operation in Thanet had fallen from around a year to six months.This type of scheme cannot replace other organisational measures to increase the regular throughput of cases, but when large waiting lists exist it is a practical way of reducing them. The details of the scheme were considered by the medical defence societies, which accepted that the arrangements provided an adequate standard of care. Using the hotel increased the bed capacity during the project from a possible 115 nights in the ward to over 400 nights. Also, it provided comfortable accommodation for the patients, nurses, and medical staff. Overall, the scheme represented an intermediate stage between day case procedures and traditional NHS treatment.Four months after the project a postal questionnaire was sent to the patients, 95 of whom completed it. In response to the question "If you had to have another cataract operation would you prefer on the four days after the operation to stay in hospital, stay in a hotel, return home and visit a hospital daily, or return home with daily visits from an eye nurse?" 73 patients said that they would prefer to stay in a hotel as they had done in Operation Cataract. Eight said that they would prefer to be treated in hospital, four that they would prefer to go home after the operation and be treated daily at the hospital, and two that they would prefer to stay at home and have an eye nurse call daily. Eight patients did not have a preference.Preliminary costings suggest that this type of scheme offers economic benefits to health authorities. A smaller variant, with perhaps 15 patients having operations on a Friday and then staying the weekend in a short stay ward or at a local hotel, might be used. As most patients awaiting cataract operations are over 70 years old they should be operated on as soon as possible, and innovative schemes such as the one we have described should be considered by other health districts with long waiting lists.We thank the many organisations and people who provided practical and financial help.The participating surgeons were
audiograms showed a 60-80 dB neurosensory loss in higher tones in both the ears. After two weeks there was a 30-35 dB gain and a month later his hearing returned to normal in most of the middle frequencies.
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