Covid-19 has created difficulties for all – none more so than the NHS, which is facing significant backlogs as a result of the pandemic.
In particular, ophthalmology has the highest volume of outpatient appointments across the NHS, with annual figures normally around 7.5 million appointments and 500,000 surgical procedures.
Therefore, it comes as no surprise that out of the estimated six million people on the NHS waiting list, ophthalmology makes up a staggering 500,000 appointments.
With an ever-growing backlog of patients waiting for treatment, and around 130,000 of the 500,000 waiting for over six months, the NHS is finding itself overwhelmed. Without any support, the NHS will struggle to keep up with their backlog, thus it is crucial that community health services are available to step in and lessen the load.
The effects of COVID-19
The pandemic has greatly exacerbated these long waitlists faced by the NHS. Eye problems, of which cataracts are most common, are often not considered urgent, meaning treatment is at high risk of being postponed. The NHS recommends waiting no more than 18 weeks before treatment yet, between 2019 and 2021, waiting times for cataract surgery increased by 84% to an average of nine months. Furthermore, a 41% reduction in cataract surgery was recorded in 2020, compounding the backlog issues that the NHS faces.
While cataract surgery is not always urgent, it can have a significant impact on the lifestyle and independence of patients. Issues with vision can cause stress, a higher risk of accidents, and lead to a further deterioration of eyesight – 22 patients per month lost their vision as a result of being on the waiting list in 2017. Consequently, it’s crucial that patients are able to access eyecare within the 18 recommended weeks, which many are currently unable to do.
To combat this, the government announced extra funding towards the NHS in September totalling £5.4 billion, £1.5 billion of which is dedicated to elective surgery in order to manage the backlog. While this funding is very welcome, it is only a short-term solution, as the demand for eyecare is predicted to increase over the next 15 years. Instead of leaving the NHS to face this alone, it is important that there are more services in place to deal with the rising demand of eyecare, and help take pressure off the NHS’s core services.
Why community-based care?
Community-based care covers a wide range of services across community clinics and schools, along with a variety of specialist services, including eyecare. Community health services cater to 100 million patients a year, accounting for £10 billion of the annual NHS budget and a fifth of the NHS workforce[8]. While making up a large part of the NHS, community services can lack the awareness and funding relative to their demand. As the NHS wants to better integrate community services, they are aiming to increase the funding available, lessening the divide between primary and community care.
Community-based care can offer the NHS support when tackling backlogs at the same time as providing patients with local care, which tends to be more accessible. CHEC’s community-based services, for example, also provide end-to-end care, meaning it can perform all the services that a patient needs without having to see different providers, from consultation to treatment. End-to-end care is important because it keeps treatment streamlined and in-house. This makes the treatment process less stressful for patients and keeps everyone on the same page and, as a result, treatment for patients is more personalised.
Most importantly, many community services are well equipped to support the NHS by having the capacity, shorter waiting lists, and specialised services to see patients quickly, relieving the backlog of the NHS in the process. However, patients are often unaware of community-based care. Under the NHS Patient Choice Framework, which allows patients to choose their care provider when referred, patients are able to seek out community services or ask for referrals, and therefore assist the NHS while accessing high-quality care.
Working together
It is critical that community health services receive the funding and profile to relieve the pressure faced by the NHS. With the shared goal of working through the backlog, community health services allow hospitals to focus on providing core services and emergency care, achieving the best outcomes for patients with shorter waiting times and more personalised care. By choosing community care, you support the NHS, cutting down the long waiting lists and reducing the burdens faced by staff.
By Imran Rahman, CEO of Community Eyecare (CHEC)
