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NHS urged to act more quickly to stop elderly patients going blind

This article was taken from: http://www.telegraph.co.uk/news/2018/01/23/nhs-urged-act-quickly-stop-elderly-patients-going-blind/

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Thousands of elderly patients are being left at risk of blindness because the NHS is too slow to prescribe drugs which could save their sight, experts have warned.

New guidelines from the National Institute for Health and Care Excellence (Nice) today say patients suffering from age-related macular degeneration (AMD) need quicker diagnosis and treatment, to avoid vision loss.

More than 600,000 people in the UK are affected by the condition, which comes in two forms, one of which can cause irreversible blindness within weeks.

The new advice from Nice says those suffering from the most damaging form of AMD should start treatment within a fortnight of diagnosis.

The authors of the new guidelines said thousands of patients – mainly elderly – were currently being denied this, leaving too many to suffer “terrifying” consequences.

Professor Mark Baker, director of the centre for Guidelines at Nice, said: “AMD can be a life changing condition for people if it is not identified early on.

“There are around 26,000 new cases of wet AMD in the UK each year and if left untreated over half will become visually impaired or blind within three years. Therefore the need to provide timely diagnosis and treatment is important.”

Cathy Yelf, chief executive of the Macular Society, and a member of the Nice committee which drew up the guidelines, said: “The consequences of delays to diagnosis and treatment are terrifying; it means losing more sight and can mean losing central vision irreversably.”

“Prompt diagnosis is absolutely critical,” she said, warning that staff shortages and poor organisation of services meant patients in many parts of the country were forced to wait too long.

It follows concern that patients are losing out because of red tape stopping the NHS from using the cheapest form of treatment available.

Why is the NHS under so much pressure?

  • An ageing population. There are one million more people over the age of 65 than five years ago. This has caused a surge in demand for medical care
  • Cuts to budgets for social care. While the NHS budget has been protected, social services for home helps and other care have fallen by 11 per cent in five years. This has caused record levels of “bedblocking”; people with no medical need to be in hospital are stuck there because they can’t be supported at home
  • Staff shortages. While hospital doctor and nurse numbers have risen over the last decade, they have not kept pace with the rise in demand. Meanwhile 2016 saw record numbers of GP practices close, displacing patients on to A&E departments as they seek medical advice
  • Lifestyle factors. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Growing numbers of overweight children show this problem is currently set to continue

Research suggests that a £12 drug called Avastin is just as effective as injections which cost up to £800 for treatment of wet AMD.

But the treatment – originally developed to treat cancer – does not have a licence for wet AMD, meaning doctors who prescribe it do so at their own risk.

The new Nice guideline says there are no clinically significant differences between the treatments.

And the General Medical Council gave their backing to doctors who prescribe the drug off-licence, following recommendations from the Royal College of Ophthalmologists.

Two drug companies Bayer and Novartis, which market the only treatments licensed for wet AMD, have threatened legal action against 12 NHS authorities which drew up plans to offer Avastin for eye conditions.

Helen Lee, from the Royal National Institute of Blind People (RNIB), urged NHS bodies to act quickly on the Nice recommendations.

She said: “The guidance makes it clear that patients need to be urgently referred for treatment if they have suspected late wet AMD.

“If late wet AMD is confirmed patients should be offered treatment as soon as possible, within 14 days of referral to the macula service.”

She said shortages of staff and lack of space in clinics meant too many patients were being forced to wait longer.