21 Dec 2018

Delayed eye appointments leave thousands unsure of retaining vision

10:13 am on 21 December 2018

Thousands of people are still waiting too long for follow-up eye appointments that may ensure they retain their vision.

Optometry concept. Male patient under optometrist optician examinination of eyesight in eye ophthalmological clinic

Photo: 123rf

Latest information from the Health Ministry showed that at 30 September 2018, 1000 eye patients were waiting more than twice as long as they should have been for follow-up appointments. That's down from 6200 waiting that long mid last year.

The total number of patients waiting at the end of September was 73,500, of whom 13,700 were overdue. Of the 13,700, 2,367 had been waiting more than 50 percent longer than they were intended to wait.

For comparison, 63,700 were waiting in May last year, of whom 22,736 were overdue.

The extra 9000 waiting this year compared to last year is down to the growing and ageing population, better treatments and the regular appointments that flow from them, and better data-gathering by hospitals.

Of those waiting up to twice as long as they should at the end of September this year, Counties Manukau District Health Board had by far the most - 657 patients waiting more than double the intended time.

In the same category, Tairawhiti DHB came next with 128 waiting more than twice as long as intended, followed by Hawke's Bay DHB with 104; Hutt Valley with 60; Southern DHB with 33; Waikato with 31, MidCentral with 13, Northland 11, Whanganui with six, and Bay of Plenty with one.

Hamilton ophthalmologist Dr Stephen Ng, the clinical director of a Health Ministry expert advisory group on ophthalmology, said he was delighted with the reduction in the number of those waiting long periods.

He said it had been achieved by "very hard work done by each and every ophthalmology department in the country".

Extra clinics had been held, including over weekends, with volunteers assisting, in order to reduce the longest waits.

"Also, the use of nurse injectors and a lot of time in the last year to 18 months has gone into up skilling nursing staff to assist us with the work that has to be done," Dr Ng said.

That included injecting drugs into people's eyes to help with macular degeneration.

Dr Ng said most eye departments at public hospitals now had at least one or two nurse injectors.

Not all DHBs reported on the waiting time details. Five could not report numbers on all or some of the categories.

The Ministry said the data was self-reported and that reporting began in May last year but some DHBs were not able to report them.

In the latest tally, in September, Wairarapa DHB could not report any information; Nelson Marlborough could only report the number waiting and overdue (685); Hawke's Bay could not provide the total number waiting, but had the other data. South Canterbury and Taranaki had reported no patients waiting in the 'at risk' categories.

The Health Ministry said that where data had "not been reported, the Ministry has been assured that potential clinical risk is being managed".

It said it was continuing to work closely with DHBs with large numbers of patients in the 'at risk' categories.

The issue of delayed follow-up eye appointments was first revealed by the Southern DHB in October 2016 when it said 30 people in Southland and Dunedin were at risk of losing their sight waiting for appointments.

A further 4600 people had received letters saying their eye operations were overdue as the DHB was failing to keep up with an increase in eye diseases causing blindness.

Last week the Ministry also released a long-awaited report prepared for it by Ernst & Young and completed in August last year on age-related macular degeneration (AMD).

It said overall public expenditure on ophthalmology services in 2016 was estimated at $124 million, of which AMD was estimated to make up $6.1 million.

The report added: "Costs for AMD are projected to more than double to an estimated $12.5 million per year by 2016 through population growth and ageing."

It said the Ministry, Health Workforce New Zealand and the Royal Australian and New Zealand College of Ophthalmology "should undertake workforce planning to consider whether the number of ophthalmology trainees places needed to be expanded."

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