Mandatory minimum waiting times for cataract surgery in England could generate more than £400 million in annual healthcare and economic losses, according to a new report commissioned by UK ophthalmology provider SpaMedica.
The report, Minimum waiting times for cataract surgery: The impact on patients, families and the NHS, published Oct. 19, suggests that policies designed to manage elective surgery spending may instead increase pressure on other NHS services while negatively affecting patients' health, independence, and quality of life.
According to the report, approximately half of England's integrated care boards (ICBs) – NHS organizations responsible for planning, funding and coordinating health services within specific geographical areas in the country – have introduced mandatory minimum waits of up to 16 weeks for cataract surgery, compared with previous waiting periods of approximately four weeks.
The report researchers estimated that every additional week of waiting represents £164 in lost health, care and economic value per patient. Across England, where approximately 510,000 cataract procedures are performed annually, just four additional weeks of waiting could therefore result in an estimated £406.7 million in annual losses.
The research, conducted among 520 patients awaiting NHS cataract surgery, highlighted the potential consequences of prolonged waiting periods. Among respondents, 85% reported worsening vision while awaiting treatment, while 69% said their mental health had deteriorated. Additionally, 75% reported becoming more socially withdrawn.
The findings also suggest that delayed surgery can affect patients' ability to work and maintain independence. Almost one-third of working-age respondents had reduced their working hours because of deteriorating vision, while 21% reported stopping work altogether. Approximately three-quarters of patients said they required additional assistance from others following their referral, while 86% of surveyed carers reported providing increased support because of patients' declining health or independence.
"Any wait for care and treatment for an eye condition can cause anxiety and uncertainty for patients and their families," said Robert Cooper, the director of strategic engagement and implementation at the Royal National Institute of Blind People (RNIB), in a recent press release. "Any delay can have a significant impact on someone's quality of life. Successful cataract surgery will ensure a person is able to go about their daily life; driving, staying in work and continuing to live independently. It’s critical all patients affected by changes in their sight can get the right support at the right time.”
Beyond the reported effects on patients, the findings suggest that prolonged waiting periods could contribute to increased healthcare expenditure. Almost one in five respondents reported attending an accident and emergency department or receiving medical treatment following a trip or fall while awaiting surgery, and the report estimates that associated emergency department attendances could cost the NHS approximately £21.67 million annually. Meanwhile, one-third of surveyed patients reported requiring additional general practitioner appointments, representing an estimated minimum annual cost of £7.6 million.
The report was commissioned by SpaMedica, with contributions from Age UK, RNIB, Fight for Sight and Thomas Pocklington Trust. Its findings highlight the potential wider consequences of policies intended to reduce elective care spending. However, the financial figures are modeled estimates rather than directly observed NHS expenditure, and the survey findings do not establish that mandatory waiting policies caused the reported deterioration in patients' health.
The report calls on ICBs to pause the introduction or expansion of mandatory minimum cataract surgery waiting periods until their clinical, economic and equality implications have been fully assessed.
Richard Woodward, CEO of SpaMedica, argued that timely cataract treatment delivers benefits extending beyond visual improvement. "Cataract surgery isn't simply about improving someone's eyesight. Timely treatment helps people stay independent, continue working and avoid the falls and additional health problems that can come with deteriorating vision," Woodward said in the press release. "Making patients wait longer when capacity is available risks being a false economy, with the consequences felt by patients, their families and the NHS."
Source: SpaMedica.
