Department of Health National Cataract Contract
THE CHALLENGE
By the age of 75, a quarter of all people in the UK will have developed a cataract. On February 9th, 2000, it was estimated that the average waiting time for the 157,000 cataract patients admitted each year was 6 months. A drive to end long waits for NHS cataract operations was launched in August 2003 by the then Health Secretary Alan Milburn. The objective was to deliver shorter waiting times for patients so that no cataract patient would be waiting more than three months by December 2004 with the average waiting time for an operation falling to just 6 weeks. Alongside extra operations in NHS hospitals, a new generation of NHS and independent sector DTCs were to make a major contribution to the drive to reduce waiting for cataract operations. As part of this initiative, a contract to provide 44,000 cataract operations over five years was awarded to the South African company, Netcare. The procedures had to be carried out at locations throughout the UK, delivering the care as local as possible to the patients.
THE SOLUTION
Netcare UK contracted with Vanguard Healthcare to provide two fleets of clinical facilities, working in two ‘loops’, one in the north of England and one in the south. Each fleet consisted of a mobile theatre and mobile ward, joined together on each site and designated as an NHS Treatment Centre. The centres are preceded by visits from Vanguard’s specially-built mobile ophthalmic outpatient units where patients are assessed for treatment.
The mobile Treatment Centres began work in February 2004, visiting some 30 sites throughout the country on a regular basis. By January 2005, these units had treated 10,000 patients. In an interview with the BBC’s Today programme on Radio 4, Secretary of State for Health Dr John Reid described the two Vanguard Healthcare mobile units involved in the national cataract chain as “revolutionary”.
Mr Reid said: "Treatment centres play an important role in speeding up access to treatment for patients and improving quality of care and patients' experience.
"This is shown by the mobile cataract chain treating 10,000 patients in less than 11 months - operating at a rate almost eight time faster than traditional NHS services. This higher rate is achievable because the units are able to concentrate on a single procedure in a modern, purpose-built unit."
On Wednesday, February 2nd 2005, the Department of Health announced that waits for NHS cataract operations had ended and that by the end of January 2005 there was no one waiting more than three months for their first cataract operation. Most cataract patients were being treated within six weeks. The achievement of a maximum three-month wait for cataract operations was four years ahead of the NHS Plan target.
THE THINGS THEY SAID
On February 9th, 2004, Dr Reid visiting the southern Treatment Centre while it was treating cataract patients at Maidstone Hospital.
Describing the mobile theatres as “state-of-the-art” and “first class”, the Health Secretary told journalists that the point about mobile treatment centres was that they could go to where the waiting lists were.
“The result for patients who have been waiting sometimes 18 months to two years for cataracts when this Government came in, is that waiting lists will be reduced to weeks rather than months. Now that’s good news all round. We’re bringing in additional surgeons, we’re bringing in additional nurses, we’re bringing in the best in the world, and it’s all delivered free to the patient”.
Dr Richard Friedland, Chief Executive of Netcare, who showed Dr Reid around the units, introduced him to six patients who had already had their cataract operations that morning. “When people think of a mobile unit they think of a caravan or a Portakabin, but this is a Rolls-Royce solution”, he said. “We are delivering something very special here”.
AND FINALLY…
Tuesday, May 18th, 2004 - Letter in the Liverpool Echo from Mrs Mary Devlin, of Huyton: “We often hear bad Press about the NHS. I would like to say a big thank you to Netcare, the South African team, who have performed cataract operations on a mobile unit in Halton, Runcorn…..The care, efficiency, dedication, expertise and aftercare are second to none”.
Wednesday, August 11th, 2004 – Letter in the Hailsham Gazette from Mrs Anne De Graaf, of Eastbourne: “…my second cataract operation was in June…due to a team called Netcare. Their mobile unit was in the grounds of the DGH and they were every bit as good as the DGH team”.
