Intermediate Care Ophthalmology Service Debbie Raven, COO Dr Lyn Jenkins, Clinical Director
Download ReportTranscript Intermediate Care Ophthalmology Service Debbie Raven, COO Dr Lyn Jenkins, Clinical Director
Intermediate Care Ophthalmology Service Debbie Raven, COO Dr Lyn Jenkins, Clinical Director West Hertfordshire 1st October 2008 The Practice - company overview • Founded in 2005 by two NHS clinicians , headquartered in Gt. Missenden, Bucks and employs 100+ • Delivers innovative community based healthcare for the NHS straddling primary and secondary care • Pioneered provision of Intermediate care ophthalmology services and now the UK’s leading provider. • Provides ophthalmology services for Bucks, E & W Berks, W Herts, Kingston, Wiltshire and shortly Harrow • Also other specialist clinical services for GPs, the MOD and PCTs - Dermatology, Sexual Health, Urgent Care and Admission avoidance, and Secure Health • Operates a network of GP surgeries Ophthalmic Intermediate Care • Why refer • How to refer • What to refer Service background • Set up by Dr Lyn Jenkins − GP − 30yrs in ophthalmic primary care − 23yrs providing retinopathy treatment • Commissioned in Bucks for 8+ yrs • Became part of The Practice in 2006 • Now covers 4 counties & 2 London boroughs • Employ 12 ophthalmologists, 4 optometrists, 1 GPwSi, 1 orthoptist, 10 ‘back office’ • Experience shows 60-70% cases managed in primary care, 10% referred to HES Assured service delivery • All clinicians specifically trained in the delivery of Ophthalmic Primary Care • Triaged same day • Waiting times max 4 weeks • Integrated IT system • Comprehensive data reporting meets 18 wk pathway Patient benefits • Waiting times less than four weeks • Accessible, community based clinics • Choice of local clinics • Excellent patient feedback • All patients seen by experienced staff • Service sensitive to patient needs Patient satisfaction results Aug 2008 • 99% patients reported no problems with making an appointment • 90% patients were seen on time • 96% patients felt they had enough time with a clinician and their case was discussed adequately with them • 72% rated the clinic environment as excellent; 24% as good West Herts appointments 200 180 160 1st 140 1st Glaucoma 120 Follow up 100 Follow up VF 80 Follow up Glaucoma 60 Minor Op 40 Retinal Bio 20 0 Jan Feb Mar April May June July August W Herts referrals May-Aug 08 180 160 140 120 100 Hertsmere 80 StahCom 60 DacCom 40 20 0 May Jun July Aug HES referrals Jan – Aug 2008 250 200 150 Retained Triaged to HES 100 50 0 Jan Feb Mar Apr May Jun Jul Aug Referral time Time between referral and first appointment 1-5 days 5-10 days 10-15 days 15-20 days Where? Hertsmere PBC StahCom Potters Bar Community Hospital St Albans Midway Surgery Highfield Surgery Parkbury Surgery Hertfordshire Clinic Elstree & Bushey Heath Schopwick Surgery Borehamwood The Grove Radlett Red House London Colney 45 Kings Road Harpenden Memorial Hospital DacCom WatCom Tring Rothschild House Surgery Watford tbc How to refer? • GPs/Optoms refer directly to: The Practice Ophthalmology Service − Fax 01494 473169 − Post to The Practice Ophthalmology Service, Lynton House, 43 London Road, High Wycombe, Bucks HP11 1BP − email to: [email protected] • Triage same day • Appointment Or • Onward referred to HES via Choose and Book • Letter to GP within 10 working days NOTE WATCOM: No direct referrals from Optoms but via GP Presenting complaint – what we see • Flashing lights/floaters 25% • Glaucoma 20% • Blurred vision 17% • Red eye 10% • Dry eye/pain 7% • Lid lesion 5% • CL 3% • Other – mac/conj/cat 13% What to refer? (glaucoma type) What to refer? (refer to full list in leaflet) • Red eye • Discomfort • Visual disturbance • Watering What not to refer? • Minor red eye conditions manage by GP in primary care What not to refer? • Emergencies (<48 hrs) Send to A&E • In patient surgery or laser • Cataract surgery • Under 16s Refer to HES What not to refer? • Diabetic retinopathy • Retinal detachment • Macular degeneration (with recent visual symptoms) • Contact lens keratitis Information from referrer • Presenting complaint • Past ocular history (squint, eye operations, trauma, contact lenses etc) • Past medical history including drugs • Abnormal findings • GOS 18 when available, fully completed Thank you on behalf of The Practice