"A very disappointing experience"

I had a very disappointing experience with the cataract service of NHS Grampian to the extent I had my surgery privately done. Based on my experience I’ve written a survival guide for patients who cannot afford to go private. I expect it will mostly be useful for patients who, like me, have cataracts because they are very short-sighted.

1. For rigid contact lens wearers: in your invitation to the assessment unit you are asked to remove your contact lenses for 2 weeks prior to the appointment. However, whilst some doctors feel 2 weeks is sufficient for wearers of rigid contact lenses, I was told by the nurses and optician met that 4 weeks is necessary and by removing them for 2 weeks only I risked disappointing results of surgery. I do not know the right answer but prepare to be thoroughly confused!

2. During the assessment appointment your eyes will be measured so that the lens that will best correct your vision can be implanted. However, whether the measurements are correct is not checked by staff at assessment but (usually) on the day of surgery. Mine turned out to be incorrect so I was booted of the surgery list. I would advice to avoid this unpleasant situation by asking the optician to check with the consultant that the measurements are correct before leaving the assessment unit.

3. Astigmatism is a common 2nd diagnosis of people with severe short-sightedness. Unfortunately, it is not treated by cataract surgery and it is likely that after surgery glasses or contact lenses are still necessary for correction. At no point did staff discuss the impact of my astigmatism on my future vision so I would advise to make sure that you are 1) aware whether you have astigmatism and 2) ask how it will affect your eyesight after surgery.

4. If you develop cataracts because of short-sightedness you are automatically a high-risk patient for surgery. In addition to the normal waiting list, NHS Grampian also operates a list for high-risk patients with surgeons who can treat complications arising during cataract surgery. However, to be placed on the high-risk surgery list another assessment is necessary. After waiting 5 months I was found to be too high-risk for the normal waiting list and needed to wait another 2 months for the second assessment to take place. I would advise, in order to avoid unnecessary delays, to ask about this high-risk surgery list at the first assessment appointment.

5. I found the communication of this department with me especially poor. To work out what was going on I have found it useful to request a copy of my medical notes. By reading my medical notes I found out that I was (wrongly) diagnosed with an entirely new eye problem and put on the high-risk surgery list without being informed.

6. Estimations about the date of my surgery were wildly inaccurate. As I was an urgent case I was told at assessment the surgery would take place within 6 weeks. At further contact an extra 6 weeks was added, followed by another month and so on. These inaccurate estimations left me unable to plan both my personal and working life and I certainly could have done without the stress it caused.

7. The administration of the waiting list seems rather poor. Six months after having been taken off the waiting list by their own consultant I am still pestered by letters, phone calls and appointments.

8. I did write a complaint about the above but the reply is underwhelming. First because the complaint service does no longer reply within the customary 20 days because of pressures on the workforce. Personally, I only received an answer after 4 months after I threatened to write to the relevant authorities. Second, because I believe the reply is aimed at exonerating the service rather than taking concerns seriously. I feel that such an attitude makes improving the service based on patient feedback impossible. In short, with the benefit of hindsight I think complaining was merely a waste of my time. Perhaps a public review is more effective in changing this department for the better.

I hope the above will improve future patients' experience with the Grampian cataract service.