Objective:

The article examines a SpaMedica-commissioned report estimating the health, care and economic effects associated with longer waits for cataract surgery in England.

Approach:

• Report and survey: The report, published Oct. 19, drew on a survey of 520 patients awaiting NHS cataract surgery and modeled estimates of health, care and economic losses.
• Policy context: The report states that approximately half of England’s integrated care boards had introduced mandatory minimum waits of up to 16 weeks, compared with previous waits of about four weeks.

Key Findings:

• The report estimated each additional week of waiting represents £164 in lost health, care and economic value per patient; four additional weeks across about 510,000 annual procedures could amount to £406.7 million.
• Among surveyed patients, 85% reported worsening vision, 69% worsening mental health and 75% greater social withdrawal while waiting.
• Almost one-third of working-age respondents had reduced working hours and 21% had stopped working; about three-quarters needed more assistance, and 86% of surveyed carers reported providing increased support.
• Almost one in five respondents reported an accident and emergency visit or medical treatment after a trip or fall. The report estimated related emergency attendances could cost about £21.67 million annually.
• One-third of surveyed patients reported additional GP appointments; the report estimated a minimum annual cost of £7.6 million.

Interpretation:

The report argues that mandatory waiting periods intended to manage elective-care spending could create wider costs and affect patients’ health, independence and quality of life. RNIB representative Robert Cooper and SpaMedica CEO Richard Woodward also described potential effects on daily activities and independence.

Limitations:

• The financial figures are modeled estimates, not directly observed NHS expenditure.
• The survey findings do not establish that mandatory waiting policies caused the reported health or independence changes.
• The report was commissioned by SpaMedica, with contributions from Age UK, RNIB, Fight for Sight and Thomas Pocklington Trust.

Conclusion:

The report calls on integrated care boards to pause introducing or expanding mandatory minimum cataract surgery waits until their clinical, economic and equality implications have been assessed.

Sources:

• SpaMedica report and article context