Access to cataract training in the independent sector has improved following collaborative work undertaken by The Royal College of Ophthalmologists, with placements available in all regions where independent sector providers (ISPs) operate, other than London North. Despite this progress, more work is needed as trainees in nearly all regions report they need additional training opportunities in ISPs.
This was the headline conclusion from the second survey of our Ophthalmologists in Training Group.
Other key findings include:
- Variation in ISPs’ ability to offer training placements continues. While SpaMedica and Newmedica now provide training placements in the vast majority of regions where they operate, Optegra and CHEC do not currently offer placements across most regions in which they operate.
- Almost two thirds (64%) of placements we recorded were for ST4-6 trainees. Further work is needed to understand if additional provision for more junior trainees is required. It is encouraging to see that two SAS doctors are now undertaking cataract training at SpaMedica sites.
- The quality of training undertaken in ISPs continues to be rated highly. 90% of trainee representatives agree it is a positive experience, with the size of theatre lists and teaching quality particularly valued. A lack of case complexity and theatre frequency was however cited as a downside by a minority of trainee representatives.
- Trainees have mixed views on what the barriers are to enabling further cataract training opportunities in the independent sector. These include ISPs making placements available (including issues relating to administrative burdens) and support from Training Programme Directors.
This survey was undertaken in light of the fact that delivery of NHS-funded cataract surgery by ISPs has surged over the last five years, with well over half of procedures in England in 2024 performed by ISPs.
One impact of this shift has been that ophthalmologists in training have struggled to access opportunities to perform cataract surgery. Our analysis of the General Medical Council’s 2024 National Training Survey found 29% of trainees who needed cataract training opportunities in the independent sector had been able to easily access them, although this was a big increase from the 8% figure in 2023.
The continuing improvements in the availability of high-quality cataract training placements, particularly at SpaMedica and Newmedica sites, reflect the collaborative work over the last two years between RCOphth, training programme directors, the independent sector and ophthalmologists in training – exemplified in our 2022 blueprint for delivering cataract training in the independent sector.
We will continue to monitor the delivery of cataract training in the coming months, including undertaking a further survey in 2025, while working with ISPs and the NHS to ensure more training is available when needed and trainees are properly supported to progress. We will also keep making the case that commissioning at both a national and local level must ensure the delivery of training is built into contracts and enforced.
As well as supporting improved access to cataract training, policymakers must do more to enable ophthalmology services to deliver timely care for all our patients and prevent avoidable sight loss. At its heart this means investing in the NHS ophthalmic workforce and infrastructure (both physical and IT) to tackle chronic capacity shortages.
