Atlas of variation in risk factors and healthcare for vision in England

  • 18 Aug 2021

Public Health England (PHE) has published their Atlas of variation in risk factors and healthcare for vision in England.

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Public Health England (PHE) has published their Atlas of variation in risk factors and healthcare for vision in England. Working with a range of clinicians, public health analysts and stakeholders, including the Clinical Council for Eye Health Commissioning1 (CCEHC); this is the first health intelligence output from PHE solely focused on eye health.  

Using the Portfolio of Indicators for Eye Health and Care (CCEHC SAFE metrics) as a guide, the Atlas brings together 32 indicators across the whole vision pathway from describing populations at risk of poor eye health, through screening to healthcare services, and eye health outcomes. The indicators are drawn from the best available population-level data sources, and the Atlas addresses a long recognised gap in regular review and reporting of eye health data arising from routine NHS care.  

New analyses of hospital eye services including outpatient appointments, intravitreal injections, cataract and retinal detachment surgery are presented, revealing local and regional variations that to date have remained unrecognised. In doing so, the Atlas has:

  • highlighted and quantified variations across a range of eye health indicators that will be hard to overlook, and deserve closer local review and scrutiny to understand their underlying causes and outliers 
  • called for making better use of existing data sources and improving their quality
  • highlighted the lack of routinely available, granular data from services provided in primary eye care and the need to ensure that is addressed.

Access to the data underpinning the indicators is available through the Interactive Atlas, an online tool to support review and interpretation of local variations in health service indicators, and prevalence of risk factors for poor vision health. 

Chair of the CCEHC, Parul Desai said:

“The Atlas is timely, presenting trends in the years immediately prior to, and provisional data during the coronavirus (COVID-19) pandemic, as a resource to support planning and monitoring the impact of actions taken by clinicians, CCGs, ICSs, providers and policymakers locally, and by the National Eye Care Recovery and Transformation Programme. 

“It should not be seen as a one-off, but as a starting point for local discussion and action.  It will be a significant tool to help monitor population eye health and its contributory factors. Practical options for action are proposed that could make meaningful differences to patients, and the quality, accessibility and consistency of care provided by eye health services – now and in the longer term.”


ENDS 

For media enquiries please contact: Ann-Marie Stevens: Annmarie.stevens@college-optometrists.org. 

 

Note to editors

Key findings:

Increases in the rates of eye health service activity between 2013-14 and 2019-20 were all associated with variations in activity and with notable reductions in 2020 during the Covid-19 pandemic.  Please refer to the Atlas for full details of these, but the following are provided as examples: 

  • Out-patient attendances:
    • There were 9 million outpatient attendances (equating to approximately 3.4 million individual patients) for vision in 2019/20, an increase of over 37% compared to a decade ago. 
    • However, in 2020, due to the COVID-19 pandemic, there was a 29% reduction in outpatient attendances equating to 2.7 million fewer visits than the previous year.
    • The rate of all vision outpatient attendances, between Clinical Commissioning Groups (CCGs) ranged from 9,821 to 24,131 per 100,000 population, a 2.5-fold difference between CCGs.
  • Intra-vitreal Injection Therapy:
    • Approximately 608,000 intravitreal injection procedures were performed for persons aged 60 years and over in 2019/20,  a rate of 4,411 per 100,000 population
    • During 2020, compared to the previous year there was a 9% decrease in the number of all intra-vitreal injection procedures,  and a 19% reduction in the number of first intravitreal injections 
    • There was a 188.6-fold variation in the rate of all intravitreal injection therapy procedures in people aged 60 years and over (2019/20) between CCGs.  However, differences in organisational practice and priorities for OPCS coding are likely to be the major, systematic factor contributing to the variation.    
  • Cataract Surgery:
    • Cataract surgery has decreased by over 40% in the year 2020 compared to the previous year.
    • The rate of cataract surgery in people of 65 years during 2019-20 ranged from 2,462 to 5,299 per 100,000 population, which is a 2.2-fold difference between CCGs.
  1. The Clinical Council for Eye Health Commissioning (CCEHC) is an independent advisory body coordinating leading organisations from across eye health to offer united, evidence-based clinical advice and guidance to those commissioning and delivering eye health services in England on issues where national leadership is needed. The College of Optometrists holds joint-secretariat of the CCEHC with The Royal College of Ophthalmologists.

Its member organisations are: 

  • The Royal College of Ophthalmologists
  • The College of Optometrists
  • Optical Confederation (AOP and FODO)
  • LOCSU
  • British and Irish Orthoptic Society
  • Royal College of General Practitioners
  • Royal College of Nursing (Ophthalmic Section)
  • Association of British Dispensing Opticians
  • Royal National Institute of Blind People
  • Faculty of Public Health
  • Association of Directors of Adult Social Services
  • Glaucoma UK
  • Macular Society
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