Comment from LOC
As of 1st November, 2025 the Cov/Warks ICB has decommissioned the Optometry CUES/MECS schemes.
Below, we have copied the signposting referral pathways that the ICB dictates (with little consultation with the LOC) for a patient that presents to you that you have not examined. The LOC strongly advises its members to reflect on whether a slit-lamp examination will be necessary by the diagnosing Healthcare Professional. If you feel that a slit lamp examination will be necessary for accurate assessment of the patient then the only pathway available to you is UHCW Eye Emergency, as no Pharmacy and few GP’s have the Slit-lamp access/skillset required.
Should you have examined the patient, please be aware that the appropriate pathway from Cinapsis / Ophthalmology Coordination Service (OCS) could be used for routine referrals. Urgent referrals should be directed to UHCW as the Urgent Referral pathways on Cinapsis/OCS may not have the urgency that you require. I.e. Weeks/Months rather than days.
For weekend & out of hours Emergency patients, please be aware of the current limited service from UHCW. This means that your only viable pathway outside the times highlighted below would be to a normal A&E or minor injuries. In the following briefing, the ICB have not commented on whether Optometrists should continue to try to contact the on-call Ophthalmologist via telephone in an Emergency or just send the patient directly to A&E. Under these imposed conditions, you may feel it prudent to just send your patient to the nearest A&E.
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ICB Referral Pathways Communication 13/10/25:
Subject: Changes to Minor Eye Conditions Service (MECS) and Community Urgent Eyecare Service (CUES) in Coventry and Rugby and South Warwickshire
To: All Coventry & Warwickshire Opticians
Dear Colleagues,
We wrote to all Coventry and Warwickshire opticians on 6th October to outline important changes to the provision of care for patients with minor eye conditions in Coventry, Rugby and South Warwickshire. From feedback received, we would now like to offer further clarity on expected signposting pathways for patients accessing an optometrist as their first point of access.
Signposting pathways
Patients presenting or trying to book an optometry appointment with the following symptoms should be signposted to their local pharmacy or their GP:
- Dry eye
- Gritty eye
- Red eye (isolated, no pain)
- Mild blurry vision (if outside of remit of GOS sight test)
- Non-specific irritation
- Watery eye
Patients presenting or trying to book an optometry appointment with the following symptoms should be signposted to the UHCW emergency eye referral service using the patient phone line (0247 696 4800) or online patient booking system (Swiftqueue):
- Red eye with pain/photophobia
- Painful eye
- Flashes and new floaters
- Pronounced blurry vision (if outside of remit of GOS sight test)
- Diplopia
- Distorted vision
- Sudden loss of vision
- Mild trauma (superficial, blunt, non-penetrating injuries)
Ophthalmology Coordination Service (OCS)
The OCS do not accept referrals for minor eye or emergency eye conditions. Please follow the appropriate pathway. Guidance can be found on the Coventry and Warwickshire Local Optometry Committee referral pathway page (Referral Pathways).
Alternative Services
The following options are available for patients with minor eye conditions. These recommendations are intended to support signposting and clinical decision-making and can be shared with appointments teams and reception staff to guide patients appropriately:
- NHS 111: Patients should contact NHS 111 for initial advice regarding minor eye concerns and can be directed to the most appropriate service. We have worked with NHS111 to update our local Directory of Service.
- Pharmacy: Pharmacies can provide advice and sell over the counter treatment for minor eye conditions. 180 out of 182 local pharmacies also participate in Pharmacy First where minor eye conditions such as lid conditions, allergies, dry eye, and minor irritants are included in our local minor ailment pathway following referral from a GP.
- General Practice: GP practices can manage some minor eye conditions in accordance with national guidance (Common eye condition management – Moorfields Eye Hospital). GPs can also refer to Pharmacy First via the minor ailment pathway or onto eye casualty if the eye condition is deemed more serious.
- Optometrist: Local optometrists remain available to provide NHS-funded eye tests Optometrists may also refer to pharmacy or directly to hospital eye services for more serious eye conditions.
- UHCW Eye Casualty: For more urgent or serious eye conditions, patients can access UHCW Eye Casualty via the Emergency Eye Referral Service. This can be done via the online booking platform (Swiftqueue) or by calling 0247 696 4800. The phone line is open Monday–Friday (excluding bank holidays) 9am–1pm and 1.30pm–5pm, and Saturday 9am–12pm.
- Out-of-Hours Emergencies: Patients should attend their closest Minor Injuries Unit or Accident & Emergency Department (A&E) for urgent eye problems outside normal hours.
If you have any questions, please email cwicb.systemtransformation@nhs.net
Thank you for your attention and cooperation.
NHS Coventry and Warwickshire Integrated Care Board
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