Restrictions on access to cataract surgery by 57 per cent of PCTs in England are forcing thousands of people to live with serious and unnecessary sight loss according to new research carried out by the Royal National Institute of Blind People (RNIB).
A year on from a previous Freedom of Information request to all PCTs, RNIB has again found that over half of them have arbitrary restrictions on eligibility for cataract surgery and are not taking into account the debilitating impact the cataract is having on a person's life such as preventing them from reading, driving, and staying safe when out and about.
It indicates that no improvements have been made in the last 12 months despite strong evidence that delaying surgery ends up costing not just the patient but the health service as a whole. The results also point towards regional variations, with patients in the North East gaining better access to surgery than those in the South East.
The findings were revealed at a Parliamentary reception held to launch RNIB's Save our Sight (SOS) campaign, aimed at challenging unnecessary sight loss, encouraging regular eye checks and promoting the importance of timely access to vital treatment.
Following a 99 per cent response rate, the statistics showed:
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57 per cent of PCTs have restrictions on access to cataract surgery based on visual acuity thresholds.
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Of those, 70 per cent have a very restrictive policy which has little or no leeway for patients outside the visual acuity threshold.
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42 per cent of PCTs have no visual acuity restrictions and will operate when cataract causes symptoms.
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There is regional variation, for example, patients in North East England can have surgery as soon as the cataract affects their lives. In the South East some patients need to have a visual acuity as low as the third line down on an eye chart before they are able to access surgery.
Clara Eaglen, RNIB Eye Health Campaigns Manager, said: "Everyone with a sight-threatening condition deserves early access to treatments that will delay or halt sight loss. People should not have to live with a reduced quality of life simply because PCTs are using arbitrary criteria to determine whether they get to keep their sight.
"When a cataract begins to affect a person's everyday life, their sight will only continue to deteriorate. They will require surgery at some point in the future and not treating now will only increase waiting lists in the future. "
PCTs and hospitals should follow the Department of Health's 'Action on Cataracts' guidance and RNIB is calling on those deviating from the guidance to provide evidence showing how their decision is in the best interest of the patient.
RNIB is also urging people to come forward if they have had any problems getting cataract treatment or if a family member has suffered as a result of being denied surgery. These stories can help us show the real impact of these restrictions on people's lives. Join the conversation with @RNIB on Twitter using the hashtag #saveoursight or write on the RNIB Facebook page at www.facebook.com/rnibuk
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Notes to editors
For media enquiries, please contact Rachel Cafferty in RNIB's Public Relations Team on 0207 391 2043 or 0207 391 2223, email rachel.cafferty@rnib.org.uk
About RNIB's 'Save our Sight' Campaign
Over 50 per cent of sight loss is avoidable. You or someone you love could lose your sight. Those of us lucky enough to live beyond the age of 90 will face a one in two chance of losing our sight. With a population growing in age and obesity, RNIB's new 'Save our Sight' (SOS) campaign will work to tackle the timebomb of avoidable sight loss in the UK.
Having an eye examination at least once every two years should be part of everyone's health care routine as many causes of sight loss are preventable if they are caught early.
Action on Cataract
Department of Health "Action on Cataract" best practice guidance establishes some straightforward eligibility criteria, which if implemented fully should prevent situations where people experience a reduction in their quality of life due to operable cataracts. It should also ensure that people do not undergo unnecessary surgery.
Action on Cataract did not establish a visual acuity threshold, but employs three criteria that need to be met for a cataract to be removed:
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The cataract affects the individual's sight.
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The reduction in the patient's sight has a negative impact on their quality of life.
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The patient understands the risks and agrees to having surgery.
PCTs introducing arbitrary thresholds to restrict access to cataract surgery do so without a robust evidence base to demonstrate that they will not harm patients or increase inequalities of access across their populations.
National SOS findings
Further details of the national picture can be found in the SOS report.
NI
In Northern Ireland capacity problems are the main concern in eye health which has knock on effects for all treatable eye conditions. One in five people referred to a consultant ophthalmologist waits over six months for an initial examination at a hospital eye clinic.
Access to treatment for cataracts is solely based on the clinical judgement of the consultant ophthalmologist rather than arbitrary criteria although lengthening waiting times do affect cataract patients.
Scotland
In Scotland, where health is devolved to the Scottish Government, waiting-times for treatment for cataract surgery are covered by a guarantee that shouldn't exceed 16 weeks. However, sight loss overall is projected to double in Scotland within two decades if no further action is taken to reverse trends, and diabetic eye conditions are a particular problem with diabetic retinopathy the main cause of sight loss among those of working age.
Wales
The Welsh National Assembly voted unanimously in favour of making 'a measurable reduction in avoidable sight loss a public health priority for Wales' and clinical pathways for the treatment of Glaucoma, AMD and unscheduled care have been developed. However, nearly one quarter of patients are not being seen within the Welsh Government's Referral to Treatment Time target and one Health Board in Wales is known to be using arbitrary visual acuity thresholds for cataract operations.
About RNIB
Everyday around 100 people in the UK start to lose their sight. There are around 2 million people in the UK with sight problems. RNIB is the leading charity working in the UK offering practical support, advice and information for anyone with sight difficulties. If you, or someone you know, has a sight problem RNIB can help. Call the RNIB Helpline on 0303 123 9999 or visit www.rnib.org.uk