Moorfields Eye Hospital Dubai’s model of care provides a blueprint for international healthcare expansion in the Middle East

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19 November 2017 (Dubai – United Arab Emirates): Moorfields Eye Hospital Dubai opened in 2007 and the Moorfields international operating model – developed over the last 10 years in the United Arab Emirates (UAE) – incorporates teaching and research as well as consultant-led clinical care, and has proved to be very successful. The hospital has treated more than 150,000 patients over the last decade and the model may provide a blueprint for other leading global healthcare institutions looking to expand internationally.

Moorfields Eye Hospital NHS Foundation Trust is the oldest, and one of the largest, centres for ophthalmic treatment, teaching and research in the world. In 2007, more than 200 years after its foundation in 1804, Moorfields moved beyond the United Kingdom to open its first overseas branch.

Moorfields Eye Hospital Dubai (Moorfields Dubai) has quickly become one of the Gulf Cooperation Council (GCC) region’s leading eye care institutions. Its success led to further expansion in the UAE with the opening of Moorfields Eye Hospital Centre, in Abu Dhabi, in collaboration with United Eastern Medical Services (UEMS), and most recently a new collaboration with Al Jalila Children’s Specialty Hospital in Dubai, where Moorfields now delivers the paediatric ophthalmology clinical services.

By choosing Dubai as the first step, Moorfields was in a position to serve its current international patient base in the region – along with the domestic population of the UAE and the British and broader expatriate population that was likely to be already familiar with the Moorfields name and reputation.

Once the hospital had identified the Middle East and GCC region as the preferred location for its first international site, there were several challenges: where to base the hospital for optimum impact and the creation of world class facilities; how to attract and recruit the professional staff required to support the Moorfields team of consultants; and how to ensure equivalent high standards of quality and safety through a robust governance framework.

Dubai Health Care City (DHCC) is a unique healthcare ‘free zone’, an area of competitive trading arrangements to attract economic activity. The benefits of joining DHCC as a host community for the hospital included its very active support for healthcare partners, the high-quality environment and its rigorous legal/licensing framework. DHCC is attracting an increased number of healthcare partners to the community, including other international providers, whilst positioning Dubai as a major global destination for healthcare tourism, which is supported by Moorfields’ presence.

Treating patients and delivering services

Since opening, Moorfields Dubai has treated more than 150,000 patients from over 185 countries. Moorfields Dubai provides day case surgery and outpatient diagnostic and treatment services for most surgical and non-surgical eye conditions, equivalent to that available at our UK main sites.

Eye care is managed by the Moorfields team of multilingual and multicultural resident ophthalmic professionals, each with a distinctive area of subspecialisation. Many of the consultants in Dubai undertook their training at Moorfields London and all of them are based in the Middle East full time, to ensure the quality and consistency of patient care and follow up.

Critically, Moorfields Eye Hospital Dubai maintains close links with London, to ensure that our patients receive the Moorfields standard of eye care and treatment. The hospital works to the regulatory governance framework and quality control standards of the local regulator, Dubai Health Care City Authority. The hospital applies the same clinical governance and operational procedures as Moorfields Eye Hospital London, where relevant.

Developing Abu Dhabi

Moorfields and United Eastern Medical Services (UEMS), Abu Dhabi’s leading privately owned healthcare development and Investment Company, signed a partnership agreement to establish Moorfields Eye Hospital Centre in Abu Dhabi (Moorfields Abu Dhabi), which opened in April 2016.

It was a natural progression, given Moorfields’ years of experience treating Abu Dhabi residents, through its collaboration with Health Plus Center, part of UEMS. Moorfields Abu Dhabi provides a comprehensive range of specialist ophthalmological services, including surgical and non-surgical treatments for common and complex eye conditions in children and adults, and the centre replicates the same approach and standards as Moorfields Dubai in its full time consultant team, clinical care, training, and teaching.

Extending the model

Most recently, Moorfields Eye Hospital Dubai has formed an affiliation agreement with Al Jalila Children’s Specialty Hospital (AJCSH) in Dubai with the aim of providing paediatric ophthalmology clinical care and exploring other collaborative initiatives such as clinical research, training and education.

For Moorfields, this is an excellent opportunity to create wider patient access to ophthalmic care, including complex ophthalmic conditions and those associated with systemic disease, in a fully equipped, multi-specialty hospital.

AJCSH is regulated by the same regulators as Moorfields Dubai – Dubai Healthcare City Regulatory – easing the process of licensing for Moorfields in AJCSH, while helping to maintain high regulatory standards.

