Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make an assessment on the effect of the changes to the NHS tariff for combined cataract and glaucoma surgery on (a) hospital costs and (b) efficiency in the field of ophthalmology.

There has been a significant change in clinical practice in ophthalmology since the last tariff prices were set and reference costs used to calculate prices were collected, with a shift to performing Minimally Invasive Glaucoma Surgery (MIGS) instead of open glaucoma procedures which are frequently combined with cataract extraction.

MIGS are significantly cheaper, and both procedures cannot be differentiated using operating procedure code supplement codes. Open/tube glaucoma procedures are nearly always done with a graft of sclera or tutoplast, which triggers multiple procedures so will receive significantly more under the 2019/20 prices than MIGS procedures, which is appropriate.

NHS Improvement has carried out an impact assessment which shows that the national tariff changes should not affect patient access to glaucoma treatment.