Moorfields Eye Hospital

A Message from Lord Pickles and Lord Blunkett, followed by Moorfields Eye Hospital'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 Moorfields Eye Hospital 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.moorfields.nhs.uk

BEST PRACTICE SPONSOR 2020
15MOORFIELDS EYE HOSPITAL |
HEALTH & SOCIAL WORK
Glaucoma Consultant
KeithBarton
Moorfields, founded
in 1804
Moorfields has provided ophthalmic care to patients for
over 200 years, and has a well-established international
reputation for its world-leading pioneering research
and innovation for eye care and treatment. It provides care to
over 275,000 patients per year and specialises in several services
including glaucoma and cataracts. Its mission is to provide the
very best care to improve patients’ sight through its flagship
centre using state-of-the-art treatments.
Moorfields Eye Hospital was founded in 1804 as the first hospital in the world
devoted to the treatment of eye diseases. While ophthalmology was still a
relatively unknown science, Moorfields set out to transform patient care through
championing transformative methods in surgery to support improvements in
eye health. Today, Moorfields provides a world-leading centre of excellence for
ophthalmic research, innovation and education. With its unique insight and
experience of providing ophthalmic services, Moorfields has become a nation-wide
example of best practice and care for eye health.
As a major hospital in the heart of London, Moorfields provides glaucoma services
to over 59,000 patients per year. We have a long-established history in treating
and caring for the prime cause of irreversible blindness worldwide. Recognising
the importance of catching glaucoma early, we provide screening and monitoring
services to keep track of the progress of patients and optimise health interventions.
Every year our 23 glaucoma consultants provide 2,685 operations and interventions
from our centre where we seek to lower the natural build-up of pressure in the eye
to prevent the deterioration of vision.
FACTS ABOUT
MOORFIELDS EYE HOSPITAL
»Founded in 1804, the hospital
has existed at its present site
since 1899
»Based in London
»Services: Treatment and
research of eye disease
»No. of employees: 2,300
including 133 leading
consultants
Moorfields Eye
Hospital
THE PARLIAMENTARY REVIEW
Highlighting best practice
THE PARLIAMENTARY REVIEW
Highlighting best practice
16 | MOORFIELDS EYE HOSPITAL
Glaucoma is one of the most common
eye conditions in the United Kingdom
with more than one million glaucoma-
related visits to the NHS each year.
In England alone there are around
480,000 cases of chronic open-angle
glaucoma, with many cases seen
in those over the age of 65 years
old. Glaucoma refers to a group
of conditions where the build-up
of pressure in the eye leads to the
optic nerve being damaged which
restricts vision. Vision loss caused by
glaucoma is permanent and is ascribed
to approximately ten per cent of UK
blindness registrations. However,
with the right combination of early
diagnosis, monitoring, and efficient
treatment, further damage to vision
can be prevented and most patients
can retain useful sight for life.
Improving patient experiences
by providing the best
glaucoma care
At Moorfields, we strive to provide
patient-centred care with exceptional
clinical outcomes and excellent patient
experience. Through our core belief
that people’s sight matters, we are
driven by the ambition to be at the
leading edge of research, making
new discoveries with our partners and
patients, and supporting innovation.
There are several different treatments
available for glaucoma, including eye
drops, laser treatment and surgery.
The most common type of surgery for
glaucoma is called trabeculectomy. This
involves removing part of the ocular
drainage pathway to allow fluid to
drain more easily. While this technique
is often effective at lowering eye
pressure and preventing progression of
glaucoma, it is an invasive procedure
requiring intensive follow-up after
surgery and tends to be reserved for
patients with more advanced glaucoma.
One of the latest innovations in the
field of glaucoma care is minimally
invasive glaucoma surgery, or MIGS,
which has been introduced in recent
years to improve the safety profile of
glaucoma surgery, lending itself to
larger numbers of patients with less
advanced glaucoma. MIGSstents are
implanted in the eye via tiny incisions
and microscopic equipment to lower
eye pressure and are often performed
simultaneously with cataract surgery.
Moorfields hospital offers patients
various options of MIGS operations
including the use of tiny devices to
bypass the trabecular meshwork
without damaging other tissues in
the ocular drainage pathway. One
of many offered devices is iStent
inject, the world’s smallest medical
device, which is inserted into the eye
through the trabecular meshwork
under high power microscopic control.
