HSE recruitment embargo impacting integrated eye care team roll-out

Irish College of Ophthalmologists, Annual Conference, Knockranny House Hotel, Westport, Co Mayo, 15-17 May 2024

The HSE’s ongoing recruitment embargo is having “a significant impact” on the roll-out of multidisciplinary integrated eye care teams, the Irish College of Ophthalmologists (ICO)was told at its 2024 Annual Conference in Westport.

The HSE is in the process of implementing these teams on a phased basis countrywide, as per the recommendations of the HSE Primary Care Eye Services Review Group Report, published in June 2017. The report estimated that 60 per cent of existing outpatient ophthalmic activity could be moved to a primary care setting, thus enabling hospital services to focus on patients who require more specialist diagnostics or treatment.

The integrated eye care teams facilitate assessment, diagnoses, management, and treatment of many eye conditions and in some cases pre-op/post-op care, thereby enabling most patients to access care locally. If needed, patients can be referred onwards to acute ophthalmology services to obtain the necessary specialist input.

To date, teams have been established in six of the nine Community Health Organisations (CHOs), namely CHO 1, 2, 4, 6, 7, and 9, according to the HSE. Waiting lists, particularly for paediatric patients, have been substantially reduced in each of these areas as a result.

Work is underway to establish teams in the remaining CHOs, with CHO 8 next on the list, as well as further expanding the existing teams. However, this is now being impeded by the recruitment embargo, Ms Aoife Doyle, HSE Clinical Lead for Ophthalmology, told the Medical Independent (MI).

While the established teams are working very well, some have not yet reached their full capacity potential as more staff need to be recruited to attain the full complement.

Also, although some of the newer, yet-to-be rolled out teams have appointed consultant medical ophthalmologists they do not have other team members such as ophthalmic nurses, optometrists, and orthoptists, to launch properly, Ms Doyle confirmed. “If we really want to improve productivity, and want our consultants working at the maximum of their licence and capacity, the only way to do that is to have the full team in place, for them to be able to delegate to [the other team members] … and also to have the proper infrastructure in place.”

Her comments were echoed by other consultants at the meeting, including ICO President Mr John Doris, who told MI that he hoped the HSE would lift the recruitment embargo as soon as possible.

Meanwhile, the roll-out of dedicated cataract theatres across the country is continuing, Ms Doyle confirmed. This follows the success of the roll-outs in the Royal Victoria Eye and Ear Hospital, Dublin, the Mater Misericordiae University Hospital, and Nenagh Hospital (from University Hospital Limerick).

Work remains ongoing on a second new dedicated ophthalmology/cataract theatre in the South Infirmary in Cork (as part of the transfer of services from Cork University Hospital), with the recently opened new cataract theatre in Waterford University Hospital understood to be working well. These dedicated cataract theatres have had a very positive impact on cataract waiting lists and patient experiences, said Ms Doyle and Mr Doris.

The meeting heard that the most pressing challenge now is a national ophthalmology electronic medical record, which would fully link up the hospital sites and integrated eye care teams in the community. Work has been ongoing for some time on the plan but it is still waiting for funding to hire the vendors and commence roll-out. Ms Doyle said getting the electronic medical record system up and running is a key priority for her and the clinical programme.