Eye Care Medical

A Message from Lord Pickles and Lord Blunkett, followed by Eye Care Medical's best practice article

The ability to listen and learn from one another has always been vital in parliament, in business and in most aspects of daily life. But at this particular moment in time, as national and global events continue to reiterate, it is uncommonly crucial that we forge new channels of communication and reinforce existing ones. The following article from Eye Care Medical is an attempt to do just that. We would welcome your thoughts on this or any other Parliamentary Review article.

Blunkett signature Rt Hon The Lord David Blunkett
Pickles signature Rt Hon The Lord Eric Pickles

www.eyecaremedical.co.uk

THE PARLIAMENTARY REVIEW
Highlighting best practice
THE PARLIAMENTARY REVIEW
Highlighting best practice
38 | EYE CARE MEDICAL
Consultant Ophthalmologist
Andrew Needham
Vision House, main hub of Eye Care
Medical, based in Macclesfield
Eye Care Medical are the UK’s only dedicated independent
NHS provider of treatment for wet age-related macular
degeneration. To meet the local demand of patients who
used to travel large distances to access treatment, they have
established a variety of convenient community-based clinics.
They have around 600 active patients and won a Macular Society
award for best patient care in 2014. Consultant Ophthalmologist
and CEO Andrew Needham tells
The Parliamentary Review
more.
Wet age-related macular degeneration is the leading cause of blindness in the elderly,
causing irretrievable visual loss. It can, however, be successfully treated. Treatment
temporises the disease and needs repeating every few months for several years.
Treatment is simple and quick, involving delivering a drug into the eye by injection.
We are the UK’s only dedicated independent provider of AMD services. Working
as a consultant ophthalmologist, I established the NHS service ten years ago to
meet the unmet AMD needs of the east Cheshire population. At the time, patients
travelled 100 miles for treatment in regional units every few months. The local state
hospital declined to introduce the service. To fill this gap, we developed a service
that has been commissioned in Cheshire, Derbyshire and beyond.
Exemplary eye care – a hunger for best care
We identified the need for a high-volume, rapid-access AMD service for vulnerable,
often frail, patients with other coexisting illnesses.
FACTS ABOUT
EYE CARE MEDICAL
»Consultant Ophthalmologist:
Andrew Needham
»Established in 2009
»Based in east Cheshire but
operating across Cheshire,
Derbyshire and Staffordshire
»Services: Treatment for
wet age-related macular
degeneration
»No. of employees: 27
Eye Care Medical
BEST PRACTICE SPONSOR 2020
THE PARLIAMENTARY REVIEW
Highlighting best practice
38 | EYE CARE MEDICAL
Consultant Ophthalmologist
Andrew Needham
Vision House, main hub of Eye Care
Medical, based in Macclesfield
Eye Care Medical are the UK’s only dedicated independent
NHS provider of treatment for wet age-related macular
degeneration. To meet the local demand of patients who
used to travel large distances to access treatment, they have
established a variety of convenient community-based clinics.
They have around 600 active patients and won a Macular Society
award for best patient care in 2014. Consultant Ophthalmologist
and CEO Andrew Needham tells
The Parliamentary Review
more.
Wet age-related macular degeneration is the leading cause of blindness in the elderly,
causing irretrievable visual loss. It can, however, be successfully treated. Treatment
temporises the disease and needs repeating every few months for several years.
Treatment is simple and quick, involving delivering a drug into the eye by injection.
We are the UK’s only dedicated independent provider of AMD services. Working
as a consultant ophthalmologist, I established the NHS service ten years ago to
meet the unmet AMD needs of the east Cheshire population. At the time, patients
travelled 100 miles for treatment in regional units every few months. The local state
hospital declined to introduce the service. To fill this gap, we developed a service
that has been commissioned in Cheshire, Derbyshire and beyond.
Exemplary eye care – a hunger for best care
We identified the need for a high-volume, rapid-access AMD service for vulnerable,
often frail, patients with other coexisting illnesses.
FACTS ABOUT
EYE CARE MEDICAL
»Consultant Ophthalmologist:
Andrew Needham
»Established in 2009
»Based in east Cheshire but
operating across Cheshire,
Derbyshire and Staffordshire
»Services: Treatment for
wet age-related macular
degeneration
»No. of employees: 27
Eye Care Medical
39EYE CARE MEDICAL |
HEALTH & SOCIAL WORK
It is no exaggeration that commencing
treatment is a race against time to
keep the disease in remission, and so
our provision must be extremely time-
sensitive. Equally, it makes sense that
there is a one-stop dedicated service
for treating AMD with no delays
between assessment and treatment.
We designed our service specifically
with the needs of the AMD population
in mind. The comfort of patients and
carers is often an afterthought in the
NHS. Because of this, we provide
ample disabled-friendly facilities and
provide free parking, refreshments and
infotainment. A happy patient and
carer will comply better with treatment
and lower non-attendance rates: care
for your patients and they will care for
