Abstract ID: 26-351
The Triple Jeopardy of Oculoplastic Access in England: Mapping Geographic Isolation, Elderly Population, and Reduced Mobility
Author: Finian O’Malley Base Hospital / Institution: Royal Free Foundation Trust, London
Presentation Type: ePoster Presentation
Purpose
England has around 2 ophthalmologists per 100,000, 4 to 7 times fewer than comparable European countries. There are few community ophthalmologists to absorb demand locally. Oculoplastic conditions are predominantly age-related, yet access has not been examined alongside population age structure. To aid workforce planning we aimed to quantify whether the poorest-access areas also carry the oldest populations, compounding need and access failure simultaneously.
Methods
National Health Service (NHS) oculoplastic unit locations (n=32) were identified from BOPSS Fellowship Directory and NHS England data. Drive times were modelled for 142 English population centres using haversine distances adjusted for circuity (1.3) at 60 km/h, classified into four tiers (<30, 30–59, 60–89, ≥90 min). Age structure (% aged 65+) was from ONS 2023 mid-year estimates. Population-weighted Pearson correlation was computed between drive time and percent aged over 65y/o.
Results
8.9% of the sampled population (2.52M) lived beyond 60 minutes from the nearest oculoplastic unit. Drive time correlated positively with percent aged 65+ (r=+0.52, p<0.001). Areas with poor access had a mean elderly population of 19.5% vs 16.0% in well-served areas. Approximately 491,000 people aged 65+ live in areas with over 60 minute drive to the nearest centre. The highest vulnerability areas were Torquay, Barnstaple, Skegness, and rural Devon and Cumbria.
Conclusion
Population centres with poor oculoplastic access are disproportionately elderly. With ~30% of people aged 75+ holding no driving licence, geographic isolation compounds with heightened age-related oculoplastic need into a critical access failure. This methodology is directly transferable to European systems facing analogous challenges of subspecialist concentration and ageing rural populations; a pan-European analysis would valuably inform oculoplastic workforce planning.