The house of the eye
Ophthalmologist and co-founder of Midland Eye, Mark Benson, discusses why and how the practice was established ahead of its 15-year anniversary
20 July 2018
01 Midland Eye was the first UK private ophthalmology practice to be established when it opened its doors in 2003.
The idea behind it was developed by a group of five ophthalmologist colleagues, including myself, who shared the same views on how a private practice should be organised. Plus, when combined, our sub-specialities covered the whole of the eyeball.
In those days, ophthalmologists undertaking private work rarely referred patients on when they didn’t specialise in the required surgery as there was a financial incentive not to – we wanted to change this and open a one-stop specialist centre for all eye conditions.
Ophthalmologist Mark Benson shares his career journey with OT
I qualified in 1982 and while I knew that I wanted to do something surgical, I was unsure as to specifically what. In order to prepare, I became a medical demonstrator teaching anatomy to medical students because it was meant to be the best way to prepare for the Primary FRCS – a notoriously hard exam that you had to pass to become a surgeon.
After passing the exam I went back to medical school and spent a year researching towards a Masters in transplantation. During this period, my first daughter was born prematurely and had to have a lot of oxygen due to respiratory distress syndrome, which is where the lungs haven’t matured. However, the use of oxygen in premature babies is known to give rise to the condition, retinopathy of prematurity.
In those days, when a baby was premature and was given oxygen they were required to have their eyes checked. I remember watching the ophthalmologist checking my daughter’s eyes and thought that it looked really interesting. I had a chat to him afterwards and he was so enthusiastic about his work that I came away wanting to give it a go.
I secured a job at Birmingham Eye Hospital and I loved it from the word go I've been in eyes ever since.
I completed my post-graduate training initially in Birmingham, before working in Sheffield and then Manchester as a vitro retina fellow. In 1994 I returned to Birmingham and was appointed as a consultant. After establishing Midland Eye, I continued to work within the NHS, splitting my time before leaving completely in 2014 to work solely at Midland Eye.
By the time I left the NHS I had specialised in retinal surgery for a number of decades. However, the thing about retinal surgery, I feel, is that you have to be doing it all of the time in order to maintain the skill level required and it would be unusual to be doing enough retinal surgery just in the private sector in this country. Therefore, when I left the NHS I also stopped doing retinal surgery, but I have carried on doing medical retina because the throughput is much higher and I enjoy what I do.
For me, the highlights of my career are always when you see someone a long-time after you initially treated them and they come in or write to you expressing their thanks for the difference that you have made to their lives. It’s a lovely feeling and makes you feel really good inside.
Another driver behind setting up Midland Eye was that the NHS was starting to contract out work when it needed support. However, if a hospital wanted to sub-contract out 100 cataract operations, as a single ophthalmologist this was not obtainable. But as a group we could efficiently and effectively complete this work to deadline.
Myself and my fellow Midland Eye founders embarked on contract work like this for a while and it soon became apparent that the way to go was to have our own facility – consequently, Midland Eye was born.
02 The practice is very unique. It used to be a local theatre belonging to the Solihull Society of Arts – our operating theatre was a ‘theatre’ before we moved in as it was where the stage was located.
We are conveniently based close to Solihull Hospital, which has a car park, and we are on the local bus route. There is also a GP next door to us, as well as a pharmacy.
We are still located in this building almost 15 years later, but we have gone through a significant renovation during that time. At the end of 2014 we closed temporarily, reopening in January 2015 following a £500,000 refurbishment.
Clinical excellence and state-of-the-art equipment has always been key to Midland Eye, which is why we were the second European centre to install a Nidek EC 5000 excimer laser, and are one of just a handful in the country to have a Lensar laser system.
Responding to patient need, two years ago we introduced a dry eye clinic at Midland Eye which is run by optometrist Nick Dash and is increasing in patient demand.
03 Our uptake by patients has always been healthy and we have gradually grown over the years. As a result, in 2010 we were approached by Aspen Healthcare. Ultimately, after a lot of discussions, Aspen bought a controlling share of the business.
The partnership happened at a good time for us. Due to the size of the contracts that we were attracting, it was becoming essential to introduce a more robust IT infrastructure and Aspen came in with the business, finance and information governance know-how required to support us in this journey.
The partnership became official in 2012 and we have been working very well together ever since. As doctors, we are still very much responsible for the running of all of the clinical aspects of the business and Aspen always defers to us on that, but we now have the benefit of the corporate know-how and contracting muscle of Aspen.
04 Workload at Midland Eye is an even mixture of private and NHS work, while we are still heavily involved in the NHS contract work that Midland Eye was born from.
An example of this successful contract work is an ophthalmology outpatient service that we have been offering in Stoke and North Staffordshire for five years. It is a consultant-led service, which generally means that we seek to resolve things in one appointment and if a patient requires treatment they are referred and can elect to have that at a local hospital or at Midland Eye.
The service was commissioned in order to take pressure off the local hospital as it was struggling. It’s been a really successful service and due to its scale is a contract that we would not have been able to take on without the infrastructure that our partnership with Aspen enables. These large contracts require data collection on scale and in real-time so the demographic of the patients and the outcomes can be assessed.
05 I hope that we continue to forge strong partnerships with the NHS and can continue to support our local trust to reduce waiting times for surgeries such as cataract and macular degeneration.
We are set up and capable when it comes to achieving a high volume of surgeries efficiently and with positive refractive outcomes.
The NHS is currently under huge pressure in relation to macular degeneration. There wasn’t a treatment for it a few years ago and now there is. It can be difficult for them to meet the required guidelines for treatment, so our next venture is going to be developing a streamlined service with our local trust to deal with macular degeneration.
We are also on our local NHS choices listing, which allows patients in the area to opt for treatment at Midland Eye and I hope that our NHS model continues to grow in that way.