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New direct referral pathway for optometrists

Moorfields hosts new direct referral pathway from optometrists across North Central London

Moorfields Eye Hospital NHS Foundation Trust is part of a new, streamlined referral pathway across eyecare services in North Central London (NCL). Community optometrists can now send referrals directly to a single point of access (SPoA), which routes them to the patient’s preferred hospital for triage and management.

Traditional referrals mean optometrists often must first send a patient to a GP to refer them to an appropriate clinic. By allowing direct referrals to a patient’s preferred hospital, the new SPoA reduces time to triage for patients and, if the patient does not have a preference, the referral is booked into the most appropriate clinic at a convenient hospital with available capacity, so patients can get the right care they need, in the right place, at the right time.

The SPoA is initially hosted at Moorfields and funded by NHS England. It is part of a NCL Integrated Care System (ICS) collaboration that also includes the Royal Free London NHS Foundation Trust, Whittington Health NHS Trust and North Middlesex University Hospital NHS Trust. The pathway spans all eyecare services across NCL, and will support around 18,000 referrals a year.

A pilot project was conducted between December 2022 and March 2023, with 108 suspected wet age-related macular degeneration (AMD) cases referred through the SPoA to either Moorfields or the Royal Free London. The project significantly reduced time from referral to triage from an average of 11 days to one single day. It also reduced travel and outpatient visits per patient and improved utilisation of urgent clinics and the quality of referral data. Patients could have appointments closer to home, and at more convenient times.

In the future, we hope to facilitate further service innovations, including centralised triaging, the launch of an advice and guidance service, the provision of targeted optometrist education and referral feedback, and dynamic digital modelling, to improve access to hospital resources.

And in other parts of England

There is a  fragmented commissioning system in England which has meant that parts of the country still use outdated models of care such as commissioners requiring optometrists and DOs to refer to ophthalmology via a GP, while direct referral from optometrists to ophthalmology is common in other areas of the UK.

In the 2023/24 priorities and operational planning guidance published this year by NHS England [Amanda Pritchard] it states drive in modernisation, in this year’s planning guidance for NHS England to prioritise implementing direct referral in eye care.

Opchat News is happy to publish local stories on LOCs, and AOCs implementing new agreed pathways both those as part of LOCSU and the many highly successful LOCs outside of LOCSU with locally agreed payment schemes. The more this knowledge is shared the greater improvements will be forthcoming.

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