There is also significant potential for agreements with governmental entities and corporates – Moorfields Dubai has agreements with Dubai Police, Emirates Airlines, and other key governmental and corporate entities for eye care, and we are actively pursuing the same types of agreements with similar entities in Abu Dhabi.

Mariano Gonzalez, Managing Director at Moorfields Eye Hospital Dubai, says: “Moorfields has managed to extend its regional patient and brand reach through a flexible international network delivery model in the UAE. One of the challenges is to scale services and ensure a consistent and joined-up network, whilst delivering the same high standard of care to patients, despite regional variances in licensing and regulatory requirements.

“As our expansion continues, the challenge remains to recruit high quality consultants – although the UAE remains an attractive destination. Moorfields’ experience in the UAE over the last 10 years may provide a blueprint for other healthcare providers to follow – there is no doubt that we have enjoyed all the benefits that the UAE provides.”

Untreated, retinal detachment usually causes permanent vision loss

This week’s blog on Retinal Detachment has been contributed by Dr Igor Kozak, Consultant Ophthalmologist, specialist in Vitreoretinal Surgery, Medical Retina and Uveitis.

What is Retinal Detachment?

Retinal detachment is a condition when the most light-sensitive layer of the human eye, the retina, is separated from its underlying structures. This is associated with decrease in vision.

Causes

Various causes lead to such separation, such as forceful traction of the vitreous causing a retinal break, contraction of the membranes that can grow on top of the retina or inflammation causing accumulation of fluid under the retina. 

Treatment

The treatment should start immediately. When untreated, retinal detachment usually causes permanent vision loss due to death of light sensitive cells – photoreceptors. These cells cannot regenerate and, therefore, retinal detachment represents a serious, vision threatening condition.

Treatment should address underlying mechanism causing the detachment. If mechanical causes such as trauma or membrane contraction lead to retinal detachment, then reattachment surgery is the standard of care. The technique of scleral buckle uses silicone band to be placed externally on the eye.  Another surgical approach is from inside the eye and is called pars plana vitrectomy. In this technique, a small opening is made in the eye for infusion, light and vitrectomy probe. The gel inside the eye, the vitreous, is removed and retinal break causing the detachment is identified and sealed, usually with laser. A tamponading agent is placed in the eye to keep retina attached until the causative break is completely sealed. This can be either intraocular gas or silicone oil. In general, post-operative recovery in retinal surgery is usually longer that in other ophthalmic surgeries given the complexity of retinal anatomy and surgical techniques we use. Topical therapy is used after retinal surgery for some time.

In cases of inflammation causing fluid exudation, the potent anti-inflammatory therapy is the treatment of choice. The amount of fluid under the retina can be monitored using imaging technology.

Dr. Mariya Moosajee

MBBS BSc PhD FRCOphth
Consultant Ophthalmologist, Genetic Eye Disease Specialist, Moorfields Eye Hospital London
Associate Professor, Moorfields Eye Hospital London, UCL Institute of Ophthalmology, and Great Ormond Street Hospital for Children, London
Dr. Mariya Moosajee is a Consultant Ophthalmologist and eminent researcher specialising in Genetic Eye Disease with a specialist interest in understanding the molecular basis of eye development and genetic eye disease, using relevant disease models, human induced pluripotent stem cell derived retinal cells and medical bioinformatics. Her current clinical focus is on developing a genomic service for children and adults affected with genetic eye disease including inherited retinal diseases and developmental eye defects.
Dr. Moosajee graduated with First Class Honours in Biochemistry and Molecular Genetics in 2000, Medicine (MBBS) in 2003, and was awarded her PhD in Molecular Ophthalmology in 2009 all from Imperial College London.  She completed her NIHR Academic Clinical Lectureship in 2016 and became the first Ophthalmologist to be awarded the prestigious Wellcome Trust Beit Prize Clinical Research Development Fellowship. She has won 30 international and national prizes for her research and published over 40 peer-reviewed publications.
Dr. Moosajee is also a Senior Lecturer at UCL Institute of Ophthalmology, Moorfields Eye Hospital London, and Great Ormond Street Hospital for Children, London. She leads a research group to investigate how genes cause eye disease, develops new treatments for patients and conducts natural history studies with forthcoming clinical trials. She is also a Lecturer in Communication Skills, Embryology and Genetics for BSc, MSc and MBBS students, Imperial College