St. John Eye Hospital USA Priory 2008

1. St. John Eye HospitalUSA Priory 2008 John F. Talbot

2. Where we are • By present standards and expectations the Hospital Group is successful • Increasing numbers of patients • Increasing charitable work • All the standards set in the Strategic Plan 2005-8 have been met

3. Clinical activityOutpatients

4. Clinical activityMajor operations

6. What is the Hospital Group for?

7. What is the Hospital Group for?Traditionally • Primary, secondary, tertiary eye care • Training • Research

8. What is the Hospital Group for?New directions • Primary, secondary and tertiary eye care • Development of eye care services in OPT • in co-operation with other agencies • Training for the OPT • Geographic spread of eye care • Coverage of disease • Public health • Research

15. SJEH • Centre for tertiary referrals • Primary and secondary care for East Jerusalem • Research • Teaching • Vulnerable to politics

16. SJEH • No separate women’s and children’s ward • Not enough visitors’ accommodation • Retinal unit needs enlargement • Some general renovation needed

17. SJEH • No separate women’s and children’s ward • Not enough visitors’ accommodation • Retinal unit needs enlargement • Some general renovation needed

20. Hebron • Rapidly expanding and successful clinic • Surgery twice a week • No need for further development in next 3 years

21. Anabta • Recently opened outpatient clinic • Slow increase in numbers • PRCS • Good focus for screening

22. Gaza clinic • Very deprived and isolated population • Clinic small and in poor condition • Housed in poor building • A move is needed

23. Peripheral clinic costs 2008 Anabta £143,806 Gaza £302,761 Hebron £333,311

24. RAAB study • Rapid Assessment of Avoidable Blindness • Age 50+ • 3,800 individuals (9% of target population) • 95 clusters (59 West Bank, 36 Gaza) • 40 per cluster • 94% acquisition

25. RAAB studyBlindness & visual impairment West Bank Gaza Total <3/60 2.14% 3.93% 2.85% <20/400 <6/18 14.16% 19.62% 16.29% <20/60 Female: male 1.8:1

26. RAAB studyCauses of blindness

27. Principal disease groups • Cataract • Corneal opacity • Diabetes • Glaucoma • Paediatric ophthalmology

28. Principal disease groups • Cataract • Corneal opacity • Diabetes • Glaucoma • Paediatric ophthalmology

29. Cataract • 55% prevalence conforms to WHO profile • By extrapolation 26,500 patients 50+ years • >60% women • SJEH currently provides 45% in West Bank • 25% in Gaza • Principal providers outside SJEH private • to exclusion of chronic disease management

30. Principal disease groups • Cataract • Corneal opacity • Diabetes • Glaucoma • Paediatric ophthalmology

31. Diabetes • Prevalence c.15% (UK 3-5%) • Self-reported in RAAB: female 26% male 23% • Poor standard of care & compliance • Unscreened • Presents late & often untreatable

33. Screenable eye diseases • Childhood amblyopia • Glaucoma • Diabetic retinopathy

34. Screening • In general, start small • Diabetic retinopathy • Amblyopia

35. Income

36. Income • Investment • Locally earned • Fundraising

37. Fund raising • Priory donations • In-house fund raising

38. Fundraising

39. Priory donations

40. Priory donations (£)

41. Priory donations (£)

42. USA Priory 2008 Children’s ward upgrade 100,000 Phaco/vitrectomy machine 95,000 Pediatric ophthalmology training 120,000 Joint SJEH/Israeli teaching 90,000 Outreach clinic 200,000 Optometry/orthoptics 65,000 Portable YAG (now Hebron) 60,000 Nurses’ home renovation 70,000 Pediatric patient relief 200,000 $1,000,000

44. Exchange rate loss 2008 Exchange rate loss 2008 £425,000

45. Summary of strategic direction • Review of costs • Fund-raising • Support the largest element of costs - staff • Staff sponsorships

46. Summary of strategic direction • Sustain financial position through current financial downturn • Maintain services in political environment • Respond to epidemiology study • Improve/rebuild Gaza clinic • Improvements in SJEH • Screening/public health programs

47. Thank you