Download For locums working in the Manchester area it is important to be

For locums working in the Manchester area it is important to be aware and
understand the many enhanced services that are in place. Below is a general
overview of the main services available. More information can be found on
the website (Manchesterloc.co.uk) in Practitioners info.
Cataract Info & Local Protocol
Criteria: Cataract scheme applies if patient is registered with a GP practice
within NHS Manchester.
Patients with a visual acuity of 6/9 or better in either eye are
considered a LOW PRIORITY for cataract surgery.
Cataract surgery will be commissioned only for patients who,
after correction have a visual acuity of less than 6/9 in their
cataract affected eyes.
Referral of patients with cataracts to ophthalmologists should
therefore be based upon three following indications;
1. Willingness to Undergo Surgery
1. Before referring, the optometrist or OMP will have discussed the risks and benefits
of surgery and ensured that the patient understands and is willing to undergo
surgery
2. Referral of patients for surgery should be based on the following indications:
2. Reduced Visual Acuity
1. Documented to be less than 6/9 in the affected eye (corrected), AND
3. Impairment of Lifestyle such as:
1. Patient at significant risk of falls
2. Patients VA affecting their ability to drive
3. Patients VA substantially affecting their ability to work
4. Patients VA substantially affecting their ability to undertake leisure activities such as
reading, watching TV or recognizing faces, OR
4. Anisometropia and/or Glare
1. Patients with cataract suffering significant functional disability from anisometropia
and/or glare. These patients will not be required to fulfill criteria
(2) and (3).
5. Ability to remain still and lie supine (flat on their back) for approx 20 mins.
· On May 1st 2012, the DVLA have revised their guidelines for drivers to include Visual acuity
6. Information regarding visual fields is available on the DVLA website.
If you are accredited for cataract referrals - conduct the full examination and counselling. If the
patient wants / is suitable for surgery, please send the completed cataract referral form printed
from Webstar to
[email protected]
using your NHS.NET email account.
A copy is sent to the patients GP. ( Manchester GPs ONLY).
The Referral Booking Management Service (RBMS) is now Manchester Integrated Care Gateway
(MICG) Burnage Community Healthcare Centre 347 Burnage Lane Manchester M19 1EW.
The new contact telephone number is 0161 443 0631,
The patient telephone number is 0800 092 4020
If If their GP is not a Manchester registered GP - please use a GOS18.
If you are not accredited for cataract referral, please ask the patient to contact an accredited
Optometrist to carry out the referral - but also inform the GP of your actions
Hospitals offering NHS cataract surgery.
Please see Practitioner info for list of accredited optometrists.
Diabetic Screen Scheme & Protocol
Screening for signs of diabetic eye disease is normally carried out by optometrists in this area, who
are accredited with the necessary qualifications. The method of screening is being improved by the
use of digital cameras to photograph the back of the eye. The camera scheme is operating across
several areas of Manchester.
You can choose to have your eye screening at any of the listed practices, the latest list is on the
Practitioner info tab.
If your practice is not listed, then you should continue to see your own optometrist for your sight
test, but you should visit one of the listed optometrists for screening, telling them that screening is
all you require.
Please see practitioner info for list of accredited optometrists.
Glaucoma information & Local Protocol
The Manchester Glaucoma Referral Refinement Service (GRRS)
What is the GRRS service?
This is a primary care optometry service for patients who are suspected, by their GP or Optometrist,
of developing non-acute glaucoma. It is provided by accredited optometrists with specialist
knowledge and skills at a local practice close to the patients home or place of work.
Who is eligible for the GRRS service?
All patients registered with a Manchester GP who present at an optometrist or GP with any suspect
signs of glaucoma or elevated intraocular pressure (IOP).
How do patients access the GRRS service?
Patients may be referred into the service from:
A non-accredited optometrist
A Manchester GP
What happens when I see the optometrist?
The optometrist will discuss the patients eye history, symptoms, risk factors and any related medical
history.
Patients should take their spectacles and a list of current medications to the appointment.
The optometrist will detect the presence or suspicion of glaucoma using specific tests relevant to the
signs/symptoms.
The patient will be found:
- to not to have glaucoma, nor be at risk of developing glaucoma in the foreseeable future and be
discharged back the care of their optometrist,
- or to have a diagnosis or suspicion of glaucoma and will be referred to the Eye Hospital (MREH) for
further assessment
The GRRS optometrist will notify the patients GP and referring optometrist about the outcome of
the consultation in order to ensure that medical records are updated.
