotland April 2017.18 Accessible at: https://www.nhshighland.scot.nhs.uk/Services/Optometry/Documents/SGHD%20National%20Ophthalmology%20Workstreams%20HES%20April%202017.pdf.

The Scottish Government. National ophthalmology workstream: hospital eye services, progress, priorities and practical actions for a safe sustainable service across Scotland. ISBN; 978-1-78652-859-9; 2017.

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