Investigation reveals doubling in NHS rationing of cataract surgery  


Eleanor Southwood, chairman of the Royal National Institute of Blind People (RNIB), said patients were being forced to wait years for surgery to save or restore their sight.

She said: “Restrictions or delays to cataract surgery can severely impact people’s ability to lead independent lives, and prevent them from doing many of the things that everyone takes for granted such as driving or reading.

“It’s shocking that access to this life-changing surgery is being unnecessarily restricted by so many clinical commissioning groups (CCGs) in England.

“Denying people the cataract surgery they need is a false economy as people with cataracts can be at a greater risk of falls and isolation, resulting in costs to the public purse.”

She urged CCGs to follow the Nice guidance, which was issued in October 2017.

Mike Burdon, president of the Royal College of Opthalmologists, accused health officials of ignoring clear evidence that surgery is clinically and cost effective.

He said: “Health economists spent 18 months reviewing the evidence for cataract surgery on both first eye and second eye, and they convincingly concluded that there was no justification to ration cataract surgery on the basis of acuity. “What is the point of Nice doing detailed evaluation if CCGs are just going to knowingly ignore that advice?

Previous research has suggested that two thirds of areas have some restrictions on cataract surgery.

Mr Burden said the situation was endangering pensioners, putting them at increased risk of falls, fractures and significant mobility loss.

“I think is insulting to our elderly patients that this rationing is going on. It is unjustified,” he said.

The figures show that the highest proportion of rejected cases came in Telford and Wreckin and Coastal West Sussex. Each rejected more than one in five patients seeking funding for an operation, because it was not routinely funded.

Nicholas Wilson-Holt, a former member of the Nice guideline committee, said the “postcode lottery” across the country showed the guidelines were being ignored.

He said: “The evidence clearly was that cataract surgery should not be rationed in this way. A lot of effort was put into producing the guidance, and it is a shame for patients that it is not being followed. It’s such an effective procedure and has the ability to change a patient’s quality of life.”

Graham Jackson, co-chairman of NHS Clinical Commissioners, said, “Unfortunately the NHS does not have unlimited resources, and ensuring patients get the best possible care and outcomes against a backdrop of spiralling demands, competing priorities, and increasing financial pressures is one of the biggest issues CCGs face.”


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