New pathway for cataract services is launched in Herefordshire

A new pathway offering cataract services has opened in Herefordshire, aiming to provide a “local and personal touch” while addressing long waiting times.

The Border Health Alliance (BHA) was formed from an ambition of local eye consultants and optometrists to “work together to reduce NHS cataract surgery waiting times” for Herefordshire patients.

All seven of Herefordshire’s NHS eye consultants are involved in the venture, with more than 10 local optometrists enlisted for cataract clinics and YAG capsulotomy clinics.

Those behind the venture highlighted that, in the aftermath of the pandemic, waiting times for cataract services continued to grow longer in Herefordshire, “despite the best efforts of the local NHS surgical team.”

In January this year, the BHA began working weekends to perform cataract clinics and surgeries, as well as YAG capsulotomy clinics.

Darren Smith, optometrist, chair of Herefordshire local optical committee, and director of BHA, said: “Herefordshire has seen excellent shared care services in eye health for over three decades and when the situation with local waiting times for cataract surgery became unmanageable, the obvious solution was one that involved all aspects of local eye care stakeholders working together.

“From optometrists and ophthalmologists, to ophthalmology scrub nurses, orthoptists, biometrists and dispensing opticians, everyone is playing their part,” he added.

The company shared that Herefordshire was one of the first counties to have pre- and post-cataract care provided in the community by optometrists, suggesting that BHA integrates into this pathway.

Simon Madge, consultant ophthalmologist and BHA director, commented: “As a collective, we’ve been working with our local optometry colleagues for many years and have forged a very strong connection – we regularly meet for CPD events and stakeholder meetings – so it was a no-brainer to further integrate their expertise into a solution for our local cataract patients.”

Georgia Wootton, an optometrist at BHA, shared that joining the company provided an opportunity to expand her skillset, sharing: “It’s great to work alongside the consultants and it has been rewarding to see the impact it has on our local community.”

BHA offers bilateral immediately sequential cataract surgery, with George Morphis, VR surgeon and BHA director, explaining that approximately 50% of the referrals BHA receive for cataract surgery are appropriate for the same-day approach.

“It makes such a difference to those patients both with significant cataract and spectacle prescriptions that would otherwise leave them with intolerable anisometropia in between surgeries,” he shared, explaining that BHA has seen no increase in complications with the approach and that patient satisfaction is high.

The company has partnered with private medical clinic, The Wye Clinic, where many of the BHA treatments will take place in 2025.

Tracy Kelly, who has worked with the local surgeons in a private setting, is a shareholder and director of BHA, providing operations oversight. Chris Butterworth is operations director, whilst Annie McBride is head administrator.

Smith reflected on the strength of community between the eye care profession in Herefordshire.

He said: “It is an honour to work as an optometrist in Herefordshire. Unlike many other areas, there is a real sense of community – whether that be with my optometry-based peers, the local ophthalmologists, or everyone else that contributes to eye care here. Our patients are our primary focus, and I feel BHA endorses that sentiment.”