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Community eye health services could ease A&E pressures


10 March 2015

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Charlotte Booth, senior commissioning programme manager, NHS Heywood, Middleton and Rochdale (HMR) CCG, explains why a minor eye condition service has proved popular with A&Es and GPs

Enabling patients to visit high street opticians for the treatment of minor conditions is convenient, often cheaper and takes the pressure off secondary care and community-based, consultant-led services, such as the HMR Ophthalmology Clinical Assessment and Treatment Services (CATS).

Charlotte Booth, senior commissioning programme manager, NHS Heywood, Middleton and Rochdale (HMR) CCG, explains why a minor eye condition service has proved popular with A&Es and GPs

Enabling patients to visit high street opticians for the treatment of minor conditions is convenient, often cheaper and takes the pressure off secondary care and community-based, consultant-led services, such as the HMR Ophthalmology Clinical Assessment and Treatment Services (CATS).

With an estimated 270,000 A&E visits and GPs using up 4.5 million appointments on eye problems, it makes good sense to free up the time spent in surgeries and at hospitals by using the skills and availability of optometrists in high street practices to quickly treat patients at convenient locations with evening and weekend appointments.

In Heywood, Middleton and Rochdale, commissioners worked with the local optical committee to develop a minor eye conditions service. The free NHS scheme offers a walk-in service and patients can be referred by doctors, pharmacists, A&E and the hospital eye service. The service is also listed on the NHS 111 directory.

Meeting the aims

The service has proved highly popular with patients – almost two thirds self-refer – and has met its prime aim to reduce hospital/CATS referrals for minor eye ailments, with just under 20% requiring referral on to secondary care/CATS. Patient satisfaction is extremely high with almost 97% indicating they would recommend to service to someone else.

Eye health doesn’t get the attention most clinical commissioning groups (CCGs) often pay to other big programme spends, yet costs have spiralled by 90% in the past 10 years from £1.2 to £2.3 billion. Meanwhile, ophthalmology remains the second largest outpatient group in the NHS, hospital capacity is stretched, and the aging population can only add more pressure.

Yet, as part of the patient-centred, preventative healthcare system we are being urged to deliver, a community-based eye care service that can make substantial financial savings and free up much needed capacity in hospitals while reducing pressure on both A&E and on GP appointments.

Just 58 CCGs have a MECs scheme covering 14 million people. This means that 39 million are not covered by such a scheme and almost three quarters of CCGs are not reaping the benefits of reducing pressure on secondary care/CATS, on A&E and on GP appointments.

A series of pathways which 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.

For more information about community-based eye health schemes, contact Katrina Venerus, Managing Director of Local Optometrist Committee Support Unit, katrina.venerus@locsu.co.uk.or visit www.locsu.co.uk/community-services-pathways.

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