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Referrals – MK CCG Area

Information reviewed in October 2021

 

The information below relates to routine referrals for patients with a GP in the MK CCG area. If you’re unsure which CCG area applies, check the lists available here.

(Note that, as of 1st April 2021, MK CCG has been subsumed into NHS Bedfordshire, Luton & Milton Keynes CCG, known as ‘BLMK’. Eventually, services will be combined across this new area, but this does not as yet affect ophthalmology referrals.)

Remember that you should only email your referrals from an address ending in @nhs.net. Every health professional is personally responsible for protecting patient data, and referrals sent from other email addresses will not be secure. If your practice doesn’t have an nhs.net email address, please check our website here for information on how to get one.

 

Routine referrals

All routine referrals, including cataract referrals, should be emailed to the MK Referral Management Service (RMS). The email address for routine referrals (only from another nhs.net account) is mk.rms@nhs.net. During the coronavirus pandemic, cases will be dealt with initially by telephone assessment.

For general queries about this service please email Milton Keynes CCG on mkccg.optics@nhs.net, or view the education event presentation available here (produced for an event in Feb 2019 and amended in Sep 2020.) Patient-specific queries may be sent (only from another nhs.net account) to mk.rms@nhs.net. Further RMS contact details are in the document available here.

For more detailed local information on referral pathways in Milton Keynes, please download the May 2021 Eyecare Pathways Milton Keynes document, which should be displayed in every consulting room. Please also refer regularly to other information on this page, and look out for email updates.

 

Cataract referrals

Cataract referrals in MK should be treated as any other routine referral and emailed to the RMS on GOS18. In August 2020, a new policy document was produced by BLMK, describing revised referral criteria for cataract surgery, and it’s available here.

Patient choice for cataract referral

Providers holding a contract with MK CCG to provide cataract services (at February 2021) include:

Milton Keynes University Hospital (default provider)

Ramsay Blakelands

Bedford Hospital

Stoke Mandeville Hospital

Northampton General Hospital

Patients may exercise their right of choice to be referred to another provider, but that provider must be listed in the NHS electronic referral service (e-RS). To check if a hospital or clinic is listed, email mkccg.optics@nhs.net.

 

Glaucoma

Following NICE guideline NG81 (November 2017) the criterion for referral is IOP >= 24 mm Hg (instead of the previous threshold of >21 mm Hg), in the absence of any other signs.

The view of LOCSU is that optometrists working in areas where no repeat measures scheme is in place should not be criticised for false positive referrals which are the result of a lack of commissioning. Consequently, it is recommended that the following statement is included, if referrals are made based solely on a non-contact tonometry reading: “This referral is being made based on non-contact tonometry results, due to the fact that no repeat measures service has been commissioned locally”.

We have written to MKCCG, and copied to colleagues in the HES, so that they are aware that the high rate of false positive referrals for raised IOP that they may be seeing is the result of a lack of commissioning, and not related to the competence of primary care optometrists making the referrals.

 

Urgent & Emergency Referrals

The hospitals have asked us to remind you not to quote to patients the timescale in which they will be seen. This decision needs to be made by the doctor who is triaging the case, and worried patients can often get quite upset if the appointment time given to them doesn’t match their expectations.

From 28th August 2021, the pathway for referral of urgent cases is the BLMK Community Urgent Eyecare Service (CUES). This service provides urgent assessment and treatment for recent and sudden onset eye problems, for children and adults registered with a GP in Bedfordshire, Luton and Milton Keynes. A new urgent & emergency eyecare pathway document will be released by the CCG soon to reflect these changes.

Examples of cases which can be managed through the CUES include:

  • Red or painful eye or eyelids
  • Recently occurring flashes and floaters
  • Recent and sudden loss of vision
  • Foreign body in the eye

The CUES hub is open 7 days a week between 08:00 and 20:00, and it can be accessed by calling 0800 316 9200. Patients can self-refer, or be referred/signposted by a health professional.

Only patients ineligible for CUES (‘red flags’, requiring emergency assessment) should be referred to the MKUH BUS clinic, and this should be by email to bus.referrals@nhs.net, on the BUS referral form (available in Word and pdf versions) during Mon – Thurs 08.00-16.30 and Fri 08.00-16.00. Outside these hours, red flag patients should attend A&E.

Typical red flag conditions include:

  • Chemical or penetrating injury
  • Sudden onset of red and painful eye associated with photophobia or nausea
  • Sudden onset, severe reduction in / loss of vision
  • Sudden onset double vision or ptosis

For suspect wet AMD referrals, please download the rapid access referral form and email it to bus.referrals@nhs.net. (Patients presenting with wet AMD during a CUES examination should be referred using the CUES pathway.)

 

Private ophthalmology at Stoke Mandeville Hospital

Buckinghamshire Healthcare NHS Trust now offers private ophthalmology care at its Mandeville Wing, running evening outpatient clinics on Monday evenings, and operations on Saturdays. Download an information leaflet here.

The information on referral pathways is intended to be helpful rather than definitive, and there may be a delay in updating information when pathways change. For urgent or emergency referrals we recommend practitioners confirm the provider has received the referral and/or give clear advice to patients on what action to take if they have not been contacted within an appropriate time frame.

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