Download Clinical Guidelines for Referral to Cataract Clinic v5.2

1. CLINICAL GUIDELINES FOR REFERRAL TO DIRECT CATARACT CLINIC
Inclusion criteria for Direct Access Referral
Patient suitability
 Patients who are willing to undergo cataract surgery, and who
 Understand the risks and benefits of cataract surgery.
Visual and Social Difficulties
 Reduced visual acuity correctable to 6/12 or worse in the affected eye, and/or
o impairment of lifestyle such as the patient being at significant risk of falls, or
o the patient’s vision is affecting their ability to drive, work, or undertake leisure activities
such as reading, watching television or recognising faces.
Second Eye Cataracts
Please note that cataract surgery will not be provided for patients who have had successful
unilateral surgery and have only mild symptoms from their remaining cataract.
Exclusion criteria for Direct Access Referral
Ophthalmic Exclusions
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Any co-existing eye condition which would in the absence of cataract requires an ophthalmological
opinion in its own right.
* for example, in the case of AMD, if there is active pathology or the patient needs additional
reassurance or registration, you should refer the patient to the General Ophthalmology Clinic.
However if the condition is known to be long standing and stable, the Direct Access system can be
used, regardless of the severity of the disease, providing the patient understands the limitations of
surgery.
 Patients who have had successful unilateral surgery and only mild symptoms from their remaining
cataract.
Other Exclusions
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Heart attack in last 3 months if patient wants Local Anaesthetic, or for patients requiring General
Anaesthetic, last 6 months.
Stroke in last 3 months if patient wants Local Anaesthetic, or for patients requiring General
Anaesthetic, last 6 months.
Patient has been put on Anticoagulant (Warfarin/Sinthrome) within last 3 months
Uncontrolled Diabetes (check with GP if unsure)
Uncontrolled Blood Pressure (check with GP if unsure)
A medical history should be taken, and any current medications listed on the form
Version 5.2 – January 2011
Guidance for completing referral form
All demographic information at the top of the form must be completed. Telephone numbers are
especially important (Home and Mobile numbers please).
One box for each of the Yes/No questions must be ticked.
Patient must be available to attend clinic and have surgery throughout the 18 weeks following referral.
Patients must be UK resident, and must not have been out of the country for more than 6 Months in an
EU country or 3 months in a non-EU Country within the last 12 month period.
Unsuitable Patients
Patients who are unsuitable for the Cataract Clinic should be referred to the Eye Unit via the normal local
referral route.
2. ADMINISTRATIVE GUIDANCE FOR REFERRING PATIENTS
Patient eligibility
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The Direct Access Cataract referral scheme is only available to patients who are registered with a Bolton
GP.
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You should only therefore refer patients under this scheme who have a Bolton GP.
No payment will be made for other patients.
Referral form
Copies of the completed referral form should be processed as follows:
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Copy 1: Cataract Co-ordinator, Eye Unit, Royal Bolton Hospital, Minerva Road, Farnworth, Bolton, BL4 0JR
Copy 2: Patient’s GP
Copy 3: Optometrist
Documentation for Direct Access Patients
Patients should be given:
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A booking letter (Direct Access Patients only), and
A copy of ‘Cataracts – Your questions answered’. Patients can request copies of this booklet on audiotape format from the Eye Unit on 01204 390390 Ext 4591.
Payment Claims
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Following your patient’s attendance at the Eye Unit, a letter will be sent back to you with a tear off slip
indicating whether the patient attended, and whether the referral was appropriate. The PCT need this
information for audit purposes. The tear off slip should be forwarded to the PCT with your claim form for
payment.
Payment will be made for each patient who is referred according to the clinical guidelines
Claims for payment should be addressed to The Finance Department, NHS Bolton, St Peters House,
Silverwell Street, Bolton BL1 1PP.
Version 5.2 – January 2011