Referral Pathways and Enhanced Services

Overview:

Following a patient safety incident, where an urgent/emergency referral is made to a GP, we want to remind referrers that this should be accompanied with a phone call to the GP practice to avoid any delays in the patient receiving care. Please share this with all referrers working in your practice.

In this sections you will find Enhanced Services and Referral Pathways for Eastern Cheshire, Vale Royal and South Cheshire.

SERVICES BY AREA

The preferred and fastest pathway is via OPERA. This pathway links into GP and hospital email accounts and gets the referrals to the correct clinics avoiding unnecessary delays.

If you do not have an OPERA account please contact us or

http://help.optom-referrals.org

Opera screenshots for paediatric orthoptic referrals

OPERA Service guides for Practices and Practitioners

OPERA Local Service Summary One-Pagers

Please be aware; protocols required are dependent on where the Patient’s GP is located. If you are unsure of where a particular GP Surgery is, please click this link: Find GP

Please only include patient identifiable information from an NHS email account. Otherwise phone. Emailing patient identifiable information from a non- NHS email account breached GDPR.

Click on the underlined headers (links) below to be directed to the appropriate Enhanced Services and Referral Pathways in your area:

Cheshire CUES Pathway

SPoA: Single Point of Access:

Full information on rollout click here

Key information:

All emergency referrals bypass SPoA. All referrals through extended service pathway e.g. enhanced pre cataract, GRR & CUES bypass SPOA.

All SPoA referrals (routine and urgent) are clinically triaged by a team of specialist optometrists; routine referral patients will be offered a choice of provider. They will then receive a text and/or letter with a link to select their chosen provider - please see ‘Patient Information Resource Leaflet’

Glaucoma Related:

Cheshire Glaucoma Repeat Readings Pathway

If pressures are over 24, there is a difference between the eyes of 5mmHg and/or a field defect please refer to the GRR pathway. If this pathway is not followed the direct referral to the hospital may be rejected.

(S6) Service Summary Cheshire Glaucoma service

The service is designed to manage those glaucoma, glaucoma suspect and Ocular Hypertensive patients, already within the Hospital Eye Service, who were considered to be stable and low-risk, with the aim of freeing up consultant-led outpatient appointments for new referrals and complex cases.

Suitable patients are referred into the service by their consultant. The use of protocols and pro formas ensures that all patients receive a comprehensive, standardised assessment with the results uploaded to the OPERA platform to be added to the patients long term ocular notes. This information is reviewed and updated at every visit, as appropriate, and is analysed by the examining optometrist who has been accredited to the WOPEC level 1 & 2 glaucoma certificate. Patients referred to the community glaucoma, OHT clinic remain the responsibility of the referring consultant and are referred back if:

• The IOP becomes raised above the target IOP

• There is glaucomatous progression of the optic disc, visual field or retinal nerve fibre layer

Cataract Related:

Central Cheshire Cataract Referral Pathway Nov 2023 edition

Eastern Cheshire Cataract Referral Pathway - Nov 2023

Western Cheshire Cataract Referral Pathway - Nov 2023

COCH Post Cataract Service Leaflets for Information:

https://www.loc-online.co.uk/cheshire-loc/wp-content/uploads/sites/8/2020/11/Post-Cataract-Pathway-Protocol-FINAL-1.pdf

https://www.loc-online.co.uk/cheshire-loc/wp-content/uploads/sites/8/2020/11/Cataract-post-op-leaflet-v2-1.pdf

Mid Cheshire Hospitals YAG Laser patient video : https://www.mcht.nhs.uk/our-services/ophthalmology-eye-care-centre/fast-track-yag-pathway

Diabetes Related:

Diabetic Eye screening Service: https://services.eastcheshire.nhs.uk/cheshire-diabetic-eye-screening-programme

Cheshire Diabetic Retinopathy Grading and referral criteria for reference

Other:

Eyecare medical

eyecare.medical@nhs.net

Sight Loss Information Line - 01244 478910

If you have a patient who needs sight loss support you can refer them to the Sight Loss Information Office. Fill out the referral form and email it to referrals@visionsupport.org.uk and the Sight Loss Team will give the patient a call.

Vision Support External Referral Form

Through My Eyes: What If You Were the Patient? By Daniel Morgan-Williams, Founding Director of Visualise Training and Consultancy

What if you walked into your own optician’s practice and suddenly couldn’t read the signs, see the forms, or find your way to the chair? This article challenges eye care professionals to step into their patients’ shoes and discover why accessibility, empathy, and practical solutions are just as vital as prescriptions.

Commonly Asked Questions:

Charge & Supply of Chloramphenicol:
It’s usually only POMs that are given free of charge only to under 2s or if the patient has a general NHS exemption. Anything [P] / OTC the patient should be purchasing. The other exception is if the patient is likely to come to harm by not purchasing the medication, which is very rare in the conditions we prescribe for.
For Chloramphenicol:
So if it’s for bacterial conjunctivitis then the medication is classed as a [P] and the patient is expected to purchase this. The exception is under 2 it is given free of charge.
If it’s for a prophylactic reason like abrasion or FB removal, then it becomes a [POM] and the patient needs to buy it from the practice. However with it being a POM, If they have an NHS exemption such as universal credit then it’s issued at no charge.