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NHS medical director admits widespread restrictions on cataract surgery

01 February 2013

Officials have described extensive restrictions on sight-saving operations as “wrong” and “unfair” after the medical director of the NHS admitted that there are limits in place across half of England. 

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A Department of Health spokesman said that restricting access to services “on the basis of cost alone is wrong and compromises patient care.”

A report by the Royal National Institute for Blind People (RNIB) found that 57% of England’s 157 primary care trusts (PCTs) uses eye test thresholds to determine who is eligible for surgery.

But in parts of the South East, patients have to struggle to read the large letters on the third line down a standard eye chart before qualifying.

Medical director of the NHS, Sir Bruce Keogh, admitted that the majority of local health authorities were not using the “best evidence” when deciding whether or not to fund surgery.

A number of health authorities claim that they are restricting access to ‘low clinical value’ treatments, in cases which are judged to provide insufficient evidence of patient benefits.

Others have admitted to rationing cataract surgery due to a lack of funds

Steve Winyard, head of policy and campaign at the RNIB, said the widespread practice was “forcing thousands of people to live with serious and unnecessary sight loss”.

Sir Bruce also said he had been “deluged” with complaints in 2010 regarding different criteria set by different authorities for cataract surgery, hip and knee replacements and other treatments. 

Speaking with MPs on the Public Accounts Committee, he said: “We do know that about 50% of PCTs have restricted access to cataract surgery, and we do know that the bulk of policies used by PCTs actually haven’t used the best evidence that’s available in order to ration that care.”

Mr Winyard continued: “This admission by Sir Bruce Keogh further underlines the need for immediate action.”

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