Viewpoint: Eye services are more accessible than ever - but not for everyone

Changes to how eye health services are delivered across the country are making it easier and more cost effective for GPs to access treatment and care for their patients writes Katrina Venerus, managing director, Local Optical Committee Support Unit (LOCSU).

Ms Venerus: 'Referrals for suspected glaucoma have improved and the CCG made £15,000 savings.'
Ms Venerus: 'Referrals for suspected glaucoma have improved and the CCG made £15,000 savings.'

But community eye health services are still not universally available.

Patients who present to GPs with eye health problems often need to be referred to centres that have access to specialist equipment and skills, rarely found in GP practices. In general this means a referral to a hospital, with associated costs and often a lengthy wait for the appointment.

This is a rising challenge for the NHS due to the aging population and an increase in demand for eye health services. Over 50% of sight loss can be avoided, and untreated eye problems mean a risk of greater isolation and more falls, all with consequences for NHS budgets.

Instead of relying exclusively on hospitals, CCGs in some areas are working with Local Optical Committees to redesign local eye care pathways. These community services cover a range of treatments and management, including cataracts and glaucoma, as well as specialist care for people with learning disabilities and low vision.

CCGs from across the country have already started seeing benefits from the new approach to eye care services. CCGs in Sefton, Merseyside, with support from the Local Optical Committee Support Unit (LOCSU), are using the new pathways to improve glaucoma referrals, treat more patients and deliver savings for the NHS.

Instead of reaching only 190 patients per year through the previous Intraocular Pressure Repeat Readings Service, the redesigned service will reach up to 1,000. GPs in the area now know glaucoma repeat reading services can be provided locally, ensuring only serious cases are seen at hospital. This will save the NHS an estimated £96,000 annually through reduced costs of hospital referrals. In Birmingham and Solihull 1.5 million residents were routinely referred to secondary care, clogging up waiting lists at eye clinics. Realising the significant pressures on the NHS, one CCG in Birmingham led a redesign of ophthalmology services using the LOCSU pathway models.

The new service delivers a consistent standard of care across Birmingham. Referrals for suspected glaucoma have improved and the CCG made £15,000 savings in just three months. More practices are signing up to the service and multiple national groups are keen to join. Patients can now access eye health services locally, improving capacity at eye clinics, and reducing waiting times and journeys to hospital.

Yet, these local services are only available in a minority of areas in England. While waiting times in accident and emergency units in England are at a nine-year high, only 30% of Local Optical Committees in England have been commissioned to provide a minor eye conditions service or primary eye care acute referral scheme (PEARS). If more eye health services become available locally, CCGs will be able to deliver increasing savings and patients will benefit from more convenient local services.

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