Why change?

The Office for National Statistics (ONS) forecasts that London’s population will grow faster than any other English region between 2016 and 2026, increasing by 774,000 to 9.5 million in mid-2026 (up 8.8%). By 2026, the number of people aged 65 and over in London is expected to increase by nearly 25% from 1.02 million to 1.27 million.

 

The predicted population of London in 2026 by the Office for National Statistics.

The ageing population
We need to plan for future health care services that can meet the needs of a growing population, especially for those aged over 65.

This means the NHS needs to be agile and adapt how hospitals and other NHS organisations provide services for patients, taking advantage
of changing clinical and technological advances.

The number of people likely to suffer from common eye conditions such as cataracts, glaucoma, macular degeneration and diabetic eye disease
is expected to rise rapidly over the next 15 years. Our ageing population means greater and more complex demand for eye services as almost
80% of people aged 64 and over live with some form of sight loss.

As more and more people will need treatment for eye conditions in the future, we need to put them at the centre of care to help support and
care for them and their families.

In order to do this, we need to replace traditional hospital-based eye services with new models of care. By using technology and by training
other health professionals, more patients could be seen in community settings near where they live.

The rising incidence of eye disease

The rising incidence of eye disease also requires the development of new techniques and technology to diagnose and treat conditions better. The closer clinicians and researchers work, the faster they can find new treatments.

Moorfields Eye Hospital on City Road, the largest hospital in the Moorfields network, offers routine, emergency and complex eye services to local patients and is also the regional, national and international referral centre for complex eye diseases.

The City Road site includes a 24/7 accident and emergency eye department and the Richard Desmond Children’s Eye Centre, the world’s largest specialist children’s eye hospital. In addition, it acts as the central research and education facility for Moorfields.

However, the ageing facilities of the City Road site do not meet modern standards. In particular the way clinics and buildings are laid out limits the innovation and interaction that could lead to the development of new treatments.

How the current facilities affect our patients

Feedback from patients and carers, particularly over the past five years, is very positive about clinical care, but often includes criticisms about the quality of patients’ experience when visiting the hospital. During inspections our regulator, the Care Quality Commission, has agreed with these comments.

Some patients have said that their journey through the current building is complicated and not always dignified; it takes longer for them to complete
treatment or investigations during an appointment than necessary. Facilities for people with disabilities, such as wheelchair users, are restricted.

The current model of care has been adapted to fit the layout of the outdated buildings at Moorfields’ City Road site, rather than designed to meet patient needs. For example, a routine appointment can involve several different tests in different locations away from the initial consultation room. This is inconvenient for patients, particularly those who find it hard to navigate the building, and makes the flow of patients through the hospital less efficient, meaning appointments take longer than they should. Our proposal will address these issues by putting patient experience at the centre of the building design.

Clinicians who look after adults and children have said having separate buildings for children and adults presents challenges. They have suggested that there could be a better use of equipment and diagnostic facilities and better “flow” by having shared flexible clinical space, as is proposed in the new building, while maintaining a separation between the two groups.

Navigating through the hospital has been highlighted as a concern for some patients, who talk about the layout of the City Road buildings as confusing,
especially on first visits. Typical comments included, ‘like a maze’, ‘rabbit warren’, ‘daunting’, ‘challenging’, ‘overwhelming’.

Waiting areas have also been raised as areas of difficulty for patients, who highlighted overcrowding and a lack of space, uncomfortable and insufficient
seating (with seats in corridors in some areas), and insufficient natural light.

Small changes over many years have resulted in a hospital that hinders, rather than enhances, the delivery of modern, ground-breaking healthcare. For example:

  • There are support columns in the centre of the main outpatient corridor which create obstacles for people who are visually impaired.
  • Ceilings have been lowered in some areas to install essential electrical cabling, making the area feel dark and cramped.
  • The layout of outpatient and surgical departments was designed in the days when we had far less diagnostic imaging and patients routinely stayed
    overnight after surgical procedures.
  • Many departments do not have step-free access, which creates physical access difficulties. Adaptations have been made to ensure that patients can
    access clinical care and that disabled staff are not disadvantaged, but these fall short of best practice.
We need spaces that will improve our lives, that build independence and confidence. We want to leave a building feeling empowered. Moorfields patient

Listen to the RNIB Connect Radio podcast

Listen back to the interview with RNIB Connect Radio’s Allan Russel with Jo Moss and local GP Deepak Hora where they discuss the advantages of creating a purpose built centre for eye care, research and education.

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