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Blog: Community glaucoma service offers impressive benefits


25 February 2016

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Head of commissioning at West Cheshire CCG, Helen Ashcroft, explains how a glaucoma repeat readings service delivered by community optometrists can deflect up to 70% of patients from secondary care, making it a cost-effective service and allowing hospitals to concentrate on the most urgent and serious cases.

Head of commissioning at West Cheshire CCG, Helen Ashcroft, explains how a glaucoma repeat readings service delivered by community optometrists can deflect up to 70% of patients from secondary care, making it a cost-effective service and allowing hospitals to concentrate on the most urgent and serious cases.

Glaucoma is a leading cause of irreversible blindness and half of all sight loss is preventable. In the UK, nearly 500,000 people suffer from glaucoma and it accounts for 14% of all those certified as blind. With an ageing population, levels are set to increase. The economic cost of blindness, estimated at £22 billion per year, will rise significantly unless eye health services are redesigned.

The aim of a glaucoma repeat readings pathway is to reduce false positive referrals to the hospital eye service. Prior to its introduction in April last year, optometrists had to refer all patients with suspect high eye pressure to hospital. Since the introduction of the service, around 70% of patients going through the service remain in primary care and evidence from similar pathways nationwide show hospital referrals reduced to just under a quarter.

Enabling patients to visit their high street opticians for glaucoma repeat readings is cheaper than an ophthalmology appointment. In terms of cost effectiveness, data from West Cheshire Clinical Commissioning Group (CCG) shows that a basic appointment cost of £34 in primary care measured against a first appointment of £111 in secondary care, translating into a significant saving across the service.

The pathway is delivered through a network of 16 local optical practices that are part of the local optical committee (LOC). The LOC formed a not-for-profit eye care company so there is just one contract meaning the fee paid by the CCG includes all administration, governance, clinical accreditation, data collection and reporting on key performance indicators.

The speed of the service, with patients seen within four weeks and many practices open weekend and extended hours, means that patient anxiety is reduced, as well as the sheer convenience of appointments in your local high street.

A series of pathways that cover a number of common eye problems has been developed by the Local Optical Committee Support Unit (LOCSU), an organisation that promotes the role optometrists and opticians to work together with local commissioners to design and add value to local eye health pathways, making services accessible for patients and cost-effective for the NHS.

Helen Ashcroft, head of commissioning at West Cheshire CCG.

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