BMJ  2007;334:222 (3 February), doi:10.1136/bmj.39108.384572.1F

Letters

NHS cataract service

ISTC programme is an expensive option

The first 150 words of the full text of this article appear below.

The improvement report in relation to cataract surgery¹ is further evidence that the independent sector treatment centre (ISTC) programme was an expensive over-reaction to the need to increase rates of cataract surgery.² Many ophthalmology departments had improved cataract surgery pathways, as part of Action on Cataract, an NHS initiative supported by the college,³ before the ISTC programme was proposed.

Modest sums of capital pump-primed increased cataract surgical activity by improved facilities and pathway redesign. As this report confirms,¹ such targeted investment quickly pays for itself. The experience in NHS ophthalmology units elsewhere is similar.

Had the Department of Health followed the advice of clinicians, the royal colleges, and the BMA when the cataract and other ISTC schemes were proposed, improved access to cataract surgery would have been realised with much less expenditure, without adverse effects on surgical training, and without destabilising NHS eye departments. However, an alternative direction was taken.⁴ . . . [Full text of this article]

¹ Bolton Eye Unit, Bolton Hospitals NHS Trust, Bolton BL4 OJR , ² Royal College of Ophthalmologists, London NW1 4QW, ³ Ophthalmic Group Committee, BMA, London WC1H 9JP

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Redesign and modernisation of an NHS cataract service (Fife 1997-2004): multifaceted approach

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BMJ 2007 334: 148-152. [Abstract] [Full Text] [PDF]