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Since our first ‘referrals special’ in 2015 the situation across the UK has changed significantly. 

There have been changes to guidelines, including the revised NICE guidelines concerning the referral of cataracts, AMD and glaucoma. Some of the policy changes we heard about in our previous referrals special have taken root as regional variations become more established. And, fundamentally, attitudes towards eye health care and management in practice are changing.

This updated resource will look at some new referral processes, hear from experts in primary care management, and the overall aim is to examine the different ways of improving referral pathways, to optimise the use of optometric expertise and resources, to streamline the process and reduce the number of unnecessary referrals whilst maintaining the highest standards of care to our patients.

Last published: December 2020 

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    • 1.2.1  Be able to explain findings and the nature of any referral in a way that will maximise compliance and subsequent effectiveness of management.

    • 2.7.2 Understand the need for follow up assessment in certain circumstances.

    • 2.8.1 Understand the significance of accuracy when recording a referral decision.

    • 2.10.1 Understand the appropriate local and national protocols for care and referral of specific conditions including cataract and glaucoma (including the latest revisions to NICE guidance).

    • 2.10.3 Understand the different layers of referrals including where referral is to a colleague with further training as part of a refinement scheme.

    • 6.1.6 Understand the importance of knowing local and national guidance regarding appropriate referral of cataract.

    • 6.1.8 Understand the importance of knowing local and national guidance regarding appropriate referral of suspect glaucoma.

    • 7.1.1 Understand the nature of local care and referral pathways with an emphasis on glaucoma and cataract but also be cognisant of other local variations throughout the regions of the UK.

     
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      Geoff Roberson

      Our presenter, John Waite, introduces the programme and its structure. Geoff Roberson, Professional Advisor to the Association of Optometrists, joins us again to explain the function of local referral protocols and the different types of referral pathways an optometrist might use in practice.

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      Craig MacArthur

      Since devolution in 1999, parts of Scotland, Wales and Northern Ireland have adopted various approaches to the implementation and funding of eye health schemes. We start our exploration of regional referral protocols in Scotland with Glasgow based optometrist, Craig MacArthur, whose practice is restructured around effective use of trained optometrists to best manage patients in the primary care community.

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      Andy Britton

      Next, we go to Wales where we talk to Andy Britton, Optometrist Director at Specsavers in Haverford West. Here, we see how a mix of national policy, regional schemes and inter-professional relationships can come together to enable the implementation of a truly innovative local referral process.

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      Raymond Curran and Margaret McMullan

      In this section, unit 4, we return to Northern Ireland to hear from policy makers about what it takes to implement national level programmes. Raymond Curran, Head of Ophthalmic Services, and Margaret McMullan, Clinical Optometric Adviser at the Health & Social Care Board, Northern Ireland, explain to us the planning and preparation that goes into rolling out new schemes from a policy perspective, as well as the long-term improvement plans.

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      Peter Turner

      In England, we talk to Peter Turner, Senior Optometrist at Peter Turner’s opticians in Bristol, about the care pathways he has been involved in developing and how these fit into the wider situation across England. Peter also provides advice on the importance and methods for finding out more about your local schemes.

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      Clair Bulpin and Clare O’Donnell

      Next, we focus on specific disease pathways, starting with cataract. We speak again with Clair Bulpin, who provides us with an update on the Gloucester Cataract Direct Referral Scheme (GCDRS). Clair explains recent updates to the scheme as well as future plans. In the second half of this unit, we talk to Clare O’Donnell Head of Eye Science at Optegra health, Manchester. Clare discusses the differences between private and NHS referral pathways and what optometrists may need to consider should a patient wish to be privately referred.

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      Amanda Harding and Kathy Morrison

      Glaucoma diagnosis and referrals have evolved significantly with the introduction of a variety of referral refinement schemes. We talk to Amanda Harding, principal optometrist at Manchester Royal Eye Hospital, to get some clarification on the different referral filtering services in the UK.  We also go back to Glasgow to hear from Kathy Morrison about how the Scottish Intercollegiate Guidelines Network (SIGN) guidelines have been implemented since the last referrals programme.

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      Geoff Roberson

      In the final unit, unit 8, we summarise the general protocols of referrals that apply regardless of pathway. We consider the importance of accurate record keeping and legal issues around referrals.

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