Scotland’s National Cataract Surgery

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After providing ophthalmology care to the Scottish Borders for 6 years, Edinburgh based eye surgeon Jonathan Ross now plays a lead role in the delivery of Scotland’s national cataract surgery service based at Golden Jubilee National Hospital. Here he describes the rewards and future challenges of his appointment…

“The NHS Golden Jubilee is Scotland’s flagship hospital for reducing waiting times. It is home to Scotland’s Heart and Lung Transplant Centre, and is one the leading hospital’s in the UK for orthopaedic surgery, having pioneered computer-assisted joint replacement and early postoperative mobilisation and discharge. It also hosts NHS Scotland’s Centre for Innovation and the Centre for Research. Its small but experienced team of eye surgeons (to which I now belong) carry out 9000 cataract operations per annum, with this target set to double over the next generation. 

Working at Golden Jubilee National Hospital gives me the privileged opportunity to perform more than 1000 cataract operations every year, one of the most surgical roles for any medical specialty in the country. Patients attend from every corner of Scotland, with a large proportion residing in Lothian. Those in attendance from further afield locations such as the Highlands often choose to use the hospital’s overnight accommodation in the on-site Beardmore Hotel. Our contemporary service includes ‘drops only’ (no needles) anaesthetic as a matter of routine, top of the range Leica ophthalmic microscopes and surgeons utilising 2 operating theatres at the same time. In this setup, the nursing team prepare a patient for surgery in theatre 1 while the surgeon operates in theatre 2, so the surgeon can move between theatres without any delays between procedures. This twin theatre system works well and is likely to go live in other NHS eye centres over the next 10-20 years.

In keeping with the hospitals pioneering heritage, my team is currently exploring the feasibility of laser cataract surgery in an NHS setting (not currently available in Scotland), and more efficient but sustainable models of surgery which already exist outside the UK. Globally there is a shortage of highly skilled cataract surgeons, and as future demographic change shifts towards an increased retired population, the need to make best use of surgeon time will climb higher up the healthcare agenda. 

Providing 18,000 cataract operations annually will require major service changes. When we are not operating, my colleagues and I are working on the design of a new state-of-the-art cataract surgery centre, a venture which already has funding from the Scottish Government. Working at Golden Jubilee is an enormous privilege and pleasure. The organisational culture is a a positive one of ‘can-do’ and the ophthalmic team are fantastic. As with Spire Edinburgh, patient feedback suggests high levels of satisfaction with the care we provide.

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