The new Royal Adelaide Hospital under construction
A capacity crisis at Royal Adelaide Hospital, which is leading to some wet AMD patients waiting three times as long as they should for injections, will get worse unless the South Australian Government acts, Macular Disease Foundation Australia says.
Over the past year public patients receiving treatment in the hospital’s outpatient eye clinic rooms, specifically anti-VEGF injections, for wet age-related macular degeneration and other eye diseases, have been experiencing treatment delays.
Some have waited more than two to three times the interval recommended by their ophthalmologist.
There are 24 ophthalmology outpatient rooms at the hospital but a new Royal Adelaide Hospital under construction plans to reduce the number of these rooms to 11.
The foundation has lobbied the South Australian Government, writing to every SA politician, and foundation CEO Julie Heraghty has met SA Health Minister Jack Snelling to discuss the crisis.
‘The existing rooms in the hospital are at capacity crisis and are not accommodating the needs of the community,’ she said. ‘There is no real plan forthcoming in terms of existing capacity needs and long-term demand for eye-health services at the new hospital.
‘We have been contacted by patients and family members, advising they have had to wait 12 to 14 weeks for an injection instead of the interval recommended by the ophthalmologist, typically four to six weeks,’ Ms Heraghty said.
24 month delay
‘Such delays risk vision loss. It is totally unacceptable and we are extremely concerned.
‘Many new patients are waiting up to 24 months for appointments for sight-threatening eye conditions such as macular degeneration and diabetic macular oedema, and two Adelaide hospitals are no longer taking new patients for treatment of these conditions.
‘Without urgent attention this will lead to people unnecessarily losing their sight,’ she said.
Ms Heraghty said the SA Health process was to register a complaint but patients had told the foundation that they had contacted the complaints section of the hospital several times without receiving a response.
‘It is a ludicrous situation to have a health system that requires you to register a complaint to receive timely treatment needed to save sight,’ she said.
‘This treatment has been around since 2007 and there is no excuse for health systems to not understand the importance of delivery of timely treatment to save sight.
‘There is no evidence to show that having only 11 eye outpatient rooms at the new hospital will accommodate the demand, especially when prevalence of AMD is predicted to increase.’
The foundation proposed that the heritage-listed McEwin building on the Royal Adelaide Hospital site be turned into an eye hospital but the SA Government announced that the building was to become a school.
‘While most requiring injections receive them in private rooms, it is imperative that the public health system provides this service to those who genuinely cannot afford private treatment, as the only alternative to vision loss,’ Ms Heraghty said.
‘We won’t give up. Access and affordability of treatment are essential for all Australians so that sight can be saved. The cost of not providing this health service to vulnerable, elderly Australians is massive. The cost of blindness far outweighs the cost of service.
‘The foundation proposed that the SA Government revisit provision of ophthalmology outpatient rooms at the new hospital.
‘We won’t allow people to be let down by the public health system. There is a duty of care to these patients and it is the SA Government’s responsibility to do something about the capacity crisis right now and for the future needs of eye health in the State.’
SA politicians Rob Lucas and Kelly Vincent asked questions in Parliament. Mr Lucas said Royal Adelaide and Queen Elizabeth hospitals had a capacity for 6,000 eye injections per year but it was estimated this would need to increase to more than 25,000 a year by 2020.
Ms Vincent said she was concerned about the lack of action by the Health Minister.
A SA Health spokesman said SA Health was looking at the best way to manage demand.
‘The demand for this outpatient service is continuing to grow and SA Health is looking at a range of options to manage this and continue to improve people’s access to the service,’ he said.
‘This includes looking at clinical protocols, service provision opportunities with public and private providers, demand forecasting and resourcing needs.
‘We believe that some changes in the administrative processes, clinical pathways and clinical practice and primary health care referrals process will have a positive impact on the demand for the Royal Adelaide Hospital’s outpatients services.
‘We will continue to work with the Royal Adelaide Hospital eye unit staff on how to implement these changes, which should help alleviate some of the demand and issues they have raised.’
Ms Heraghty requested that any optometrist in SA aware of patients not receiving timely injections at RAH refer them to the foundation.