Local Pathways and Protocols:
Frimley ICB area:
The following locally commissioned services are in operation within the Frimley ICB area and are processed via the OPERA electronic referral platform:
Pre Cataract Enhanced Cataract Referrals
Frimley ICB Enhanced Cataract Referral Service Summary April 2025 V2
Enhanced Cataract Referral Service Guide for Practices and Practitioners
Patient_Information_and_Support_Requirements_forCataract_Surgery_HFAC_2025
Post Cataract Refraction (Frimley Trust, and local Independent Service Providers (ISP) such as Optegra and Spa Medica)
Frimley Trust Post-Cataract Service V1.0 June 2023
Slides from Frimley Trust post-op launch event November 2023
Frimley (Frimley Health NHS Foundation Trust) Service Summary- Post-operative Cataract Service 2025
Post-Operative Cataract Service Guide for Practices and Practitioners
Optegra Service Summary – Post-operative Cataract Service 2025
Spa Medica Service Summary – Post-operative Cataract Service 2025
Wet AMD referral via the GOS 18 function on OPERA
Frimley ICB Direct Wet AMD Referral Service Summary April 2025 V2
Direct Wet AMD Referral Service Pathway & Protocol
Glaucoma Repeat Readings (GRR)
Frimley ICB GRRS Service Summary April 2025 V2
GRR Pathway & Protocol IOP only
Glaucoma Repeat Readings Service Guide for Practices and Practitioners
Frimley Service Summary – Glaucoma Repeat Reading Service August 2025
Cataract Policy for Frimley ICB:
When referring a patient for first or second eye cataract surgery the following thresholds must be met to ensure that surgery is a cost effective intervention:
The cataract must be sufficient enough to account for the visual symptoms experienced by the patient and all other possible causes for the visual symptoms should be excluded prior to referral.
AND
The visual acuity is 6/12 or worse in either eye
OR
The cataract and visual symptoms experienced by the patient should be negatively affecting the patient’s quality of life and activities of daily living such as:
Significant glare or dazzle in daylight due to the opacities
Difficult with night driving due to the opacities
Difficulties reading due to significant anisometropia or aniseikonia
Management of other coexisting eye conditions such as Glaucoma, Diabetic retinopathy (ungradable photograph)
Refractive error changes due to cataract
It is important that a shared decision making process has taken place prior to cataract referral this should include:
How the cataract affects the person’s quality of life and how this may be impacted by not having surgery
Whether it affects one or both eyes
Where spectacles have not helped and the patient wants to have cataract surgery
Risks and benefits of surgery should be considered and discussed fully prior to surgery
Surrey Heartlands ICB area:
The Surrey Heartlands ICB was formed in 2022 with the merger of former CCG areas which include, East Surrey, NW Surrey Alliance, Surrey Downs and Guildford and Waverley as a result there are variations in locally commissioned services reflecting the former CCG boundaries.
The following services are in operation in some areas and are operated through the OPERA electronic referral platform:
Post Cataract Refraction (Kingston Trust and ISP such as Spa Medica and Optegra)
Post cataract assessment service_ Kingston hospital_Webinar 23.11.22 _updatedFINAL (1)
Post-Operative Cataract Service Guide for Practices and Practitioners
Optegra Service Summary – Post-operative Cataract Service 2025
Spa Medica Service Summary – Post-operative Cataract Service 2025
Pre Cataract Enhanced Cataract Referral (across all areas)
Enhanced Cataract Referral Service Guide for Practices and Practitioners
Surrey Heartlands Service Summary – Enhanced Cataract Referral Service May 2025
Ashford and St Peters Cataract Surgery
Patient_Information_and_Support_Requirements_forCataract_Surgery_HFAC_2025
Wet AMD referral via the GOS 18 function on OPERA (Surrey Downs and Guildford and Waverley areas only)
Glaucoma Repeat Readings (GRR)
LOCSU-Glaucoma-Repeat-Readings-CMG-Feb-2019-V1
LOCSU-Glaucoma-Repeat-Readings-diagram-Feb-2019-V1-5
Glaucoma Repeat Readings Service Guide for Practices and Practitioners
Minor Eye Conditions Service (MECS) (Surrey Downs and Guildford and Waverley areas only)
OPERA:
The OPERA electronic referral platform is operated by Primary Eye Care Services to access the referral portal click on the link below:
For further help and assistance with using OPERA click on the link below:
Or email: hello@referral.support