Community Eye Care services: Introduction
For many years the Department of Health has been trying to encourage delivery of more routine and minor emergency eyecare outside the hospital, and into community optical practices. The aim of this is to free up capacity in the hospital, and to help cope with increasing demand from both the ageing population and new technologies such as wet age-related macular degeneration (AMD) treatments.
Here in Cornwall and the Isle of Scilly, community optical practices are successfully and safely delivering enhanced services as part of local eye care pathways which link into the hospital as appropriate.
This means that patients with a range of eye health problems are diagnosed, and often treated, by specially trained community optometrists situated in local practices, without the need to travel to hospital. This is the main advantage of this service, as getting to and negotiating a large hospital may be daunting, especially for old or frail patients. Other key benefits are:
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Increased choice for patients – they may be able to attend a practice close to home, or one with which they are familiar
- Speedy assessment – many practices can offer appointments within a few days.
- Convenient appointment times – many practices can offer weekend or evening appointments.
- Explanation of eye problems – most optometrists will have time to discuss eye health problems with the patient, and to answer questions, providing valuable reassurance.
Information on each of the community eye care pathways is provided below.
Post – Operative Cataract Pathway
After a cataract operation, where there have been no complications from the surgery and you don’t suffer from any other eye conditions, the hospital may give you a choice of accredited high street opticians practices who can perform your follow up appointment within 6 weeks after the operation.
This saves you from having to return to the hospital outpatients for follow-up. The Optometrist examines your eye to ensure that it has healed and to ensure there are no complications developing as a result of the surgery. Your vision is also checked at this appointment to ensure that you have a good visual outcome.
- Patient Cataract Journey
- Post Operative Cataract update (OCT 2016) http://www.primary-eyecare-cornwall.co.uk/uploads/8/2/5/6/82564694/post_op_cataract_update.key
GAT & OHT
- GAT referral form to other practice/practitioner. GAT intra practice referral form
- GAT & OHT Patient referral pathway and NICE guidelines. GAT and OHT service spec flow diagrams
- OHT Monitoring Scheme patient leaflet. Eye services for patients at risk of glaucoma
Minor Eye Conditions (MEC’S)
Aims of a MECS service
- A MECS consultation provides a timely assessment of the needs of a patient presenting with an eye condition (usually within 24 hours of the patient presenting to the practice if the condition is deemed urgent, or within 14 days if deemed non-urgent)
- Reduce unnecessary visits to the hospital eye service or A+E
- Reduce the pressure on GP practices
- Quick access to high quality eye services
- Appropriate and timely referral to the hospital eye service when necessary
Who can provide the service?
- Specially trained and accredited community optometrists and dispensing opticians.
What is a “Minor Eye Condition”?
Basically something that has changed with your eyes recently (usually within the last three days). This includes but is not limited to:
- Red eyes
- Sore/painful eyes
- Sudden onset of blurred vision or loss of vision
- “Flashes and floaters”
- http://pharmoutcomes/
- MECS Patient referral pathway: Overall MECs Pathway PDF
Emergency Eye Casualty
RCHT is happy for this form to be used in order to streamline the service and improve patient access. The form must be completed in full and emailed to rch-tr.emergencyeyeclinic@nhs.net using a secure NHS e-mail account and a copy must also be sent to the patient’s GP. Patients who are referred to the service should be given a ‘What happens next’ form.
- EEC Form – Click here.
- Email address: rch-tr.emergencyeyeclinic@nhs.net
WARM clinics
DeMac – Direct E-referrals to Macular service was launched in 2018. It has been designed in collaboration between Kernow CCG, the Local Optical Committee and the Royal Cornwall Hospital team. NHS England is happy for this to be used in order to streamline the service and improve patient access
The form must be completed in full and emailed to rcht.demac@nhs.net using a secure NHS e-mail account and a copy mjust also be sent to the patient’s GP. Patients who are referred to the service should be given a ‘What happens next’ form.
This initiative is for the referrals for patients with macular pathology only and it does not affect any other referrals to ophthalmology.
Once the referral is received, patients will first undergo retinal scans and photographs. These results will be analysed virtually 2-3 days later and based on the clinical findings, patients will then be booked urgently or routinely in to appropriate clinic to see a doctor or a specialist nurse. Patients who are not found to have any abnormality on scans and photographs will not be brought back into clinic.
LOW VISION
Low vision assessments and loans of LVAs, is a service provided by for the hospital by iSight Cornwall in Truro.
They offer Low Vision assessments throughout Cornwall. To be able to access this service a patient requires a referral from their optician or eye hospital consultant – iSight Cornwall are unable to book an appointment without one.
To complete a referral, you must have seen a patient with the last 12 months.
If the patient is under the care of RCHT their consultant can refer at their next appointment. You may also be able to request this over the phone.
Low Vision assessments are carried out by Tara Butler, who works with iSight Cornwall and the Opthalmology department as an Eye Clinic Liaison Officer (ECLO). If you have a patient that requires the services of an ECLO and not just a LV assessment please mark this on any referral sent, as a longer appointment is required.
iSight Cornwall Referral From.
Contact details for iSight Cornwall:
iSightCornwall
The Sight Centre
Newham Road
Truro
TR1 2DP
Tel: 01872 261110.
Email: info@isightcornwall.org.uk