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An in-depth exploration of the referrals process in the UK, hosted by BBC presenter John Waite.

We travel the length and breadth of the country, interviewing practitioners and policy makers, to find out how the referrals process works across England, Wales, Scotland and Northern Ireland.  We look specifically at how emergency, urgent and routine referrals should be handled according to national guidelines and local protocols, framing the discussion around dramatised case studies.

To establish best practice, we speak to proponents of innovative regional referral refinement schemes that are improving efficiency and offering increasing opportunities for optometrists to manage conditions in-practice, to reduce unnecessary referrals and decrease the burden on secondary care.

Last published: December 2017

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    • 2.7.2 Ensure the appropriate pathway for referral is adopted in full knowledge of the urgency, to whom referral is appropriate, and an understanding of national and local protocols.
    • 2.8.2 Ensure the correct information is recorded when referring a patient.
    • 2.10.1 Understand the appropriate professionals that might be best able to meet the needs of any individual patient you refer.
    • 6.1.11 To understand the management of a range of ocular conditions ranging from the emergency, fast-track and the outpatient or GP managed conditions and to ensure the appropriate route to access this care in each case is adhered to and understood.
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      This unit includes a discussion of the national guidelines available to optometrists. Dr Sue Blakeney goes through the guidelines from the College of Optometrists, Geoff Roberson looks at how local protocols can vary and how it is important for practitioners to be aware of these variations and emphasises the need for understanding when emergency referral is appropriate, and Dr Dan Rosser describes the rules for referral of suspect retinal detachment in the Norfolk area.

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      This unit uses the case of a suspect wet AMD and explains how emergency referral may not be the best route to get a specific condition to an appropriate specialist for treatment as soon as possible. Dr Robert Petrarca explains urgent referrals and Geoff Roberson looks at the best practice for optometrists.

      View only 'Topic 5'

      In this unit Stephen McPherson and Dr Nik Sheen look at the regional variation in schemes for referral in Scotland and Wales respectively.

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        References

        McPherson S, et al. 2014. The Eye Health Network – An ‘optometry first’ approach to eye care. Eye News. 20 (6), 12-16
        Sheen NJL, et al. 2009. Novel optometrist-led all Wales primary eye-care services: evaluation of a prospective case series. Br J Ophthalmol. 93, 435-438
        Sheen NJL, et al. 2012. Auditing Enhanced Eye Care Referrals. Optometry Today. Sept 21st, 28-32
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      In this unit, Raymond Curren discusses the situation regarding referral routes in Northern Ireland.

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      This unit uses cataract referral to illustrate a referral that needs to be seen in a routine outpatient’s appointment or for general practice appointment. Geoff Roberson clarifies the concept and then there is a discussion of the Gloucestershire cataract referral scheme.

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      This unit looks at another ‘routine’ referral challenge and Simon Frankiewitz explains when referral for orthoptic assessment might be appropriate.

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      This unit discusses how primary open angle glaucoma is now referred via referral refinement schemes which have significantly improved accuracy of referral and resource usage. The scheme established with Manchester Royal Eye Hospital is explained as an example of such a scheme.

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      Geoff Roberson summarises the essentials to bear in mind regarding documentation of any referral process.

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      Essential resources & references

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        DOCET would like to thank the following for their contribution to this programme:

        • Geoff Roberson, Professional Adviser to the Association of Optometrists

        • Dr Susan Blakeney, Clinical Adviser to the College of Optometrists

        • Dr Dan Rosser, Principal Optometrist at the Norfolk and Norwich University Hospital

        • Dr Robert Petrarca, Consultant Ophthalmologist on the London Deanery rotation

        • Stephen McPherson, Eye Health Network Optometry Advisor for NHS Grampian

        • Nik Sheen, Clinical Lead for Eye Health Examination Wales

        • Janet Pooley, Optometric advisor to the Scottish government & Programme Director for Optometry at NHS Education for Scotland (NES)

        • Fergus Bain, Northern Ireland representative on DOCET Council

        • Steve Guilford, Gloucester LOC member, involved throughout Action on Cataracts and the Gloucester cataract scheme

        • Clair Bulpin, Gloucester community optometrist

        • Simon Frackiewicz, Optometrist and Orthoptist

        • Amanda Harding, Principle optometrist at Manchester Royal Eye Hospital

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