Abstract
Background: COVID-19 caused disarray in global healthcare systems. Ophthalmology elective outpatient services which accounts for 10% of all hospital outpatient services were shutdown resulting in a significant backlog of patients with sight threatening consequences. Vulnerabilities within our healthcare systems were brought to light, demonstrating the need for transformational change in the delivery of care. Worcestershire Acute Hospitals NHS trust established first diagnostic hubs in Midlands for ophthalmic service to restructure its ophthalmology service delivery using the Covid-19 special funding. There is paucity of data on the efficacy of setting up diagnostic hubs in ophthalmology delivering efficient virtual clinics in glaucoma service.
Aim: To assess the impact of diagnostic hub by measuring the slippage in follow up appointments after setting up the diagnostic hub & virtual glaucoma service after pandemic in July 2020
Methods: This is an observational study comparing delays in follow up appointments before Covid-19 and post-Covid-19 set up of a diagnostic hub for data collection and enhanced use of the virtual clinics in glaucoma service at Worcestershire Acute Hospitals NHS Trust. We compared the Slippage (delay beyond the clinically suggested interval) in follow up appointments and stability of visual fields to assess the efficacy of a diagnostic hub and new virtual clinic service.
Result: The slippage of more than 3 months in appointment has reduced from 94% in 2020 to 20% in 2023. The visual field stability had significantly improved to 89.8% in 2023 from just 2% in 2020. This significant improvement is a direct result of setting up of diagnostic hub delivering efficient virtual glaucoma service
Conclusion: This study clearly demonstrates the positive impact of transformational change in healthcare delivery by setting up a diagnostic hub for ophthalmology. This study supports that building this capacity is important to reduce how long people are waiting for treatment. The reduced delay in treatment has led to improved clinical outcomes.