Referrals – Bucks ICB Area

The information below relates to referrals for patients with a GP in the Bucks ICB area. (If you’re unsure which ICB area applies, check the lists available here.)

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 should be emailed using the EeRS/ Rego referral system.

For any technical queries regarding EeRS in Bucks ,please email rego.support@necsws.com

For EeRS login set up and training , send a request to rego.implementation@necsws.com

Here is a youtube demo link for EeRS/ Rego which will help with understanding the features and navigation of EeRS/ Rego system.

As you are aware, Operose took the decision to cease providing all ophthalmology services locally and nationally in March 2023. All Operose patients have been transferred to the new provider, Buckinghamshire Healthcare NHS Trust (BHT).

NHS BOB ( Buckinghamshire, Oxfordshire, Berkshire West ) ICB have been working with BHT and colleagues from the LOC to support safe transfer of service which is now complete.

Please continue to refer as per your existing routes – EeRS/Rego for routine referrals & NHSmail for UBOC ( Urgent Booked Ophthalmology Clinic – previously known as EyeCasualty)

For more detailed local information on referral pathways in Mid & South Bucks, please download the December 2024 version of Eyecare Pathways Mid & South Bucks 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

All Cataract referrals in Bucks should be sent via EeRS/ Rego.

This applies to cataract referrals intended for Stoke Mandeville Hospital and for all the approved ISPs.

Practitioners are advised to refer to the latest BOB ICB cataract referrals threshold document (January 2024) to confirm that patients meet the required criteria for referral.

All cataract referrals in Buckinghamshire are processed through a single point of access (SPoA) that is accessed via Rego. This service is provided by Ufonia, an autonomous telemedicine company that conducts clinical conversations with patients over the telephone in plain English using an autonomous system named DORA.

Direct referral to independent service providers is no longer possible for patients registered with Buckinghamshire GPs, and all referrals should be processed through Rego.

Once you have referred your patients, you can tell them to expect a call from DORA. They should get a text advising when the call will take place – usually giving around 48 hrs notice, and they will need to answer some questions, following which DORA will direct the patients to their provider of choice.

If after 3 attempts, DORA is unable to get through to the patient, then by default, patients will have their referral sent to Stoke Mandeville Hospital.

Waiting time for Stoke Mandeville (at Jan 2024) is currently 8-10 weeks from referral to surgery. Most cataract operations now take place in the standalone cataract theatre. Watch a virtual tour of the cataract theatre and the patient journey. Toric IOLS and /or immediate sequential bilateral cataract surgery (ISBCS) is offered to those patients who are deemed as suitable.

Patients may exercise their right of choice, and be seen outside the area. The ICB website has a page listing all the cataract providers and their current waiting times, which is updated regularly.

For cataract referral queries – such as referral sent to wrong provider or a missed Dora call – optometrists and patients may contact Ufonia directly via bobicb.dora@nhs.net

Further Information

Cataract Post-op Portal

As of June 2024, patients attending for cataract surgery at BHT will be given a printed letter to take their optometrist when attending the post-op refraction appointment. The letter will have their unique PIN code and a link to the secure Medisight Portal. This is to enable BHT to collect post-op visual acuity and refractive outcome data. A fee of £10 per return will be paid by the ICB. Invoices should be emailed to NHS SBS at sbs.apinvoicing@nhs.net ,following the same procedures as for the Direct Cataract referral invoices. An updated template invoice is available to download.

Please note: This portal is NOT for referring patients. It is purely for collection of cataract post-op data. All referrals should be sent using appropriate existing referral pathways.

For further details see the letter from Buckinghamshire NHS Trust here.

Glaucoma

Following NICE guideline NG81 (November 2017) ophthalmologists working in Buckinghamshire Healthcare NHS Trust agreed that patients should now be referred to BHT on IOP >= 24 mm Hg (instead of the previous threshold of >21 mm Hg), in the absence of any other signs.

The Bucks IOP repeat readings scheme ceased in October 2020. 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.

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.

A new document on Referral Information for Stoke Mandeville Eye Casualty was produced in March 2022. Urgent referrals should be sent via Rego, clearly marking it as Urgent by selecting the urgent option. Emergency referrals should be referred by email to buc-tr.buckseyecas@nhs.net. Please use the associated SMH eye casualty referral form.

Please note:

Stoke Mandeville hospital have an urgent booked ophthalmology clinic (UBOC) which was previously called Eye Casualty, and DO NOT provide a walk-in service.

They are not staffed to provide a Walk-in Service and can only offer booked urgent appointments 7 days a week.

Wet AMD referrals

For suspect wet AMD referrals, please download the rapid access referral form and send it via Rego using the Wet AMD option.

Visual Processing Difficulties (VPD) Clinics for Children Aged 7+

We would like to make you aware that Buckinghamshire Healthcare NHS Trust runs Visual Processing Difficulties (VPD) clinics for children aged seven and above.

These clinics are held at Stoke Mandeville, Amersham, and Wycombe hospitals.

The clinics are designed to support children with reading difficulties and include assessments for:

Visual stress
Visual tracking problems
Visual perception skills

If there are concerns about possible VPD, referrals can be made by a local optometrist, GP, or Occupational Therapist (OT). Optometrists should send the referral via REGO, to the Orthoptics department, requesting an assessment in the Visual Processing Difficulties clinic.

Attached are a VPD information leaflet and poster, which you are welcome to display or share as needed.

Low Vision

Weekly low vision clinics are held at Stoke Mandeville Hospital, Amersham Hospital and High Wycombe hospital. The service supports both adult and paediatric patients with any eye condition causing vision loss.

Optometrists can refer patients to the low vision clinic via Rego. Referrals are triaged according to urgency. Patients are usually contacted within 2-4 weeks and offered a low vision assessment at their most local site within 4-6 weeks.

Where appropriate, patients may be referred to the Eye Care Liaison officer (ECLO) for emotional support, onward referral and signposting.

Ocular Prostheses

The National Artificial Eye Service provides a manufacturing and fitting service for the supply of ocular prostheses to all eligible patients throughout England.

The National Artificial Eye Service is part of the NHS. Patients who wear an artificial eye or cosmetic shell and are eligible for NHS treatment should be referred to them via the GP, where they can have the prosthesis checked and polished and be provided with a replacement when necessary.

Further information can be found on their website: https://www.naes.nhs.uk/

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. For enquires, you can call the Private Patient’s Office number :01296 315131

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.