Out of hours ophthalmic surgery: a UK national survey

Aims There have been significant changes in the management of out of hours services in ophthalmology recently. The European Working Time Directive (EWTD) and economic measures have anecdotally reduced the availability of staff and facilities outside normal working hours, and there have been various...

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Veröffentlicht in:Eye (London) 2013-03, Vol.27 (3), p.363-366
Hauptverfasser: O'Colmain, U, Wright, M, Bennett, H, MacEwen, C J
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creator O'Colmain, U
Wright, M
Bennett, H
MacEwen, C J
description Aims There have been significant changes in the management of out of hours services in ophthalmology recently. The European Working Time Directive (EWTD) and economic measures have anecdotally reduced the availability of staff and facilities outside normal working hours, and there have been various responses to the provision of emergency surgical care. There are disparate attitudes to the optimum management of the emergency surgical case. We sought to establish a nationwide picture of the management of out of hours surgery. Methods A questionnaire was distributed to every consultant ophthalmologist working in the NHS and registered with the Royal College of Ophthalmologists ( n =947). Information was requested regarding departmental and personal policies, local facilities, and personal beliefs regarding emergency surgery. Results A total of 440 (46.5%) questionnaires were returned from 155 units; 18.7% of the units had no out of hours services or no operating facilities. Sixty-three percent of units reported a local policy regarding a time after which patients should not be taken to theatre. For 57%, this time began between 2100 hours and midnight. The most common reasons for not operating after a certain time were ‘belief that delay does not significantly affect the outcome’ (41.6%), ‘delayed access to theatre due to competition with other surgical specialities’ (40%), and ‘no specialist ophthalmic-theatre nursing input’ (32.7%). Conclusion We report the first nationwide study on out of hours ophthalmological surgical working practices. This demonstrates variation in work patterns. It is significant to patients and ophthalmologists that there should be units in United Kingdom without full local facilities and staff.
doi_str_mv 10.1038/eye.2012.280
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The European Working Time Directive (EWTD) and economic measures have anecdotally reduced the availability of staff and facilities outside normal working hours, and there have been various responses to the provision of emergency surgical care. There are disparate attitudes to the optimum management of the emergency surgical case. We sought to establish a nationwide picture of the management of out of hours surgery. Methods A questionnaire was distributed to every consultant ophthalmologist working in the NHS and registered with the Royal College of Ophthalmologists ( n =947). Information was requested regarding departmental and personal policies, local facilities, and personal beliefs regarding emergency surgery. Results A total of 440 (46.5%) questionnaires were returned from 155 units; 18.7% of the units had no out of hours services or no operating facilities. Sixty-three percent of units reported a local policy regarding a time after which patients should not be taken to theatre. For 57%, this time began between 2100 hours and midnight. The most common reasons for not operating after a certain time were ‘belief that delay does not significantly affect the outcome’ (41.6%), ‘delayed access to theatre due to competition with other surgical specialities’ (40%), and ‘no specialist ophthalmic-theatre nursing input’ (32.7%). Conclusion We report the first nationwide study on out of hours ophthalmological surgical working practices. This demonstrates variation in work patterns. 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The European Working Time Directive (EWTD) and economic measures have anecdotally reduced the availability of staff and facilities outside normal working hours, and there have been various responses to the provision of emergency surgical care. There are disparate attitudes to the optimum management of the emergency surgical case. We sought to establish a nationwide picture of the management of out of hours surgery. Methods A questionnaire was distributed to every consultant ophthalmologist working in the NHS and registered with the Royal College of Ophthalmologists ( n =947). Information was requested regarding departmental and personal policies, local facilities, and personal beliefs regarding emergency surgery. Results A total of 440 (46.5%) questionnaires were returned from 155 units; 18.7% of the units had no out of hours services or no operating facilities. Sixty-three percent of units reported a local policy regarding a time after which patients should not be taken to theatre. For 57%, this time began between 2100 hours and midnight. The most common reasons for not operating after a certain time were ‘belief that delay does not significantly affect the outcome’ (41.6%), ‘delayed access to theatre due to competition with other surgical specialities’ (40%), and ‘no specialist ophthalmic-theatre nursing input’ (32.7%). Conclusion We report the first nationwide study on out of hours ophthalmological surgical working practices. This demonstrates variation in work patterns. 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subjects 692/700/1538
692/700/565/545
After-Hours Care - statistics & numerical data
Clinical Study
Emergency Medical Services - statistics & numerical data
European Union
Health Services Research
Humans
Laboratory Medicine
Medicine
Medicine & Public Health
Ophthalmologic Surgical Procedures - statistics & numerical data
Ophthalmology
Ophthalmology - statistics & numerical data
Pharmaceutical Sciences/Technology
Practice Patterns, Physicians' - statistics & numerical data
State Medicine
Surgery
Surgical Oncology
Surveys and Questionnaires
United Kingdom
Work Schedule Tolerance
title Out of hours ophthalmic surgery: a UK national survey
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