Furthermore, the ability to combine
Consultants often engage
their expertise beyond the
hospital such as providing
surgical teaching, patient
education, and supporting
charitable projects
We have a
long-established
history in
treating and
caring for the
prime cause of
irreversible
blindness
worldwide
»EXTRA FACTS
»Moorfields has been at the forefront of pioneering research and
innovation since its inception, including the first to offer instruction
in ophthalmology to doctors in the early 19th century
»A total of 2,300 staff are committed to delivering the very best care
in ophthalmology, including 133 leading consultants
»The practice is committed to providing revolutionary eye treatments
for glaucoma and cataracts, vision correction, prevention of sight loss
»Moorfields provides glaucoma services to over 59,000 patients
peryear.
17MOORFIELDS EYE HOSPITAL |
HEALTH & SOCIAL WORK
both glaucoma and cataract treatment
in one procedure using an iStent or
other such device, should offer better
glaucoma control in large numbers
of patients with a reduced need
for chronic medication use and the
associated side effects.
While MIGS procedures might
potentially revolutionise the care of
many patients, they are best suited
to less complex cases of glaucoma,
and there is still a need for greater
innovation in the treatment of more
complex and advanced glaucomas.
There have been great improvements
in cataract surgery over the past forty
years. From prolonged recovery in
the 1970s and 80s, to 15-minute
procedures and fast recovery in the
modern day, new discoveries and
innovations have led to vast progress
in patient care. Advances in glaucoma
surgery for the more complex cases,
comparable to those seen in cataract
surgery are still quite a long way off. A
renewed effort is required in this area
to deliver improvements.
Nevertheless, providing patients with a
balanced treatment portfolio is essential
to their care and permits a positive
experience throughout their treatment
in hospital and in the community, as
well as providing a longer-term cost-
effective solution to the NHS.
Outlook into the future
At Moorfields, we are committed to
taking advantage of the opportunities
new technologies will bring to our
patients. In November 2019, Moorfields
announced it will be partnering with
Fight for Sight to create the UK’s first
large-scale glaucoma biobank which
will help to create prediction models,
enabling the identification of patients
most of risk of losing their sight and
allowing for crucial early interventions.
Through our partnerships, we work
together to ensure technologies are
utilised to prevent sight loss.
Although we have yet to see full
impact of the changes implemented
in the NHS national tariff, which sets
the prices and rules on payments for
hospitals to spend on care, one area
where policy can support hospitals is
to ensure that operations are properly
mapped and coded, so we receive the
appropriate resources to deliver world-
class treatments and care.
Looking into the future, policies
should support the healthcare sector
in meeting the challenges posed
to capacity with Britain’s ageing
population. In ophthalmology, that
includes supporting treatment which
reduces the need for continuous
patient follow-up. Innovation must
continue to be a main driving force
behind services along with improving
experiences, all while delivering the
efficiency and equity which has guided
the NHS for more than 71 years.
This World Glaucoma Week, running
from March 8 to March 14, 2020,
it is imperative that more is done to
increase early detection and access to
innovative treatments which enable
the NHS to deliver a better quality of
life for patients across the country.
With the right
combination of
early diagnosis,
monitoring, and
efficient
treatment,
further damage
to vision can be
prevented and
most patients
can retain useful
sight for life
The iStent inject device
BEST PRACTICE SPONSOR 2020
THE PARLIAMENTARY REVIEW
Highlighting best practice
16 | MOORFIELDS EYE HOSPITAL
Glaucoma is one of the most common
eye conditions in the United Kingdom
with more than one million glaucoma-
related visits to the NHS each year.
In England alone there are around
480,000 cases of chronic open-angle
glaucoma, with many cases seen
in those over the age of 65 years
old. Glaucoma refers to a group
of conditions where the build-up
of pressure in the eye leads to the
optic nerve being damaged which
restricts vision. Vision loss caused by
glaucoma is permanent and is ascribed
to approximately ten per cent of UK
blindness registrations. However,
with the right combination of early
diagnosis, monitoring, and efficient
treatment, further damage to vision
can be prevented and most patients
can retain useful sight for life.
Improving patient experiences
by providing the best
glaucoma care
At Moorfields, we strive to provide
patient-centred care with exceptional
clinical outcomes and excellent patient
experience. Through our core belief
that people’s sight matters, we are
driven by the ambition to be at the
leading edge of research, making
new discoveries with our partners and
patients, and supporting innovation.
There are several different treatments
available for glaucoma, including eye
drops, laser treatment and surgery.
