Setting up a Satellite Cataract Service

Setting up a satellite cataract serviceTop 3 priorities:1. Location2. Equipment3. PeopleOtherwise known as Resources

• Other considerations• Options• Planning• Example satellite service costs

LocationGeographical area & demographics

Site/Building/Room

Theatre (scrub & prep area)

Patient area (admission/discharge)

Changing room (staff)

Stock room/storage

EquipmentTheatre – phaco machine, phaco handpieces, microscope, operating trolley, instrument sets/single use instruments, laying up trolleys, computers (Theatreman, PAS, EDN), lens bank & storage, operating light(s), scrub sink

Consumables – cataract packs, gowns, gloves, caps & masks

Pharmacy – eye drops & ointments, fluids (BSS bags, normal saline, iodine)

Clinic – IOL Master (biometry), A-scan, slit lamp

PeopleStaff - Theatre (scrub, circulate & anaesthetic) - patient area (admission & discharge) - admin/clerical staff (notes)

Number will be dependent on how many sessions per week but usually 2 x scrub, 1 x circulate, 1 x anaesthetic, 1 - 2 x patient area, 1 x admin/clerical

Staff PGD/PSD trained to administer eye drops

Other considerationsService users – patients (below ASA 2)

Outside services – sterile services

Procurement – purchasing & storage

Theatre apparel – scrubs

Pre & post op assessment (clinic – consultant/nurse led, telephone)

Compatibility – if sharing equipment(phaco machine, phaco handpieces & accessories)

Options1. Run by their own staff

2. Rotation of staff from existing unit at hospital (more staff required, transport considerations)

PlanningOrganisation and communication

Finance

Strategic Management

EstatesITProcurement/Medical Stores

SERCO

‘Some hospital eye services, particularly those serving large geographical areas, run satellite services. Satellite services can provide several levels of cataract service, and need to be equipped as shown below:

Level 1Diagnostic and follow-up clinics: slit lamp £10,000; lenses and other equipment £5-8,000

Level 2Pre-op assessment: as above, plus £5-6,000 for biometry equipment

Level 3Day case surgery: as above plus phacoemulsification machine £40-60,000; phaco handpieces £2,000 per patient and

instrument sets £1,500 per patient

Satellite clinics can reduce the time and cost of travelling for patients, though if a consultant is away from his/her ‘base’ hospital, he/she is not available to deal with emergencies or to advise other staff. Satellite clinics will need

the right staff and equipment, and the cost of these need to be justified by the number of patients treated.’ Taken from - Action on Cataracts: Good Practice Guidance

NHS Executive, Department of Health, Jan 2000, p16

Any questions?

Thank you

Terry Boston-Marsh

15th August 2016