Consulting Room: Making the right choice

In England, NHS-funded surgical eye care at the end of the 20th century came from the local general hospital. The much loved eye hospitals up and down the country closed decades earlier (with some notable survivals, including Sunderland and Moorfields). What drove centralisation was the need for beds and safe anaesthetics. What has driven recent decentralisation is day surgery under local anaesthetic, lack of investment in NHS infrastructure, realisation that elective care is disrupted by acute care on the same site, and that sometimes care closer to home is better. This move has been led by growing private sector investment in NHS funded care. Together with patient choice, this has pushed up standards of service and improved physical environment. Patients need a helping hand in understanding choice in their area, and optometrists acting as the primary care referrer need to know what ophthalmology services are available locally. Here are some factors that might influence choice: