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The OSNE300 Survey
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Has the financial crisis in Europe impacted how you practice ophthalmology in any way?
In the National Health Service in the U.K., the main impact of the financial crisis is less money to pay staff and we are seeing non-replacement of secretarial and nursing staff. There is also less money for equipment and maintenance. On my National Health Unit, we use an OCT for assessing the disc when we know that an HRT would be far superior for glaucoma management.
We also have not serviced our pachymeter, which is unreliable at present and, therefore, I am not able to accurately follow the NICE Guidelines for the management of ocular hypertension.
We have also seen rationing in the form of arbitrary thresholds in visual acuity to qualify for cataract surgery and exclusion of certain procedures deemed cosmetic, including infected chalazion.
– N.A. Jacobs, FRCS, FRCOphth
Birch Hill Hospital, Rochdale, U.K.
Disclosure: No products or companies are mentioned that would require financial disclosure.
Do you see possible future cuts in government funding impacting patient care and other aspects of ophthalmology?
N.A. Jacobs
The important thing to understand about the U.K. is that there is a fundamental reorganization of the National Health Service (NHS), as well as recent major financial cutbacks. The main focus of the reforms is to move routine work into the community, including outpatient visits and cataract surgery. There is an NHS fixed tariff remuneration rate recommended for each procedure. The tariff rate for cataract surgery has recently dropped and the main risk is that private providers will undercut the tariff rate to secure contracts, but then find that they are forced to cut corners.
The training of future surgeons is also going to become more problematic. The hospital units are being left with more and more complicated cases, which are not suitable for training junior doctors.
– N.A. Jacobs, FRCS, FRCOphth
Birch Hill Hospital, Rochdale, U.K.
Disclosure: No products or companies are mentioned that would require financial disclosure.