A sight test will not be performed as part of the assessment and a prescription for glasses will not be
issued. However, where a referral originates with a GP it may be necessary to carry out a sight test
first. The GRRS optometrist will be able to give advice. Any patient that you suspect has glaucoma or
raised pressures (taking into account the advice regarding age and pressures) should be referred to
an accredited Optometrist for further assessment.
Please see practitioner info for list of accredited optometrists.
Macular degeneration + WET AMD protocol
Manchester Royal Eye Hospital has developed a new service to streamline and improve the access
for patients requiring an urgent review of their macula. This has previously been done through the
Macular Assessment Referral Refinement (MARRC) clinic and was primarily focussed on AMD
patients. However, we recognise that with continuing development in macular treatments and other
diseases being treated urgently such as central retinal vein occlusion and myopic CNV there was a
need to alter the referral guidelines and improve access for patients.
From week commencing 11th May it will be possible for you to refer all patients in whom you have
concerns about the macula urgently to the new EMAC (Emergency Macula) Service.
The referral guidelines can be found in the Practitioner Info Tab.
All patients in whom you are concerned that the macula may need urgent assessment and treatment
may be referred through this service.
Please use the contact details contained in the EMAC service referral guidelines in the practitioner
info tab to make an urgent appointment for the patients while they are in your practice. If seen out
of hours or on a weekend please take urgent contact details from the patient and call the next
working day. The patients will have a rapid access appointment in which the aim will be for them to
be assessed urgently using OCT and appropriately triaged by our specialist optometrists either to an
urgent macular treatment centre appointment for intravitreal therapy if necessary or routine
outpatient clinics for less urgent pathology or for monitoring.
The Manchester Red Eye Service
You can now get walk-in assessment and treatment for red, sore or itchy eyes through your local
optometrist.
What is the Red Eye Service?
This is a free service available to all patients over the age of 12 years who are registered with a
Manchester GP.
The service provides a patient experiencing recently occurring red eye conditions with appropriate
treatment closer
to home or work.
The service is provided by accredited optometrists (also known as opticians) with the specialist
knowledge and skills
to carry out this work at a local optometry practice.
Eye conditions which can be treated in the Red Eye Service.
The service is designed for recently occurring medical eye conditions such as:
•Red eye/s or eyelids.
•Significant recent discharge from or watering of the eye.
•Irritation and inflammation of eye/s or eyelids.
•Stye – infection at the edge of the eyelid.
•Tear dysfunction – dry eye.
If you are unsure whether your symptoms qualify, please contact one of the optometry practices
who can advise you.
How do I access the Red Eye Service?
A list of practices providing the Service is found on the Practitioner info tab.
Please be aware that your normal optometry practice may have chosen not to offer this service.
You can contact any of these practices directly (self-refer) to make an appointment and ask to be
seen under the Red Eye Service.
Appointments are available during normal working hours and you will be seen within 24 hours.
Alternatively, your GP or other healthcare professional may refer you to the optometrist for
treatment.
What happens when I see the optometrist?
The optometrist will discuss your eye history, any symptoms you may be experiencing and any
related medical history.
You will receive an eye assessment relevant to your symptoms. This does not replace the routine
sight test.
Please take your glasses and a list of current medications with you to the appointment.
As a result of the consultation you may be:
•Given appropriate treatment by the optometrist, this may include a follow-up appointment.
•Referred to your GP for appropriate treatment if your eye condition is related to your general
health
•Referred directly to the hospital eye service, if your eye condition is more serious.
•Following your appointment the optometrist will notify your GP about the outcome of your
consultation in order to ensure your medical records are updated.
Please note:
This service does not replace the routine eye examination.
A sight test will not be performed as part of the assessment or treatment and you will not be issued
with a prescription for glasses.
Remember:
You may not be able to drive immediately after your eye examination.
Eye conditions not treated under the Red Eye Service.
If you have any of the following conditions you must go directly to your nearest Accident and
Emergency
Department or Manchester Royal Eye Hospital Oxford Road Manchester M13 9WL:
•Sudden loss of vision in one or both eyes
•Considerable eye pain
•Significant trauma, such as penetration injury or lacerations to the eye(s) or lid(s)
•Chemical injury or burns
•Problems arising from recent eye surgery
Please refer to Practitioner Info for further information.
Lumps and Bumps Information
EYELID LUMPS AND BUMPS
NHS Manchester does not commission the surgical removal
of eyelid lumps and bumps. However, as stated in the
specification for the red eye scheme you should continue to
refer lumps and bumps to the patients GP and they will then
make the clinical decision to forward on the referral.