OBJECTIVES

: An aging population is resulting in increased demand for cataract procedures in the UK. This increased demand together with current budgetary pressures on the NHS, mean that efficiencies in the delivery of cataract services must be identified if more patients are to be treated using existing NHS resources. This study aimed to evaluate whether changes in the treatment of cataract patients will enable more patients to be treated without the need for additional resources.

METHODS

: A Discrete Event Simulation model representing the cataract services pathways at Leicester Royal Infirmary Hospital was developed. Data to run the model was sourced from national and local sources as well as from a cataract procedure demand forecasting model developed in the study. Validation and verification of the model was achieved with the participation of the cataract services clinical and management teams.

RESULTS

: Using new treatments that reduce the time taken to perform cataract procedures, four scenarios involving an increased number of procedures per half-day theatre slots were simulated using the model. Results indicated that the total number of procedures per year could be increased by 40% at no extra cost. However, the rate of improvement decreases for increased number of procedures per half-day theatre slot due to a higher number of cancelled procedures. Productivity is expected to improve as the total number of doctors and nurses hours will increase by 12% and 18% respectively. However, non-human resources such as pre-surgery rooms and post-surgery recovery chairs are under-utilized across all scenarios.

CONCLUSIONS

: Using new technologies for cataract procedures could help address the increased demand especially as this would be achieved with limited impact on costs. Non-human resources capacity needs to be evenly levelled across the cataract pathway to improve their utilisation. The performance of cataract services could be improved by better communication with and proactive management of patients.