End of postcode lottery for cataracts treatment

Thousands of patients will be offered cataract surgery under the first national guidelines to end the ‘lottery’ in treatment.

In a victory for the Mail, the health watchdog will say that patients should be offered help as soon as their quality of life is impaired.

NHS trusts will also be told to abandon the sight tests which mean many are refused surgery until they are nearly blind. And they will be instructed to offer surgery for both eyes at once, rather than only for the one which is worse.

I borrowed cash for life-changing private operation 

Helen Heraty was told that she could only have cataract surgery on one eye – despite being virtually blind.

So the 58-year-old, who runs a boutique hotel in York, had to borrow money from her son to pay for the treatment privately.

Her local health trust had told her it would only do her right eye and would wait until her left deteriorated even further.

Helen Heraty was told that she could only have cataract surgery on one eye – despite being virtually blind

Mrs Heraty, who has seven children aged 12 to 28, said: ‘I couldn’t function, it was a very difficult time. It was like looking through a Vaseline-coated lens.

‘One eye was completely gone and the left eye was down to 50 per cent vision. I couldn’t drive at night, I could barely drive during the day and I couldn’t see colour.

‘Had I been 70 or 80, I wouldn’t have been so fussed about it. But I was 55, I knew I was going to be working for a lot of years.’

She was treated privately at the London Eye Hospital, Harley Street, in December 2014 and opted for a far more high-tech lens than those offered by the NHS, which cost £8,000 an eye.

They worked so well she no longer needs glasses to read or see long distances.

Officials want to end the shameful postcode lottery which is leading to many sufferers being denied the straightforward 30-minute operations. As many as half of the over-65s have cataracts – some 4.5million adults in England. They occur when the eye becomes cloudy with age.

Yet currently, patients in some areas of the country are four times as likely to be offered corrective surgery than those living elsewhere. This is due to irrational rules set by most NHS trusts which state patients can only have treatment if their sight has deteriorated below a certain level.

Many sufferers have been told they still do not qualify for surgery despite being unable to read without a magnifying glass, drive or recognise friends’ faces.

The new guidelines from watchdog Nice – due in October – will be a huge victory for the Mail, which has long campaigned against the current unfair system.

Last summer, this paper exposed how three-quarters of hospitals were refusing to carry out surgery unless patients had scored very badly in sight tests. The hospitals were following strict guidelines set by their local Clinical Commissioning Groups (CCGs).

Nice suggested these rules were based on the hope some patients would die on the waiting list, before they qualified for surgery.

In a victory for the Mail, the health watchdog will say that patients should be offered help as soon as their quality of life is impaired

In a victory for the Mail, the health watchdog will say that patients should be offered help as soon as their quality of life is impaired

Yet cataract surgery costs just £750 per eye. The operation lasts between 30 and 40 minutes, and many patients say their lives are ‘transformed’ as they can regain their independence.

Mike Burdon, chairman of the Nice guideline committee, who is also president of the Royal College of Ophthalmologists, which represents eye doctors, said there was ‘no justification’ for the current system. ‘I’m very keen that there should not be a postcode lottery of ophthalmology services across this country,’ he said.

‘Once their quality of life has been impacted, then there’s no point waiting any longer. The patient’s quality of life is the key aspect in the decision-making.’

Referring to the restrictions imposed by health trusts, he said: ‘The only way it could save money is by hoping some patients die whilst on the cataract list. I don’t know if the CCGs are doing this overtly, but that’s the only way they can save money.’ A draft version of the guidelines drawn up by Nice state that for ‘the majority of patients’ with cataracts ‘it is clearly optimal to offer surgery’.

The final version is due on October 24 and charities say that if properly adopted by health trusts, they will lead to thousands of extra cataract operations a year.

The guidelines won’t be legally binding, but Mr Burdon said health trusts would come under heavy pressure to follow them.

Caroline Abrahams, director of charity Age UK, said: ‘We are pleased to see this new guidance and hope it will help the thousands of people who are waiting in misery for far too long for cataract operations they badly need.’ A report by the Royal National Institute for Blind People in 2013 exposed a fourfold variation in the number of cataract operations performed in England.

The lowest rate was in NHS South Reading CCG at 267 operations per 100,000 population – rising to 1,147 operations in NHS Fylde and Wyre, in Lancashire.

Helen Lee, from the RNIB, said: ‘We welcome the Nice cataract guidelines and we urge providers to fully implement them.

‘Our concern is that, despite the new guidelines, the postcode lottery for treatment may continue if solutions are not found to address the current capacity crisis in ophthalmology. Cataract surgery is highly effective and patients must receive timely treatment based on their clinical need.’

NHS bosses have faced criticism for rationing cataract surgery while spending money elsewhere.

From next month, for example, they will pay for a controversial drug to prevent HIV, which will be offered to up to 10,000 high-risk patients such as gay men and sex workers.

Known as Prep, it disables the HIV virus before it can take over the body, although it does not prevent the spread of sexual diseases such as gonorrhoea.

Bed-blocking costs the NHS enough to fund 450,000 cataract operations, while health tourism is estimated to cost up to £2billion a year.

The NHS has also been hit by ‘revolving door’ scandals in which executives ‘retire’ for 24 hours before being rehired in the same role.

This will now be ended under new rules from the Department of Health that allow retiring staff back into the same hospital only under exceptional circumstances.

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