Investing in doctors pays dividends

Optegra Eye Health Care’s chief executive Dr Peter Byloos reveals how the company has changed focus and the way it works with consultants.

At a time of expansion and new opportunity, the Optegra specialist eye hospital group has a sharp, precise view of how it works with its consultants and how it secures the best outcomes for patients.

Since I joined in 2018, we have reviewed and challenged the strategic focus of the business and the way we work with our consultant surgeons. 

As a business, we have also made inherent, necessary changes as a direct result of the global pandemic, which have shaped our approach for the future.

These combined factors have led to great success as we see increased patient numbers across our private self-pay treatments and a dramatic increase in NHS patients, particularly for cataract surgery.  We have also secured new investment, which allows us to expand our business both in the UK and in Europe.

When I joined Optegra, we were very much offering ‘the A to Z of eye health’ in terms of treatments.  

We had an extensive range of procedures available – from laser eye surgery and a miniature telescope for age-related macular degeneration (AMD) to oculoplastic surgery.  

Re-align priorities

This meant we drew on the expertise of a broad number of consultant ophthalmic surgeons, some of whom would spend perhaps just half to one day a week in our consultation rooms and theatres, and the remainder of their working week in their own private practice.

Recently, we took the strategic decision to re-align our priorities, and, in fact, the pandemic gave us the opportunity to do so.

  

When our hospital doors had to close, rather than furlough our clinical teams, we used this time to draw together all that fantastic expertise and medical knowledge to really streamline our pathways.  

We established a process which was tight and focused, with all clinical teams in each hospital following the same consistent and standardised approach and, most importantly, this has led to excellent clinical outcomes for all our patients, across all our hospitals.

Concentrate on cataracts

We also took the decision to refine our focus and move the clinical teams to largely concentrate on cataract surgery and vision correction treatments. We also continue to provide AMD injections.

The rationale for this is that by focusing on higher volumes across fewer pathways and serving those patients really well, we continually drive standardisation and provide excellent care and outcomes in these specialist areas. 

It also means we can treat more patients a day and so reduce the wait times for patients to have essential cataract surgery.

All Optegra patients receive a clinical phone call within 48 hours of the optometrist’s referral, diagnostic tests within three weeks and treatment within just six-seven weeks.

E-clinics became a necessity as the hospital clinics opened again after Covid and a welcome approach to keep patient time in the hospital to a minimum. 

Our optometrists and ophthalmologists have adapted well to this approach and it is a benefit for patients to respond to initial questions and discussions from the comfort of their own home. E-clinics are certainly here to stay.

Reviewed relationships

We have increased the responsibilities of optometrists running pre- and post-op checks, which allows our surgeons more time within theatre and so we are able to increase the number of patients treated on each list.

At the same time as these practical medical changes, we really reviewed our relationships with our surgeons. They are now enveloped into the business to levels we have not seen in the past. 

This has been created out of trust and by investing in the very best technologies, training and clinical support teams. So our consultants now spend several days a week with us and many work with us full time.  

This, in turn, means they can develop stronger relationships with their scrub nurses, patient liaison team and optometrists – a win-win for both clinical outcomes and successful, enjoyable working relationships.

Attract staff

While the UK faces a shortage of medical staff, we like most other hospitals are eager to attract more clinical staff.  

By providing five-star facilities, latest technologies and excellent support, we are in a strong position to attract and retain new clinical colleagues and are always happy to meet and discuss such opportunities.

Our medical director and consultant ophthalmic surgeon, Mr Amir Hamid, shares his opinion on this: ‘Optegra aims to provide an efficient and stress-free environment for surgeons working with us, where excellent patient outcomes and high satisfaction rates take centre-stage in our standardised pathways. 

‘We always take on board the suggestions of our consultants to improve and innovate. This collaborative effort is hugely beneficial for our patients and the consultants themselves.’

A further big change to Optegra in recent years is our increased commitment to NHS patients.  

Prior to the pandemic, we worked with the NHS to provide both AMD injections and cataract surgery. During the pandemic, we kept some of our hospitals open for NHS teams to provide essential AMD treatment and ensure patients could retain their existing vision at a time when that was at risk.

Huge opportunity

However, the demands on the NHS have provided a huge opportunity for us to increase our cataract offering to the many thousands of patients around the country who were facing large waiting lists.  

So we have gone from treating 3,000 NHS cataract patients in 2019 to more than 30,000 in 2022. We predict this rising to over 50,000 patients this year.

Our newly standardised pathways give our consultant surgeons the reassurance that all adequate processes are in place – and the outcomes speak for themselves. 

From January to September 2022, for example, outcomes included:

 Cataract surgery: visual outcome of 6/12 or better 94% – against RCOphth/NOD bench­mark of 86%;

 Cataract surgery: zero operative complications 99.46% – against RCOphth/NOD benchmark of 98%;

 Lens replacement: visual outcomes on 6/12 or better 98% – compared to benchmark Rosen et al of 96%.

From a corporate viewpoint – as, of course, from my chief executive perspective I also need to keep our investors happy – Optegra is in a very strong position.  

Alongside our ongoing relationship with H2, we also have new majority shareholders, MidEuropa, which provides an opportunity for us to escalate our expansion programme.  

In order to further meet the surgical needs of patients throughout the UK, we have recently launched three new NHS cataract Optegra clinics: in Newcastle, Maidstone and Uttoxeter.  

We are launching in Brighton in April and have a further three UK clinic launches planned for later in 2023.  

Of course, this is an opportunity for us to also attract more consultant surgeons to the business, where they can lead on treatment for NHS patients initially; with a view to the clinics also offering private cataract – with multifocal lenses – and vision correction at future dates.

On an international level, we have recently invested in a series of eye clinics in Slovakia, and we continue to have a very strong presence in Poland and the Czech Republic, which is a very sophisticated eyecare market. We are the number-one provider in those regions.

Optegra continues to respond to market need, to identify opportunities for growth and we are excited for the years to come as we continue to work with leading doctors, nurses and clinical teams, providing the highest visual outcomes for our patients.

• See ‘Two new developents for Optegra eye clinics’