NHS Tayside’s ophthalmology service has doubled the number of cataract surgical procedures that can be carried out in a day thanks to a number of innovations by the team at Ninewells.
As part of NHS Tayside’s Remobilisation Plan for services to recover from the effects of the pandemic, the ophthalmology team worked together to develop and implement a number of innovative improvements to how the service operated.
The team previously carried out 12 to 14 cataract surgical procedures in a day but wanted to increase that number driven by dedication to see as many patients as possible and to reduce waiting times for patients following the pandemic.
They looked at all the ways they could increase service capacity as a whole team, drawing on all experiences of working differently during COVID and reviewing how theatres were run and how the surgical procedures were carried out.
Following the introduction of the new ways of working, the team is now able to complete between 24 to 32 procedures in one day. This has placed Tayside as the best performing health board in Scotland for cataract surgery.
Consultant Ophthalmologist, Dr John Ellis, who leads the high volume cataract surgical work, explains: “This has been a whole multidisciplinary team effort with input from everyone involved to increase our service capacity. I am very proud of what we have achieved so far and the very positive results for our patients.
“One of the changes we have made which has had a major impact is that we are now carrying out simultaneous bilateral surgery. That means if a patient has cataracts in both eyes, we remove both of them at one appointment rather than doing one and bringing the patient back for a second appointment to do the other eye.
“Since around 60% of patients require surgery on both eyes, this is making a big difference to our waiting lists as the number of appointments required for each patient is reduced, allowing us to see more people more quickly.
“We have also taken steps to speed up our theatre model by introducing a double nursing team who work on a ‘tag team’ basis to support the surgeon. This cuts down time in between patients to allow us to carry out more procedures in a day. We have also stopped using slow-acting pupil drops on patients when they arrive in the ward which means we can cut out any delay waiting for the drops to take effect and take people into theatre sooner.
“There are many advantages for patients from this new way of working including a shorter overall journey time from being referred to being seen. Of course, the main advantage is that patients have their sight restored sooner. We know that sight loss is one of the most feared health conditions as it has such a major impact on people’s lives.
“Cataract surgery is 98% successful and only takes about 10 minutes per eye to perform, yet it can absolutely transform someone’s life and give them back their independence.
“We also know that cataract surgery saves lives; a study published earlier this year showed cataract surgery reduced the risk of dementia by 30%. What other healthcare intervention does that?”
Arlene Kell from Dundee recently had bilateral cataract surgery having been referred as an urgent case by her optician.
Dr Ellis and his theatre team performed the short procedure on Arlene who, minutes after, was able to look at a clock on the far wall of the theatre and tell the time – something she would have been unable to see before the operation.
The 64-year-old said the difference in her sight since her operation was “night and day” and she is now able to focus on detail and see colours.
NHS Tayside Chief Executive, Professor Grant Archibald, said, “Services across Tayside are focused on innovating and improving how they work so we can see more patients sooner to address waiting times that have built up over the course of the pandemic.
“The ophthalmology team is to be congratulated for its insight and dedication. Simple operational changes identified by the team have made a huge difference to service delivery and to the experience of our patients.
“Tayside is now the best performing Scottish board for cataract surgery and I am delighted that the team has been sharing the learning from their improvement work with other health boards so that patients across Scotland can benefit.”