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Written Statement - Wet-Age Related Macular Degeneration Funding Allocation 2014-15

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Vaughan Gething, Deputy Minister for Health
Wales is making good progress in eye health care.  Whilst there is more to be done, the overall trend is one of improvement.  Our Together for Health:  Eye Health Care Delivery Plan sets out a clear forward agenda on what we are doing, working in partnership across Wales.
 
The number of people certified as having a visual impairment in Wales has reduced over the last five years (from April 2008 to March 2013).

  • April 2008 – March 2009  1,737
  • April 2009 – March 2010  1,544
  • April 2010 – March 2011  1,425
  • April 2011 – March 2012  1,463
  • April 2012 – March 2013  1,362
 
This reduction in visual impairment in Wales is in part a result of new treatments such as that for wet age-related macular degeneration (AMD). In 2007, there was no treatment available for wet AMD.  Last year (2013-14) the Welsh Government provided more than £16m for almost 15,000 treatments which prevent sight loss (Welsh Government management information).
 
Best outcomes are achieved through primary and secondary care services working together to meet the needs of citizens, based on the principles of prudent healthcare. We are continuing to develop optometry services so care once seen as the preserve of specialised hospital services can routinely be provided in local communities. This will become the strength of the NHS in Wales, as set out in our new plan for primary care services.
 
In recognition of the progress made, we are now moving the funding from the management of the Welsh Government to the health boards for the treatment of wet AMD using the drug Ranibizumab and Aflibercept.  I set out below, in more detail, the history and background to the treatment of wet AMD.
 

Background


The treatment of wet AMD has been funded centrally by the Welsh Government since 2008.  
 
It was always intended that the funding would be transferred to the NHS Wales once this new treatment became routine.  Table 1 outlines health boards current costs.
 
Wet AMD causes a swift loss of sight. Patients need to be seen within two weeks of referral and reviewed every four or eight weeks depending on the treatment used. The change in funding arrangements will not result in services falling below national standards.
 
Monitoring of activity and the assurance that patients are seen in a timely manner will be strengthened. Activity levels; the proportion of patients who began treatment within two weeks of referral and the proportion of patients treated within their clinician-allocated follow-up interval will be monitored monthly and reported at the quality and safety meetings and through to the joint executive team meetings.  Health boards will provide information on a monthly basis and report to the Wales Eye Care Steering Group (and myself initially) on a quarterly basis starting this month.
 
We will continue to work with all partners to examine the possibility of the treatment of wet AMD to be delivered in a primary care community-based setting.
 
The total number of injection treatments given to patients over the last five years, across Wales, is highlighted in the table below.