Mandatory cataract surgery delays increase NHS pressure and patient health risks  

Mandatory cataract surgery delays increase NHS pressure and patient health risks  

• 85% of patients report worsening vision while waiting for surgery, 69% say their mental health has worsened and 75% have become more socially withdrawn
• Almost one in five report attending A&E or receiving treatment following a trip or fall, while nearly one in three working-age patients have reduced their working hours because of worsening vision
• Every additional week of delay represents an estimated £164 loss in health, care and economic value per patient, with just four extra weeks potentially resulting in a £406.7m annual loss across England

Mandatory cataract operation delays are driving up NHS pressure and impacting patients with deteriorating sight and loss of independence.

Making patients wait longer for cataract surgery could result in more than £400 million in lost health, care and economic value each year new research has found. Patients report worsening sight, falls, declining mental health and a reluctance to leave home while waiting for treatment.

Around half of Integrated Care Boards (ICBs) across England have introduced mandatory minimum waits of up to 16 weeks for cataract surgery, compared with previous waits of around four weeks. The targets are intended to help manage elective activity and spending, but the research suggests the measures risk shifting costs into other parts of the NHS rather than reducing them.

The report, Minimum waiting times for cataract surgery: A false economy for the NHS, was commissioned by SpaMedica with contribution from Age UK, RNIB, Fight for Sight and Thomas Pocklington Trust. It looks at what longer waits mean for patients and their families, as well as the wider impact on the health service.

Cataract surgery is one of the most cost-effective procedures in modern healthcare. When delivered promptly, it restores vision, maintains independence and prevents downstream harm. When delayed, patients live longer with impaired sight, increasing their risk of falls, A&E attendances, GP visits, reduced employment and greater reliance on carers.

For patients, even a short delay can mean more time struggling to see clearly, drive, work or live independently. With around 510,000 cataract procedures carried out in England each year, the report finds that even relatively short additional waits can have significant consequences for patients, families and the wider health service.

Research among 520 people waiting for NHS cataract surgery found 85% had experienced further deterioration in their vision, while 75% had become more socially withdrawn and 69% said their mental health had worsened. Almost a third of working-age patients had reduced their working hours because of worsening vision, while 21% had stopped working altogether.

Longer waits are also having an impact on patients’ families and carers, who are increasingly providing additional support as patients lose independence. Around three in four patients said they had needed more help from others since being referred, while 86% of carers surveyed said the patient’s declining health or independence had required them to provide additional care.

Robert Cooper, Director of Strategic Engagement and Implementation at Royal National Institute of Blind People (RNIB), said: “Any wait for care and treatment for an eye condition can cause anxiety and uncertainty for patients and their families. Any delay can have a significant impact on someone’s quality of life. Successful cataract surgery will ensure a person is able to go about their daily life; driving, staying in work and continuing to live independently. It’s critical all patients affected by changes in their sight can get the right support at the right time.”  

The consequences are being felt across the NHS too. Almost one in five patients surveyed reported attending A&E or receiving treatment following a trip or fall while waiting for surgery, with the report estimating the cost of these A&E attendances alone at £21.67 million a year. A third of patients reported needing additional GP appointments, representing an estimated minimum cost pressure of £7.6 million annually.

Eamonn Dunne, Partnerships & Projects Development Manager at Thomas

Pocklington Trust, said: “Whilst we appreciate the pressure on hospital eye services in managing limited resources, ensuring equity of access, and balancing capacity, any delay to patient treatment increases the risk of trips and falls and may have significant negative impact on a person’s ability to manage their daily life.”

The report calls on ICBs to pause the introduction or expansion of mandatory minimum waits for cataract surgery until their clinical, economic and equality impacts have been fully assessed.

Richard Woodward, CEO of SpaMedica, said: “Cataract surgery isn’t simply about improving someone’s eyesight. Timely treatment helps people stay independent, continue working and avoid the falls and additional health problems that can come with deteriorating vision. Making patients wait longer when capacity is available risks being a false economy, with the consequences felt by patients, their families and the NHS. We are asking commissioners to pause the further rollout of mandatory minimum waits and consider the full impact before extending these policies further.”