Through the patient’s eyes 

OT  found out about the cataract surgery patient journey at SpaMedica, Wokingham, earlier this week

Getty/Rhys Hayward

On Tuesday morning I stepped away from my desk, changed into scrubs and stood in theatre to observe cataract surgery for the first time.

The procedure was seemingly straightforward and as I watched in close-up on screen, the consultant ophthalmologist explained each step as he took it. Time went by quickly and before I knew it, the operation was over and I was sitting with patient, Jacqueline Brown, in recovery. The operation itself took just eight minutes.

I had met Brown around 90 minutes or so before surgery and observed as she moved through the patient journey – from check-in through to dilation, surgery, recovery and discharge – at SpaMedica’s Wokingham facility.

Brown was at the clinic for cataract surgery on one eye. She had already attended some 10 weeks previously for surgery on her other eye. “I was a little anxious the first time I suppose, but now I know what’s going to happen and the impact it will have on my sight. This time I can’t wait to have it done and get home,” she shared.

Brown was referred to SpaMedica in January by Eyesite Opticians in Reading. As someone who has always regularly attended for a sight test, she was informed during the appointment that she had cataracts in both eyes and met the criteria for surgery. Provided with the options around surgery, she opted to have the procedure done at SpaMedica and her optometrist made the referral.

Speaking about the diagnosis, Brown said: “I knew that my vision had been getting worse and I expected that I needed a new prescription, so I was surprised to be told I had cataracts in both eyes.”

Reflecting on her vision pre-surgery on her first eye, she now realises how much she was unconsciously adapting to what her vision allowed. “I wouldn’t watch television for more than 30 minutes, or read the paper in the morning as it would give me a headache for the rest of the day,” she said. “The difference the surgery has made to my life has been massive,” she added.

As an amateur abstract painter, Brown is now looking forward to being able to see the colour palette clearly. “I didn’t realise the impact that my vision was having on my perception of colour,” she said, adding: “I can see everything so much clearer now.”

Speaking about her experience at SpaMedica, Brown shared: “The process has been very professional yet personal. All of the staff are very friendly and caring.”

SpaMedica Wokingham opened in November 2020. Like other facilities across the growing SpaMedica portfolio, it has a two to four week waiting time for patients. A consultant at the facility will see 24 patients a day, and the desired patient journey time in the facility is three hours.

A common patient misconception when informed about SpaMedica is that there is a private cost associated to having the procedure outside of the traditional NHS setting. But James Gallagher, regional promotions manager at SpaMedica, emphasised that the services provided by the company are completely funded by the NHS so there is no cost to the patient.

Community optometrists are able to refer suitable patients to SpaMedica for treatment if that is the patient’s preferred choice after being informed of the options. SpaMedica encourages optometrists to complete its accreditation – which is around a two-and-a-half-hour session in person or via webinar. Gaining accreditation enables SpaMedica to refer the patient directly back to their opticians for post-op care. To date, more than 4700 optometrists have completed this accreditation.

Aware of the rising NHS wait times in many locations for cataract surgery, OT is curious as to how SpaMedica has maintained its two to four weeks wait window? “The pandemic did not stop us processing referrals, despite not being able to perform surgery. This meant that as soon as we were able to open the theatres, we were ready to go,” Gallagher shared, adding that there was, of course, still a surge in referrals when things opened up again.

He explained that SpaMedica’s growing nationwide spread, paired with its postcode app, enables it to allocate patients to the most appropriate facility with ease.

When it comes to tips for optometrists referring to SpaMedica, colleagues Kerry Steinhour and Gallagher encourage practitioners to check the referral pathways and protocols in their area before making a referral – some clinical commissioning group (CCG) pathways (now Integrated Care Boards) would require a GP referral, for example, and this must be followed in order to avoid a delay for the patient, they highlighted.

The pair added that when referring a patient for cataract surgery for both eyes, while the patient may not have both operated on at the same time, the referral must state that it is a bilateral referral, or the patient will need to be re-referred after the first surgery – something that increases wait time for the patient and cost for the CCG.

Currently there are 41 SpaMedica facilities across the UK, and the company has steep growth plans to be able to keep up with demand. It is expected to increase to 47 facilities by the end of the summer, with locations in Oxford and Truro opening soon.

When it comes to growth, the company analyses its waiting times, the location demographics of its patients, and the general population age demographics in order to best determine where the most need is and therefore what locations it will explore opening.

On SpaMedica’s website, a facility in Belfast, an area where OT is aware that patients are experiencing long wait times for cataract surgery, is labelled as ‘opening soon.’

Freedom of Information requests submitted by OT in March this year found that the average wait for routine cataract surgery from the Belfast Health and Social Care Trust is three years and seven months. At the Royal Victoria Hospital the average wait for urgent cataract surgery is two years and six months.

You can read OT’s June/July cover story, in which we speak to patient, John Clifford, who has waited over three years for cataract surgery, online.