Providing a Safe and Effective Intravitreal Treatment Service: Strategies for Service Delivery

Winfried Amoaku,¹ Clare Bailey,² Louise Downey,³ Richard P Gale,⁴ Faruque Ghanchi,⁵ Robin Hamilton,⁶ Sajjad Mahmood,⁷ Geeta Menon,⁸ Jenny Nosek,⁹ Ian Pearce,¹⁰ Yit Yang<sup>11

1</sup>Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK; ²University Hospitals Bristol NHS Foundation Trust, Bristol, UK; ³Hull and East Yorkshire Eye Hospital, Hull University Teaching Hospital, Hull, UK; ⁴York Teaching Hospital NHS Foundation Trust, York, UK; ⁵Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK; ⁶Moorfield Eye Hospital NHS Foundation Trust, London, UK; ⁷Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; ⁸Frimley Health NHS Foundation Trust, Frimley, UK; ⁹Royal Shrewsbury Hospital, Shropshire, UK; ¹⁰St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK; ¹¹Wolverhampton Eye Infirmary, The Royal Wolverhampton NHS Trust, Wolverhampton, UK

Correspondence: Louise Downey Email Louise.Downey@hey.nhs.uk

Abstract: An aging population leads to increasing demand for medical retina services with chronic diseases being managed in long-term care pathways. Many hospital services struggle to deliver efficient and effective MR care due, at least in part, to infrastructure that does not expand responsively enough to meet the increased demand. A steering committee of retinal specialists from a variety of UK NHS hospital ophthalmology departments with experience of leading and managing NHS retinal services in the intravitreal era came together for the generation of this document to review and compile key aspects that should be considered when optimising intravitreal treatment capacity within MR services. This article aims to provide a useful collation and signposting of key published evidence, consensus and insights on aspects of delivering an intravitreal service, including treatment regimens, virtual clinics, staff training and governance, telemedicine and information technology, and data collection and key performance indicators. The objective is to equip ophthalmologic healthcare professionals with the necessary tools to develop and adapt their local service in the face of current and projected increased demand.

Keywords: capacity, intravitreal service, nAMD, resources