The
Chief Operating Officer (COO) and the Divisional Director and
Glaucoma Consultant (DDGC) at Moorfields Eye Hospital NHS
Foundation Trust delivered a presentation on the proposal to
provide additional eye care at a new site in Stratford from Spring
2023, which would bring together in one place a range of eye
services for the local community including glaucoma, medical retina
and cataracts, a specialist pharmacy, diagnostics, face-to-face and
surgical treatments. The existing site at Barking would become a
centre offering diagnostic tests for eyes, jointly operated by
Moorfields, BHRUT and Barts Health. All face-to-face eye clinics
provided at Barking would relocate to the new Stratford
facility.
The
presentation detailed the case for change, the proposals and
feedback from patients. In response to questions, the COO and the
DDGC stated that:
- Whilst there was an eligibility
criteria, the Trust did provide patient transport, which
would continue under the new proposals and those eligible would be
able to be transported from their homes to Stratford. Nevertheless,
the Trust’s aim was to support the
majority of patients who currently received their care at
Barking, to remain at Barking for their care. It was looking to
expand the number of patients that it could see at Barking, where
patients wished to be seen there. Whilst there was a small number
of patients that would have to go to Stratford for their care, the
Trust would assess each patient on an individual basis to look at
how it could support them.
- The Trust had a close working relationship with colleagues at
BHRUT and Barts; in the future, it may be possible for patients who
lived near to one of these sites, to receive their care
there.
- The Stratford site would provide better and additional
facilities for patients. The Trust was also hoping to offer some
low visual aid appointments, so that patients did not need to
travel outside of the Borough for these.
- The proposal would enable patients to receive a range of
diagnostics within the community, through a separate pathway that
meant that they would not need to travel to a hospital
site.
- The Trust hoped to operate the Barking Ophthalmology Community
Diagnostic Centre (CDC) five days a week, seeing around 21,000
patients per year. This was significantly higher than the 8,000
currently seen at Barking.
- The Stratford site would be based at the former MIND charity
offices, which was a four-floor 13,000 square foot building and a
four-to-five-minute walk from Stratford train and bus
stations.
- Cataracts patients were currently seen at Barking for the
initial part of their patient pathway and would then need to travel
to St. Ann’s for their surgery, outside of the Northeast
London area. The proposal would enable a “one-stop”
model for cataracts patients, who would be able to receive
all of their care and treatment at the
Stratford site.
- Medical retina and glaucoma patients would have periods of
stability where no intervention was required, with these patients
being able to continue to receive care at Barking during this. If
they were found to require injections or had queries about changing
their treatment, then they would go to the Stratford site to meet
the clinicians face-to-face. Once the patients had stabilised, they
would be able to return to Barking. As such, the new proposal would
have a mixed pathway for patients, based on their need.
- Patients were currently having to travel much further for
surgery than proposed under the new model. The Trust had mapped out
parking areas for the Stratford site; whilst this was not as
straightforward as for Barking, there was parking available due to
the proximity of local shopping centres.
- Ophthalmology was generally an outpatient or day patient
service. Whilst there were currently six inpatient beds at the City
Road site, these were for overnight-stay patients with a
co-morbidity.
- The Trust was currently looking at exploring its emergency care
model of delivery. It was piloting a model that enabled it to
triage patients that had been referred to its A&E, which had
been developed at its City Road site. The Trust was looking into
how it could roll this model out to the other areas that it served.
Patient feedback had been received as to having emergency support
at the Stratford site and the Trust would look
into this in future years.
- Diagnostics was divided into lanes, with each service designing
the investigations that were required to make a
decision about the patient’s stability. No clinical
decision would be made at this point, with the patient receiving a
letter at a later date as to the
findings of their diagnostic tests.
- The Glaucoma service ran across various sites; however, all
staff had service meetings and received the same service teachings,
so that the same standard of care was kept across all of the sites. The Trust worked hard to offer the
same standards, with the same imaging devices, diagnostic
tests and set-up.
- The Trust had undertaken a lot of work around ‘Did Not
Attends’ (DNAs). This had peaked at 30 percent during the
Covid-19 pandemic, with the Trust now striving to reduce this to
ten percent. A lot of work was being done to improve the patient
portal, in order to digitise reminder
letters and guarantee that patients received these. The Trust was
also starting to aim for a more predictive model to show which
patients were most likely to not attend appointments and to reach
out and work in partnership with them. Where there were spikes in
DNAs, the Trust was working to understand the reasons for these,
such as through socio-economic circumstances.