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Solution to rising ophthalmology wait times in SA ‘already exists’

Optometry Victoria South Australia (OV/SA) is calling on the South Australian Government to resolve long wait times for public outpatient eyecare as statistics show semi and non-urgent patients are waiting longer to see an ophthalmologist than they would for nearly all other speciality medical services.

At one Adelaide hospital, patient wait times doubled from 11 months in July 2018, to 22 months in July 2021. At another, the current median wait time for semi and non-urgent patients is 48 months.

“During this time some patients are quite literally going blind, while others are suffering irreversible damage to both their long-term vision and quality of life,” OV/SA said.

It comes as South Australian health officials reintroduced a pause on some elective surgeries just one day before the recent 19 March election, in response to rising COVID-19 cases. New Premier Peter Malinauskas revealed the elective surgery ban impacted all non-urgent overnight elective surgery in public hospitals, a development he said he was disappointed to learn.

OV/SA – the peak body for the optometry sector in SA – said that while some of the increase in wait times can be attributed to the COVID-19 pandemic, median wait times for non-urgent Category 2 and 3 patients have increased more than expected.

“And there’s potential for further increases as South Australians who have put off having their eyes checked or known eye health issues addressed during the pandemic, make the decision to visit their GP or optometrist,” the organisation said.

OV/SA president Ms Elise Pocknee-Clem said a solution to the issue already exists, but it needs government funding and support.

“In 2020 OV/SA backed a joint ophthalmology and optometry pilot at Modbury Hospital and data from the pilot showed that 40-60% of the non-urgent waitlist could be effectively managed by optometrists in a collaborative care setting. All it cost was $50,000 to operate – pocket change when you consider the significant benefit for so many South Australians’ lives,” Pocknee-Clem said.

“Employing optometrists in public ophthalmology outpatient clinics would further address the situation, where they could review ophthalmology wait lists, streamline care through patient work-ups for ophthalmologists, and provide eyecare to patients on the wait list who do not require tertiary care or refer those patients back to community optometry,” she said.

Infographic based on data from an optometry pilot at Modbury Hospital, SA.

OV/SA is also calling for government to prioritise the development of clinical prioritisation criteria (CPC) for public ophthalmology, which would ensure that only patients who need tertiary care are referred.

“The CPC should utilise the skills of community optometrists to ensure that patients referred to public ophthalmology have the appropriate work-up completed in the community, creating further efficiencies for ophthalmologists,” Pocknee-Clem said.

Ms Jacqueline Warren, lead optometrist on the Modbury pilot, said that the pilot showed there is a solution.

“The Modbury pilot proved that wait times can be reduced with only a small amount of investment. It showed that by putting in place a system of collaborative care with optometrists, the number of patients unnecessarily waiting to see an ophthalmologist was reduced,” Warren said.

OV/SA is asking the government to work together with public hospitals, ophthalmologists, GPs, optometrists and patient groups to better manage non-urgent public ophthalmology outpatient waiting lists.

“This collaboration would in turn reduce lengthy wait times, reduce the per patient cost of public eyecare, and make more effective use of the clinical skills of eyecare health professionals in the interests of better patient outcomes,” OV/SA said.

OV/SA represents 88% of all optometrists in South Australia and many of these members have contacted the government to voice their concerns at the lack of action on escalating wait times.

OV/SA representatives have also approached the Premier, Health Minister and Opposition Health Minister seeking a pre-election commitment to address this issue.

More reading

Politicians weigh in on Adelaide eye hospital proposal

OV/SA appoints Ilsa Hampton as new CEO

Patients left in limbo on ‘hidden’ elective surgery waiting list

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