The most common type of surgery for
glaucoma is called trabeculectomy. This
involves removing part of the ocular
drainage pathway to allow fluid to
drain more easily. While this technique
is often effective at lowering eye
pressure and preventing progression of
glaucoma, it is an invasive procedure
requiring intensive follow-up after
surgery and tends to be reserved for
patients with more advanced glaucoma.
One of the latest innovations in the
field of glaucoma care is minimally
invasive glaucoma surgery, or MIGS,
which has been introduced in recent
years to improve the safety profile of
glaucoma surgery, lending itself to
larger numbers of patients with less
advanced glaucoma. MIGSstents are
implanted in the eye via tiny incisions
and microscopic equipment to lower
eye pressure and are often performed
simultaneously with cataract surgery.
Moorfields hospital offers patients
various options of MIGS operations
including the use of tiny devices to
bypass the trabecular meshwork
without damaging other tissues in
the ocular drainage pathway. One
of many offered devices is iStent
inject, the world’s smallest medical
device, which is inserted into the eye
through the trabecular meshwork
under high power microscopic control.
Furthermore, the ability to combine
Consultants often engage
their expertise beyond the
hospital such as providing
surgical teaching, patient
education, and supporting
charitable projects
We have a
long-established
history in
treating and
caring for the
prime cause of
irreversible
blindness
worldwide
»EXTRA FACTS
»Moorfields has been at the forefront of pioneering research and
innovation since its inception, including the first to offer instruction
in ophthalmology to doctors in the early 19th century
»A total of 2,300 staff are committed to delivering the very best care
in ophthalmology, including 133 leading consultants
»The practice is committed to providing revolutionary eye treatments
for glaucoma and cataracts, vision correction, prevention of sight loss
»Moorfields provides glaucoma services to over 59,000 patients
peryear.
17MOORFIELDS EYE HOSPITAL |
HEALTH & SOCIAL WORK
both glaucoma and cataract treatment
in one procedure using an iStent or
other such device, should offer better
glaucoma control in large numbers
of patients with a reduced need
for chronic medication use and the
associated side effects.
While MIGS procedures might
potentially revolutionise the care of
many patients, they are best suited
to less complex cases of glaucoma,
and there is still a need for greater
innovation in the treatment of more
complex and advanced glaucomas.
There have been great improvements
in cataract surgery over the past forty
years. From prolonged recovery in
the 1970s and 80s, to 15-minute
procedures and fast recovery in the
modern day, new discoveries and
innovations have led to vast progress
in patient care. Advances in glaucoma
surgery for the more complex cases,
comparable to those seen in cataract
surgery are still quite a long way off. A
renewed effort is required in this area
to deliver improvements.
Nevertheless, providing patients with a
balanced treatment portfolio is essential
to their care and permits a positive
experience throughout their treatment
in hospital and in the community, as
well as providing a longer-term cost-
effective solution to the NHS.
Outlook into the future
At Moorfields, we are committed to
taking advantage of the opportunities
new technologies will bring to our
patients. In November 2019, Moorfields
announced it will be partnering with
Fight for Sight to create the UK’s first
large-scale glaucoma biobank which
will help to create prediction models,
enabling the identification of patients
most of risk of losing their sight and
allowing for crucial early interventions.
Through our partnerships, we work
together to ensure technologies are
utilised to prevent sight loss.
Although we have yet to see full
impact of the changes implemented
in the NHS national tariff, which sets
the prices and rules on payments for
hospitals to spend on care, one area
where policy can support hospitals is
to ensure that operations are properly
mapped and coded, so we receive the
appropriate resources to deliver world-
class treatments and care.
Looking into the future, policies
should support the healthcare sector
in meeting the challenges posed
to capacity with Britain’s ageing
population. In ophthalmology, that
includes supporting treatment which
reduces the need for continuous
patient follow-up. Innovation must
continue to be a main driving force
behind services along with improving
experiences, all while delivering the
efficiency and equity which has guided
the NHS for more than 71 years.
This World Glaucoma Week, running
from March 8 to March 14, 2020,
it is imperative that more is done to
increase early detection and access to
innovative treatments which enable
the NHS to deliver a better quality of
life for patients across the country.
With the right
combination of
early diagnosis,
monitoring, and
efficient
treatment,
further damage
to vision can be
prevented and
most patients
can retain useful
sight for life
The iStent inject device

www.moorfields.nhs.uk

This article was sponsored by Moorfields Eye Hospital. 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