19 Sep 2017

Thousands face long wait for eye clinic appointments

7:20 am on 19 September 2017

More than 9000 patients are still waiting one and a half times longer than intended for follow-up eye appointments nationwide.

eye doctor, Opthalmology, optometrist

Photo: 123rf

The figure was obtained by the Royal Australian and New Zealand College of Ophthalmologists under the Official Information Act.

The Southern District Health Board (DHB) revealed last November that its eye services were overwhelmed and that 30 people risked losing their sight waiting for follow-up appointments.

It led to confirmation from other DHBs that they also had large numbers waiting for follow-up care.

That was sparked by a growing and ageing population and improvements in care, notably Avastin injections to maintain good vision in those with macular degeneration.

The data supplied to the college by the Health Ministry shows that all DHBs saw 200,000 people for follow-up eye appointments over the past year. Ten percent, or 20,615, were overdue at the end of June. As well, 9571 patients were overdue for appointments by 50 percent or more.

Counties Manukau DHB was listed as having the most in this category: 3714 at the end of June; followed by the Auckland Ophthalmology Service (combining Auckland and Waitemata DHBs) on 2535; and the Southern DHB on 1100.

More up-to-date information released to RNZ News late yesterday reveals that, since February, Auckland has reduced the number of patients in its waiting list who've waited one and a half times longer than intended, from 3129 to 1603 as of today.

Counties Manukau DHB also told RNZ separately it had cut the number waiting longer than intended to 5182 at the end of August. Of those, 3118 had been waiting 50 percent longer than the intended time of their appointment, and 2142 had been waiting twice as long as they should have.

The DHB's director of hospital services, Phillip Balmer, said the reduction was achieved by a range of initiatives, including nearly 300 extra patient clinics over the past year, employing two more ophthalmologists, and a team-based approach, with clinical nurse specialists delivering many Avastin injections.

DHBs 'working very hard'

The New Zealand chair of the college, Northland eye specialist Brian Kent-Smith, said DHBs were "working very hard" to get on top of the backlog.

It was a testament to them that there were not more patients waiting lengthy periods for follow-up care, he said.

The main concern was that specialists didn't know the individual clinical circumstances, including the degree of severity, of the 9500 who were more than 50 percent overdue for follow-up appointments.

"Some of them will be people where it's not terrible that they're overdue. I'm not saying it's ideal... let's say somebody has stable, well-controlled glaucoma and I wanted to see them in six months' time but I only get to see them in nine months' time. There's probably no harm done.

"But if there's somebody who's got advanced glaucoma, whose optic nerve is threatened, and I wanted to see them in a particular timeframe and I didn't see them in that particular timeframe, that person could be at risk of losing vision."

RNZ asked whether that worried him. Dr Kent-Smith replied: "Absolutely. I wouldn't want to be in one of those 9500 and I wouldn't want my parents to be in one of those 9500."

He stressed that hard work by DHBs reduced the number overdue for appointments by 14 percent between May and June. He said that momentum must continue, and the college looked forward to the Health Ministry's release of a report by EY on how processes could be improved nationwide.

The ministry said this report was on track to be completed and published this year.

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