Birmingham sight clinic wins 2009 clinical award
The ophthalmology team at University Hospitals Birmingham NHS Trust won the clinical category of our 2009 Shared Learning Awards. The award was for a new service to treat age-related macular degeneration (or AMD), the leading cause of sight loss in the UK.
The key to planning the award-winning service was to follow the progress of our AMD guidance while it was being developed. It meant the Birmingham team treated their first patient with the recommended drug, ranibizumab, on 1 September 2008 - just 3 working days after our guidance was published.
AMD mainly affects people over 60 and causes particular problems with reading, driving and recognising people's faces.
We recommend ranibizumab (also known as Lucentis) for people with one form of this eye condition (wet AMD [technology appraisal 155]). This is injected directly into the eye, once a month for 3 months. If tests show it is working, several more monthly injections are given.
In 2007, the winning team had read our draft guidance and knew that, if the treatment was recommended, this would have a big effect on its workload. So they started planning straightaway.
A consultant ophthalmologist was appointed on a flexible timetable to ensure the service could respond to changing demand.
In addition, primary care trusts, GPs, optometrists and patients were involved early on. For example, a database of patients who might benefit from treatment was created, along with a fast-track referral system which makes use of standard letters. In addition, GPs and optometrists were trained in how to recognise the signs early, and when to refer patients who might benefit from the treatment.
During the first year, the team saw 439 patients - more than three times the 120 originally planned for - thanks to the short waiting times and the service's good reputation. Careful planning and flexible organisation has enabled it to expand to meet this increase in demand (there are now three ophthalmologists working in the team).
All patients have their first assessment within a week of being referred and none of those treated during the first year has been registered blind.
The results of all tests and treatments are recorded electronically so that everyone involved can check a patient's progress - and the trust can monitor how well the service is doing overall.
Consultant ophthalmologist Miss Marie Tsaloumas, who leads the team, commented: "Having anticipated the guidance, we have worked in close collaboration with our referral base and patients. The number of patients treated is a clear testament to the effectiveness of this approach.
"The main lessons we have learnt are that NICE guidance is your 'friend' in developing services to help patients, and that team work is essential."
For more information on University Hospitals Birmingham NHS Trust's Shared Learning competition entry, see http://www.nice.org.uk/usingguidance/sharedlearningimplementingniceguidance/examplesofimplementation/eximpresults.jsp?o=350
This page was last updated: 10 May 2010