Longer cataract surgery waits could cost NHS more than £400m a year

New research says mandatory minimum waits for cataract surgery are worsening patients’ vision, mental health and independence while adding pressure across the NHS. The report estimates just four extra weeks of delay could drive a £406.7 million annual loss in health, care and economic value in England.

Why it matters: - Longer waits for cataract surgery are affecting patients’ sight, mobility, work and independence. - The report estimates every additional week of delay costs £164 in health, care and economic value per patient. - Just four extra weeks of delay could create a £406.7 million annual loss across England. - Delays also appear to shift costs into other parts of the NHS, including A&E and GP services.

What happened: - New research found mandatory minimum waits for cataract surgery are being used by around half of Integrated Care Boards across England. - The waits can extend to 16 weeks, compared with previous waits of around four weeks. - The report, Minimum waiting times for cataract surgery: A false economy for the NHS, was commissioned by SpaMedica with contributions from Age UK, RNIB, Fight for Sight and Thomas Pocklington Trust. - The report examines the impact of longer waits on patients, families and the wider health service.

The details: - Cataract surgery is described in the report as one of the most cost-effective procedures in modern healthcare. - Prompt surgery restores vision, supports independence and helps prevent downstream harm. - Delayed treatment can increase the risk of falls, A&E attendances, GP visits, reduced employment and greater reliance on carers. - England carries out about 510,000 cataract procedures a year. - In a survey of 520 people waiting for NHS cataract surgery, 85% said their vision had worsened. - In the same survey, 69% said their mental health had worsened. - 75% said they had become more socially withdrawn. - Nearly one in three working-age patients had reduced their working hours because their vision had worsened. - 21% had stopped working altogether. - Around three in four patients said they needed more help from others after referral. - 86% of carers surveyed said the patient’s declining health or independence required them to provide extra care. - Almost one in five patients reported attending A&E or receiving treatment after a trip or fall while waiting for surgery. - The report estimates those A&E attendances cost £21.67 million a year. - A third of patients reported needing extra GP appointments. - The report estimates that creates at least £7.6 million in annual cost pressure.

Between the lines: - The research suggests mandatory minimum waits may look like a capacity-management tool, but they can produce higher costs elsewhere in the NHS. - The findings also point to a broader equality issue, because delayed sight treatment can hit older adults, workers and carers in different ways. - Robert Cooper of the Royal National Institute of Blind People said delays can cause anxiety, uncertainty and a major hit to quality of life. - Eamonn Dunne of Thomas Pocklington Trust said any delay increases the risk of trips and falls and can affect daily life.

What's next: - The report calls on Integrated Care Boards to pause new or expanded mandatory minimum waits for cataract surgery. - It says clinical, economic and equality impacts should be fully assessed before the policy is extended further. - SpaMedica CEO Richard Woodward said commissioners should pause further rollout and consider the full impact before expanding these policies. - More information is available in the report announcement.