Eye surgery operating theatre.
Report on changes to eye surgery. Image: NCL.

Patients who need cataract surgery could face longer journeys under plans to reduce the number of hospitals in north central London performing eye surgery for “low complexity” conditions and free up theatres for other operations.

The North Central London Integrated Commissioning Board is planning to concentrate eye surgery for “low complexity” conditions, including cataracts at Edgware Community Hospital in Edgware, a report to the North Central London Joint Health Overview and Scrutiny Committee in June has heard.

It will have an extra seven sessions a week there for this kind of operations and health bosses said patients going there for cataract operations should only need to travel there once or twice in their life.

This would move surgery from the Royal Free Hospital in Hampstead, the Whittington Hospital in Archway and Chase Farm Hospital in Enfield and is likely to affect a fifth of eye operations.

Eye surgery would still be offered at North Middlesex University Hospital in Edmonton and Moorfields Eye Hospital in Old Street, which is planning a move to a £350m new home in Kings Cross.

Health bosses said the plans would mean a “higher number” of operations could be done at one site.

The North Central London area — Barnet, Camden, Enfield, Haringey and Islington — has some of the largest ophthalmology waiting lists in the capital and its waiting list increased by 48 percent between 2016 and 2023.

The move aims to free up surgery space to help the hospitals in North Central London keep up with demand and the 38,000 patients waiting for surgery, including eye surgery.

The NCLICB said the move should free up operating theatres at Whittington and Chase Farm hospitals to tackle waiting lists for other surgery such as orthopaedics, gynaecology, or general surgery.

A report said: “NCL cannot keep up with demand” with surgery waiting lists.
Its waiting lists for surgery grew by 30 percent between 2016 and 2022, but the number of operations has only increased by eight percent, and waiting lists were made worse by the backlog caused by covid lockdowns.

More complex eye operations which are not suitable for Edgware Community Hospital and are currently carried out by surgeons at the Whittington and Chase Farm would be moved to other hospitals, including the Royal Free, which will have an extra three sessions a week for complex eye operations.

A spokeswoman said the move would “allow us to improve surgical efficiency” and perform an extra 3,000 eye operations a year.

The move should cut waiting lists by ten weeks for some patients to under 15 weeks.

Currently patients are facing waits of up to 21 weeks for eye surgery at the Royal Free.

Health bosses said the move would affect 5,000 of the 25,000 eye surgery procedures carried out each year by the three trusts – Royal Free London NHS Foundation Trust, North Middlesex University Hospital NHS Trust and Moorfields Eye Hospital NHS Foundation Trust

The commissioning board wants to bring in the changes in November and December.

Members of Islington’s health and wellbeing board were told the over 65s and Black and Asian residents who are more likely to need eye operations and people living in more deprived areas could be “most affected” by the plan.

A report warned changes at Chase Farm could have an adverse impact in on the over 65s in Barnet and Enfield; the Black community in Enfield and the Asian community in Barnet; and those with long term conditions.

Changes at Whittington could affect those from the most deprived areas, whilst older people, those with long term conditions, and Asian residents in Barnet could benefit from the increased surgery at Edgware.

Some patients would have to travel “a bit further”, with an average of 19 minutes more travel time, although some could face longer trips.

Islington Healthwatch chief executive Emma Whitby wanted to know more about the impact on travel, especially for patients “who are visually impaired when they come for surgery.”

According to the commissioning board the patients whose journeys would be most affected are those patients moving from Chase Farm to Edgware or Hampstead, or moving from Hampstead to Edgware, or moving from Whittington to Edgware.

Patients who live near Chase Farm could face an extra 70-minute journey by public transport to Edgware.

A spokeswoman said: “Doing more procedures on fewer sites is more efficient as it maximises the productivity of theatres and the surgical workforce. Efficiency is also enhanced by hubs being separate from emergency care, which reduces last minute cancellations and delays.”

Patients will be invited to share their views this summer.

The commissioning board plans to hold focus groups with people who live near Whittington and Chase Farm hospitals and those might likely to need eye operations.

Agenda Item 12: Surgical Transformation Programme. North Central London Joint Health Overview and Scrutiny Committee, Monday, 26 June 2023 10.00 am, Enfield Council Chamber, Civic Centre, Silver Street, Enfield EN1 3XQ.

The North Central London Joint Health Overview and Scrutiny Committee (JHOSC) is tasked with engaging with NHS bodies on strategic area wide issues in respect of the co-ordination, commissioning and provision of NHS health services across the whole of the area of Barnet, Camden, Enfield, Haringey and Islington.