you, too.
With around 600 active patients, we
receive 99 per cent positive feedback
and a huge number of thank-you cards
and gifts. We won the Macular Society
award for best patient care in 2014,
having been nominated three times
over previous years.
To support our service, we have
state-of-the-art retinal imaging,
including OCT angiography. Accurate
comparable imaging is invaluable. We
utilise Heidelberg Spectralis technology
as the pupil tracking allows blur-free,
reproducible results on static and
moving cellular tissue. Beyond this, we
devised and utilise an electronic, highly
reproducible randomised vision testing
system and have invested in seven-
day temperature stable refrigeration
in case of power outage. We are also
exploring mobile screening.
We have multiple convenient
community locations to access the
service: from the Macclesfield hub
to the “spoke” Northwich and
Bromborough health practice units.
Our service is flexible – it can adapt
to demand by increasing volume and
offering more clinicians and clinics –
and integrated, with ancillary social
services and low visual care all under
one roof. Our appointment system
books new patients within one week
of referral and provides a one-stop
assessment with imaging and treatment
service taking place on the same day.
We give flexibility of appointment times
to meet carers’ and patients’ needs.
Appointments are also given in-house,
which prevents appointment slippage
and waiting-time delays.
Effective staffing and leadership
Key to our service are a number of
priorities:
»Adequate staffing numbers
»An open environment with integrated
nursing and managerial care
»Direct clinical control to ensure
prompt and successful care
»Highly trained, multiskilled staff
capable of covering for other staff in
their absence
»Staff familiarity with the condition,
allowing the streamlined deliverance
of assessment and treatment
»Clinical issues being raised promptly
and addressed rapidly
»A small group of senior medical
retinal specialists, allowing for better
continuity of care and understanding
of patient needs
The Eye Care Medical
team
It is no
exaggeration
that
commencing
treatment is a
race against
time to keep the
disease in
remission, and
so our provision
must be
extremely time-
sensitive
THE PARLIAMENTARY REVIEW
Highlighting best practice
THE PARLIAMENTARY REVIEW
Highlighting best practice
40 | EYE CARE MEDICAL
Clinical effectiveness – no
hiding place for poor care
Our service has provided excellent
results and very low complication rates.
We are CQC approved and regulated
by multiple agencies, which we
recognise is an important precaution to
stop the state and independent sectors
failing patients with unsafe practice.
There is, however, much overlap by
different bodies doing similar jobs.
Patients benefit from a 24-hour
helpline and a post-treatment follow-
up call for the early recognition of any
potential problems, which they find
reassuring. We also generate calendars
showing distorted landmarks as an
educational tool for referring opticians,
and all correspondence is copied to
the referring GP and optician during
everyvisit.
Our service may sound expensive but
costs no more than that provided by
NHS hospitals. Activity is funded on
a case-by-case basis and our service
reduces the chances of costly patient
returns or worsening problems.
NHS competition has driven up local
standards and reduced prices. Our
contracted prices are now among the
lowest, having dropped multiple times
over ten years and contributed to
significant NHS savings. This is allied to
patient access schemes facilitated by
the drug companies Bayer Healthcare
and Novartis Pharmaceuticals UK
Ltd, which allow the lowest tariff
drug price possible for Aflibercept
and Ranibizumab – the most highly
effective licensed drugs currently used
in the treatment of wet AMD.
Happier work environment,
happier staff
We aim for less stressful working
conditions with the added potential
benefit of fewer clinical errors and
a happier working environment for
staff and patients. As clinicians by
training, we should influence patient
management and pathways. The bean
counters often disregard all patient
comforts in pursuit of a stripped-out
service. We have a valuable role to
play to change this mentality if we are
given a voice, although sadly we are all
too often excluded.
One of the biggest challenges we
face is convincing commissioners to
ensure the most effective treatments
are available. Currently, commissioners
wait for NICE guidance regarding the
cost-effectiveness of new products,
and this bureaucracy can hamper the
introduction of new treatments.
Patients are often expected to be
treated and funded as part of a
standardised approved treatment
pathway, but some patients require
individualised care which may entail
a variation in the type of treatments.
This may result in a failure of funding
by commissioners even when proven
to be clinically effective. This can
also mean that patients whose
vision at onset is too good to meet
the inclusion criteria may have to
lose vision until it deteriorates to
the required level before they can
betreated.
NHS
competition
has driven up
local standards
and reduced
prices. Our
contracted
prices are now
among the
lowest, having
dropped
multiple times
over ten years,
and
contributed to
significant
NHS savings
Retinal OCT scanning in
progress

