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National Patient Safety Agency

Delayed appointments can lead to blindness: NPSA report

Thursday 11 June 2009


NHS trusts and other healthcare providers are being urged to review their patient appointment systems and ensure all patients with glaucoma are treated appropriately and on time.


The alert, released today by the National Patient Safety Agency (NPSA), comes as new figures reveal that 135 patients with glaucoma experienced cancellations or delays to their follow up appointments - 44 of these resulted in partial  loss  of  eyesight,  including  13  patients  who  went

NPSA Announcements

completely blind in one or both eyes. In some cases, patient appointments had been delayed by as much as 18 months.


As part of National Glaucoma Awareness Week, the NPSA is reminding all trusts and healthcare providers of the importance of glaucoma patients receiving timely and regular follow up.


Dr Kevin Cleary, Medical Director of the NPSA said:  “Glaucoma, although serious, is a very manageable disease providing treatment is consistent and appointments are adhered to.  We believe that all of these incidents could have been easily prevented if those patients were seen on schedule.


“We want all NHS trusts that provide glaucoma services to review their current booking and cancellation systems and to ensure that all patients with glaucoma are monitored effectively.”


Dr Cleary added: “Members of the public can similarly help ensure that they are safely cared for by attending their designated appointments.  If a patient does have to cancel their appointment, it is vital that these are rearranged as soon as possible.”


Steve Winyard from the Royal National Institute of Blind People said: "RNIB welcomes this guidance from the NPSA. Too many people with glaucoma are losing sight unnecessarily due to delayed and cancelled appointments. We look to PCTs and Hospital Trusts to respond to the Agency's report without delay. We also urge patients to contact RNIB for advice if their appointments are cancelled or they get information about appointments or managing their glaucoma in a format they can’t read."


To view the NPSA guidance visit www.npsa.nhs.uk/nrls/alerts-and-directives/rapidrr.




Notes to Editors:


NPSA Press Office

Media enquiries to:

Simon Morgan, Senior Media Manager – 020 7927 9580 / simon.morgan@npsa.nhs.uk

Paul Cooney, Press Officer – 020 7927 9351 / paul.cooney@npsa.nhs.uk

Out of hours – 0788 411 5956


What is glaucoma?

Glaucoma is a progressive eye disease and can cause blindness if left untreated. It most commonly affects those aged over 40 years. It occurs when the natural fluids of the eye are not able to drain properly, causing intraocular pressure to build up, which over time damages the optic nerve. The risk of sight loss from glaucoma is greatly reduced if detected early. It can be treated via medical or surgical treatment to reduce intraocular pressure. For more visit the NHS Choices website.


National Glaucoma Awareness Week – 8th-14th June 2009

Monday 8th to Sunday 14th June 2009 is National Glaucoma Awareness Week.  During this week the International Glaucoma Association is encouraging everyone over the age of 40 to have a routine eye test (every two years) that includes all three glaucoma tests (ophthalmoscopy, tonometry and perimetry) whether or not they believe there is anything wrong with their vision.


Patient safety incidents

From 01 June 2005 to 31 May 2009, 133 patient safety incidents were reported to the NPSA involving the delaying, postponing or cancellation of appointments with glaucoma patients. Of these reports, 44 patients suffered deterioration in vision, including 13 reports where there was a total loss of vision. The incidents predominantly took place in hospital outpatient clinics. For more information visit the Supporting Information to the Rapid Response Report


NICE guidance

The NPSA guidance supports guidelines issued by NICE in April 2009, entitled “Glaucoma: diagnosis and management of chronic open angle glaucoma and ocular hypertension”. This sets out best practice on the diagnosis and management of chronic open angle glaucoma and ocular hypertension including optimal treatment and follow-up standards.


NPSA guidance

The NPSA guidance on “Preventing delay to follow-up for patients with glaucoma” is the latest in its ongoing series of Rapid Response Reports. Rapid Response Reports are page-long notices which are based on evidence of harm to patients and identify clear actions for healthcare staff to reduce risks of recurrence. NHS Trusts are required to implement the specified actions within set timescales; compliance of these is monitored by the Care Quality Commission (for England) and the Health Inspectorate Wales.



The National Patient Safety Agency is an Arm’s Length Body of the Department of Health. It encompasses three divisions; the National Research Ethics Service, the National Reporting and Learning Service and the National Clinical Assessment Service. Each has its own sphere of expertise to improve patient outcomes. The NPSA’s vision is to lead and contribute to improved, safe patient care by informing, supporting and influencing healthcare individuals and organisations.