Need for urgent action to relieve pressures on ophthalmology
1 November 2016
Need for urgent action to relieve pressures on ophthalmology service
“The unnecessary loss of eyesight by people waiting too long for appointments is a terrible reminder of what happens when a service is not adequately resourced,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).
He was commenting on the news that 30 patients suffered partial loss of sight in 2015-16 because of ophthalmology delays at Southern District Health board, and that thousands of overdue patients had been told they might be affected (https://www.odt.co.nz/news/dunedin/health/dhb-delays-affect-thousands-30-suffer-partial-sight-loss and http://www.radionz.co.nz/news/national/316970/eye-patients-losing-vision-in-long-wait-for-specialists).
“This is obviously a very distressing situation for those patients and also for the ophthalmologists trying to keep up with the increased need for treatment,” says Mr Powell. “Clearly, the pressures on the service are unsustainable, and urgent action is needed.”
He says a top-down leadership culture, especially within Southern’s senior management, has for several years effectively “snuffed out” the clinical voice at the DHB.
“This has been reinforced by the financial pressures placed on DHBs and the reduced commitment from Government to clinical leadership.
“But this is not simply a local DHB problem. It is a serious national problem that ophthalmologists warned the Minister of Health about around a year ago. New developments in treating macular degeneration significantly increased patient demands on public hospital eye services, with a lack of staff to treat many other chronic visual illnesses.
“It has been made worse by the Government’s rigid adherence to arbitrary targets. Targets are about the patient’s first admission for treatment, not the follow-ups. The perverse outcome in this case is that many of these bad outcomes involve the lack of follow-up treatment because they can’t be counted for the target.
“There’s been a real failure to address specialist workforce planning in DHBs, and this has created an environment in which the medical workforce is really struggling to adapt to increasing demand and high levels of unmet health need.”