www.eyecaremedical.co.uk

This article was sponsored by Eye Care Medical. The Parliamentary Review is wholly funded by the representatives who write for it. The publication in which this article originally appeared contained the following foreword from Rt Hon Elizabeth Truss.

Rt Hon Elizabeth Truss's Foreword For The Parliamentary Review

By Rt Hon Elizabeth Truss

Even by the standards of the day –this has been one of the most exciting and unpredictable years in British politics.

The leadership election we’ve just seen marks a huge moment in our country’s history. This government is taking a decisive new direction, embracing the opportunities of Brexit and preparing our country to flourish outside the EU.

As international trade secretary, I’ll be driving forward work on the free trade agreements that are going to be a priority for the government. Free trade isn’t just an abstract concept bandied around by technocrats. It is crucial for a strong economy and for the ability of families to make ends meet. Free trade benefits people in every part of our country, as British firms export to new markets and people doing the weekly shop have access to a wider choice of goods at lower prices.

The essence of free trade is in the title: freedom. It’s about giving people the power to exchange their goods without heavy government taxation or interference. Commerce and free exchange are the engine room of prosperity and social mobility. I’m determined to tackle the forces who want to hold that back.

One of my priorities is agreeing an exciting new free trade deal with the US, building on the great relationship between our two countries and the Prime Minister and US President. But I’ll also be talking to other partners including New Zealand, Australia and fast-growing Asian markets.

And with the EU too, we want a friendly and constructive relationship, as constitutional equals, and as friends and partners in facing the challenges that lie ahead – a relationship based on a deep free trade agreement. Our country produces some of the world’s most successful exports, and the opportunity to bring these to the rest of the world should make us all excited about the future. It is this excitement, optimism and ambition which I believe will come to define this government.

For too long now, we have been told Britain isn’t big or important enough to survive outside the EU – that we have to accept a deal that reflects our reduced circumstances. I say that’s rubbish. With the right policies in place, we can be the most competitive, free-thinking, prosperous nation on Earth exporting to the world and leading in new developments like AI. To do that, we’ll give the brilliant next generation of entrepreneurs the tools they need to succeed. Since 2015, there has been a staggering 85 per cent rise in the number of businesses set up by 18 to 24 year olds – twice the level set up by the same age group in France and Germany. We’ll help them flourish by championing enterprise, cutting taxes and making regulation flexible and responsive to their needs.

As we do that, we’ll level up and unite all parts of the UK with great transport links, fibre broadband in every home and proper school funding, so everyone shares in our country’s success.

2019 has been the year of brewing economic and political revolution. 2020 will be the year when a revitalised Conservative government turbo charges the economy, boosts prospects for people across the country, and catapults Britain back to the forefront of the world stage.



Rt Hon Elizabeth Truss
Secretary of State for International Development