Staff shortages, ageing equipment, an increase in people requiring eye care and a backlog of patients in need of operations are some of the major issues impacting the Ophthalmology Department at the Queen Elizabeth Hospital (QEH).
Head of the department Mr David Callender said that section of the hospital had the busiest outpatient clinic, with more than 20 000 patients annually “but that number has been increasing yearly”.
He said the department was in need of more hands to operate effectively.
“We don’t have enough staff; we still have a shortage of staff. We are working on getting some more junior doctors on staff. We have, on any given day, one or two consultants in the clinic and five junior doctors,” he said on Wednesday at the Lions Eye Care Centre as his department received a donation of four slit lamps from the Barbados Canada Foundation.
“So that’s also a limiting factor. We are hoping to get another two junior doctors on staff.”
Consultant ophthalmologist at the QEH Dr Dawn Grosvenor said the University of the West Indies (UWI) Cave Hill campus’ recent capability to train doctors locally would assist in this regard in the future.
“A big part of being able to maintain our staffing is that we can now train our doctors in the department locally. We didn’t [always] have the opportunity and we had to go overseas to train, and inevitably you would lose some people through brain drain. So it means that we can train staff here, retain them more and then those persons then feed back in and continue to give back locally and continue to train other people.
“So we’ve been doing that through the university’s postgraduate training programme . . . and that started in 2016. And since about 2020/2021, we’ve been producing graduates from that programme who now contribute as consultants at the hospital and they then will train more junior doctors. So, that is really helping us to retain more staff. And now we’re starting to attract very high-level applicants,” she said.
Regarding the eye surgery backlog, Callender said the department was working to reduce patients’ wait time to three months.
“We still have a backlog again. We had an issue with our operating theatre – the cooling system and the equipment challenges because of humidity in the operating theatre. So we couldn’t do as many surgeries as we would like during that period a few months ago,” he said.
The surgeon said the cooling system has been fixed and surgeries have increased but the department was still limited given the current staff numbers, which have also been affected by vacation leave for consultants and nurses.
“We try to do what we can in between, but when we have everybody on staff again, I guarantee we’ll get our numbers back up to at least a minimum of 80 cataract [surgeries] a month. Currently, the number is at 60 per month,” he explained.
“In terms of the [overall] backlog, we have hundreds of patients who are getting cataract surgery. We will never clear the backlog. There’s a constant addition to the waiting list . . . . We are trying to make patients wait for a shorter time so that we can have a short wait time for surgery, but there will always be a waiting list so our aim is to do as many cataracts as we can so that as patients are added, we take them off within about three months. So we are aiming for three months’ wait time for surgery. That’s a long-term goal, but it would take a while to get there.”
The ageing equipment in the department has also impacted the medical staff’s ability to assess patients in a timely manner. However, Callender said the donation of the slit lamps – machines that use a bright light to examine the eyes – would improve that situation.
The department head expressed concern about the increasing number of people, especially those with non-communicable diseases, presenting for treatment.
“I think that we are seeing more patients coming through the hospital for financial reasons rather than going to a private doctor. So that number has increased because of that. We are seeing more patients with diabetes who have eye problems – a lot of them present with diabetic eye disease – and you have a lot of patients with glaucoma. So even though we focus on cataracts a lot, we still have to share theatre time with other specialists who need to deal with those problems.
“More patients are referred from doctors . . . . Especially now we have more equipment, they are going to send more patients here. We try to keep pace with the workload and manage that but we still try to deliver other services. So it is a work in progress and we need all hands on deck to help us achieve our goals,” Callender said.