The National Cataract Surgery Survey: III. Process features.

The process of how medical care is provided for cataract patients within the National Health Service is reported in this paper with particular emphasis on features relating to access to surgery and delivery of the surgical service. Access to the hospital eye service is considered in terms of lengths of waiting time and level of visual impairment at specific periods of patient care: first assessment in an ophthalmic out-patient clinic, at listing for surgery and for admission for surgery. Delivery of the surgical service is considered in terms of threshold of visual acuity at which surgery is considered necessary and some features of post-operative management: length of stay, duration of post-operative medication, number of post-operative out-patients visits and whether final refraction had been performed and spectacles dispensed by 3 months after surgery. Regional operation rates are presented as indicators of activity. These results describe the experience of a sample of all patients admitted for cataract surgery in 1990 and provide national figures for the process features considered in this report with respect to current surgical practice in the United Kingdom.