'Enormous improvement' in eye service

Eighteen months after being slated in a stern health and disability commissioner report, the Southern District Health Board's ophthalmology service is showing "enormous improvement'', the organisation says.

In April 2018, the HDC said responsibility for a Mataura man going blind in one eye lay with SDHB clinical and senior management, after continual delays in follow-up treatment for a 2014 glaucoma diagnosis meant his sight gradually deteriorated, to the point where he lost the sight in his right eye.

The HDC report said the SDHB relied on administration staff who lacked training and clear guidance to prioritise cases appropriately.

Waiting lists had blown out and people's sight had been permanently damaged.

The service's performance in 2015-16 was examined in a 2017 external review. At that time, more than 1500 patients were classed as clinically overdue, having waited longer than one and a-half times the recommended interval between appointments.

It focused on 34 cases, and found in all but one subsequent issues with the patient's sight were because they were not seen in a timely manner.

This week, the service had 254 patients in that category, SHDB surgical and radiology general manager Janine Cochrane said.

No patients were in the two highest risk categories, over twice the recommended internal or "do not delay''.

"The current results represent an enormous improvement in the service and are the result of ongoing and dedicated efforts and teamwork between clinical and management staff,'' Ms Cochrane said.

"The staff involved are very proud of these numbers and the difference we have been able to make for our patients.''

The 2018 HDC report said a contributing factor to the Mataura man's loss of sight in one eye was an insufficient response by senior management to growing demands for ophthalmology services over many years

"There was a lack of recognition among management at SDHB of the clinical risk caused by this lack of capacity - that patients were losing vision because they were not being seen within evidence-based timeframes.''

The SDHB engaged an external provider to bring out-of-town ophthalmologists to Dunedin to stage a series of weekend clinics and tackle waiting lists.

Extra eye specialists were recruited, more equipment was bought, and the service's referral system was changed.

Annually, about 18,000 patients are seen by ophthalmology services, accounting for between 32,000 and 35,000 appointments,

Work continued to control waiting list numbers, Ms Cochrane said.

"The ophthalmology department has made significant gains following the feedback from HDC reports and external reviews and continues to improve the patient waiting times.

"Its focus now is on continued quality improvement and ensuring its systems remain sustainable, as demand for these services are continually increasing.''



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