Transcript Direct Cataract Referrals

Dudley Direct Cataract Referrals
Optometrist Accreditation for
Cataract choose and book
Presented by:
Sue Lane, Dudley PCT
Humphrey Yorke, Dudley LOC
Charles Barlow, Dudley LOC
19th April 2005
Direct Cataract Referrals
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Understanding “Choose and book”
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Assessing Patient eligibility
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Patient Choices
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Administration
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Following up the booking
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Payments
Patient Choices
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What?
Where?
When?
Patient choice if they want surgery
Patient choice of provider
Patient choice of appointment date
Patient Choice Decisions
1.
2.
Patient Does Not want to proceed with
surgery
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Choice of provider not required
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Noted in records (including score from clinical guidelines)
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GP informed
Patient Wishes to proceed with surgery
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3.
Choice of provider offered
Patient wishes to take time to consider
surgery
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Choice of provider offered
Helping the patient to choose
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Discuss general information on cataract
surgery
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Issue RNIB leaflet Understanding Cataract.
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Issue NHS Leaflet A Guide to Choice &
Booking in Cataracts
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Issue Cataract Provider Information Leaflets
Patients wanting to choose later
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Ensure patient’s contact information is correct
Patient goes away and discusses with family
and friends and thinks about choice
Patient then contacts Optometrist with choice
If patient has not chosen after 7 days –
Optometrist must contact patient for decision
If patient cannot be contacted or fails to
choose, then annotate records accordingly
Patient Chooses Provider
1.
2.
3.
4.
Referral Form C1 Completed
Patient completes and signs reverse of C1
Optometrist advises patient to telephone
provider and book their own appointment at a
suitable time.
Patient contacts chosen hospital for
appointment.
Administration
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Completed C1 is faxed to provider ASAP after
choice decision
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Completed C1 is also faxed to GP
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GP will then complete form C2 & forward to provider
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C1 is photocopied for payment submission
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Original C1 is stored with the patient record for
audit purposes.
Following up the booking
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If the Patient fails to make a booking, the
provider will contact the patient.
If patient declines appointment, the provider
will notify optometrist.
The Optometrist must then contact the patient
within 7 days to discuss re-referral.
Optometrist informs Provider & GP of new
decision
Fax original C1 back to provider, clearly
annotated re-referral
Payment
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C1 is photocopied (confidential clinical
information can then be removed)
Collate C1’s in batches for forwarding to PCT
with GOS1’s
Complete 2 GOS Voucher scheme forms as
per GOS1’s
Post/Deliver to usual PCT address
Payment will be made the following month.
Patient Choice Pathway
GP sees patient with cataract and refers them to an accredited optometrist OR
Patient attends routine eye examination with non-accredited optometrist and is referred to an accredited optometrist
Accredited optometrist undertakes sight test.
Optometrist identifies whether surgery would be
beneficial & if the patient wishes to proceed with
surgery and if the referral guidelines are met
Patient wishes to proceed with surgery
Patients not wanting surgery Noted in records and GP notified
Patients not wishing to make choice immediately
The patient’s telephone/contact information is checked to
ensure they can be contacted.
Choice information given to patient.
Choice information given to patient.
Patient discusses choice with family and friends
Patient Makes choice of provider
Patient contacts the optometrist to inform them of
choice.
Optometrist completes Referral form C1 & faxes to
provider ASAP
Patient signs reverse of C1 to confirm choice
offered and consenting to referral & information
exchange
Optometrist informs patient to book appointment
directly with appropriate provider.
Patient not chosen
Optometrist contacts patient after 7 days.
Patient cannot be contacted or fails to choose
Annotate records, no further follow-up required
The patient contacts the chosen hospital to book
the appointment at a convenient time
F A Q ‘s
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Does The Patient have an NHS ST if referred
from a non accredited Optometrist?
Yes – If they are entitled –
Only if referred from another practice
Do they have to be dilated?
That is entirely at the discretion of the
practitioner – A routine examination is required
as per the College guidelines on best practice.
F A Q ‘s
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Can we refer Diabetics?
They can be referred through the scheme if
there is no Retinopathy. If there is Retinopathy
they should be referred through the normal
pathway explaining direct referral is not
appropriate
Do I have to follow up the patients myself?
At the discretion of the practitioner – it may be
delegated to a member of staff.
F A Q ‘s
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What happens to Optometrists new to the area
or newly qualified Optometrists?
Any Optometrists can be accredited by
attending an accreditation session. These will
be held at least 3 times a year and details can
be obtained from the PCT or the LOC
Can Locums be accredited?
Yes, as long as they attend an accreditation
session.
F A Q ‘s
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What do we do for patients who come to see
us who do not live in Dudley?
Exactly the same
You offer them the choice of providers in their
area – on the sheet in the info pack for the
whole of the BBC region.
Faxing the C1 and your claim for payment in
the normal way
F A Q ‘s
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Why hasn’t my patient received an
appointment yet?
Because they haven’t phoned for an
appointment – did they forget? or did you forget
to RE-INFORCE the point?
THE OPTOMETRIST MUST ENSURE THE
PATIENT UNDERSTANDS THEY HAVE TO
PHONE TO BOOK THEIR OWN
APPOINTMENT
F A Q ‘s
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Any more questions?
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Any further queries contact myself or Sue Lane
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Do not forget to hand in your completed
accreditation forms
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Thank you & Goodnight