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Enhancing Public Accountability: Key Elements of the Public Office (Accountability) Bill 2025
Kirsty Cook
Within my practice, I specialise in claims relating to eye care and sight loss. As a result, I am acutely aware of the difficulties facing ophthalmology (the area of medicine dealing with the eyes) at the current time. Here, I consider the main reasons for negligence claims, some of the quite surprising problems facing ophthalmology services and what the future may hold.
According to NHS England, ophthalmology is the busiest outpatient speciality in secondary care (hospitals and specialists) and makes up almost 10 percent of the entire waiting list. Ophthalmology units are under significant pressure and with this can come problems with patient care. The Royal College of Ophthalmologists predicts that demand for eye care services is going to increase by 40 percent over the next 20 years. Therefore, it is vital that inherent problems facing these services are addressed as soon as possible.
Ophthalmology and legal claims
Ophthalmologists diagnose, treat and prevent disorders of the visual system, using many medical and surgical skills.
Common conditions include cataracts (when the eye lens develops cloudy patches, possibly leading to blindness), diabetes-related retinopathy (where high sugar levels damage the back of the eye), retinal detachment, and glaucoma (where the optic nerve connecting the eye to the brain becomes damaged).
Patients may be referred to hospital to see an ophthalmologist by their GP or an optometrist. If there is a failure to refer a patient when a serious eye issue should have been suspected or if the subsequent ophthalmology care is below a reasonable standard, there may be a claim for clinical negligence.
At Kingsley Napley, we regularly deal with cases involving misdiagnosis or a delay in diagnosis and treatment. A common is example involves retinal detachment - when the retina, the thin layer at the back of the eye, becomes loose. If not treated quickly, it can lead to a loss of sight. We also deal with claims related to many other eye conditions including glaucoma, Giant Cell Arteritis (where arteries in the side of the head become inflamed) and optic neuritis (damage to the optic nerve from swelling).
Failing technology
As matters stand there are a variety of issues facing ophthalmic services – a primary problem being related to technology.
To date, there has been no standardisation across ophthalmic imaging technologies. This means that there is no easy way to exchange digital images between different systems.
Consultant ophthalmologist Anthony Khawaja states that ‘our ability to prevent sight-loss from common eye diseases is hugely reliant on our sophisticated eye imaging systems. However, these systems do not communicate with each other, which makes accessing patient information challenging.’ The Royal College of Ophthalmologists and The College of Optometrists are lending their weight to the problem by calling for the standardisation of digital imaging across eye care services.
Further inefficiencies ensue from patients being referred to ophthalmology units as a result of inaccurate testing. According to NHS England, as many as two in five suspected new glaucoma cases and half of all suspected diabetic maculopathy cases referred via routine tests or eye screening are false positives, due to the poor sensitivity and specificity in existing tests.
New guidelines bring fresh hope
However, new clinical guidance has recently been published proposing that patients get access to more sophisticated imaging before being referred to a consultant. Essentially, this would mean that patients would have better tests to diagnose their condition earlier.
NHS Medical director Sir Stephen Powis expects the proposed changes to ‘prevent thousands of unnecessary referrals to ophthalmology services’. Consultants would have a more comprehensive view at the outset of a patient’s needs allowing those requiring specialist care to be prioritised.
Not enough Ophthalmologists
Another key problem is that there are simply not enough ophthalmologists. In 2021, Public Health England found that the country had just 2.5 consultant ophthalmologists per 10,000 of the population, well below the recommended level of 3 to 3.5.
Nonetheless, there is further positive news as NHS England have just published the NHS Long Term Workforce Plan which looks to significantly increase medical school places with a commensurate increase in specialty training places. It is hoped by the Royal College of Ophthalmologists that this will translate into more ophthalmology training places but further clarity is needed.
If you are concerned about your eye care treatment and want to speak to a specialist lawyer, please contact us by clicking the button below.
We welcome views and opinions about the issues raised in this blog. Should you require specific advice in relation to personal circumstances, please use the form on the contact page.
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