GPs lose points in retinopathy testing delays

Delayed implementation of retinopathy screening services in at least a third of PCTs is putting patients' health at risk and costing GPs quality points.

One hundred and twelve PCTs in England failed to reach the NSF target of 80 per cent of diabetes patients being offered annual retinopathy screening by March 2006, a recent report on the NSF for diabetes showed. Five PCTs in Hampshire, Surrey and Sussex are not offering the service at all.

Guildford and Waverley PCT failed to offer adequate retinopathy screening to any of its 6,819 diabetes patients last year.

In a report submitted to the House of Commons' Health Select Committee NHS deficits inquiry, the charity Diabetes UK said the fault lay at SHA level.

Surrey and Sussex SHA has delayed release of funds for retinopathy equipment to PCTs due to an expected £83 million deficit. This is despite SHAs across England receiving the final instalment of the £27 million ring-fenced for implementation of the service last year.

GPs are concerned that they are being penalised financially for not being able to refer diabetes patients for retinopathy, which is worth up to five points under the quality framework.

Wendy Lockwood, spokeswoman for Guildford and Waverley PCT, said that the PCT had negotiated arrangements to make sure GPs were not penalised by the delays. But Dr Julius Parker, medical director of Surrey and Sussex LMC, said that he was unaware of any negotiations.

He wants GPs to be able to exception report diabetes patients for retinopathy screening. He wrote to the PCT in early May requesting clarification, but has not received a reply.

'I have not yet had confirmation that GPs will be able to exception report if the service is not available,' he said. 'Although, obviously, I would be delighted if that was the case.'

He is also concerned that patients are being forced to pay local opticians for retinopathy instead of receiving treatment on the NHS.

Dr Ruth Milton, director of public health at the PCT, said the delays were partly due to the development of a plan for a screening programme for the whole of Surrey and Sussex.

'Implementation has now started and will be rolled out over the coming months,' she said.

This could mean that the December 2007 NSF target of offering retinopathy to all diabetes patients will be met.

'We are hoping to be able to reach it,' said Dr Milton. 'But there are issues around staff, training and IT programmes.'

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