GREATER GLASGOW & CLYDE GLASGOW OPTOMETRIC LEARNING NETWORK Inverclyde Royal Hospital 10th May 2011 7.30pm Tonight’s Programme
Welcome
Panel Introductions
The GG&C Optometric Learning Network
Direct Referral
Gartnavel Eye Casualty Update
Questions & Discussion Tonight’s Panel
Laura Pervaiz – Lead Optometrist, Inverclyde William Wilkie – Lead Optometrist, GG&C Dr Lawrence Bidwell – Clinical Director, Inverclyde Dr David Mansfield, Consultant Ophthalmologist, Inverclyde Royal Hospital Dr Prem Venkatesh, Consultant Ophthalmogist, Inverclyde Royal Hospital Background
New GOS Regulations 2006
Optometry 1st Port of Call
All eye problems triaged or managed by Optometry
GG&C Demands Shift in the Balance of Care GG&C Patient Numbers
Primary GOS Supp GOS 2009 /10 Total 396,067 31,270 427,337
HES Total HES New 2009 / 10 101,858 27,903 2009 10 111,419 30,645 2005/06 Clinical Conditions 2009 / 2010
Total Cases 815,839
GG&C 265,883
0 1 2 3 4 5 6 7 8 9 10 HES New Referrals - 2006 v 2010
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0 1 2 3 4 5 6 7 8 9 10 Referrals to NHS Scotland Secondary Care
2010 2006 4%
9% 40% Greater Glasgow and Clyde 26% Fife Grampian 1st Port Of Call Triage For All Acute Presentations
Red Eye Ocular Disturbance Visual Loss
Reduce Referrals - Grampian 40% - 9% GG&C
Retain Px in Community eg GIES 77% eg Grampian 70% eg PEARS 70% Main
Aims Reduce burden: Eye Clinics Eye casualty
All GG&C Optometrists Enhanced GOS
Triage Role: Care, Share or Refer!
GPs / Pharmacy Primary Care accept Optometry = 1st Port of Call Eye Care
Network Optometry Primary Care Ophthalmology
Care Pathways Direct Referral
Joint Working to Improve Patient Care
Learning Network Ongoing CPD Benefits Patients Rapid Access Convenience No Wait for Quality Care
GPs /Primary Care Refer eye problems safely to a competent clinician
Ophthalmology Reduced burden Improved Referrals
Optometry Utilising Full Skill Set Complying with GOS Structured care for patients Challenges
Establishing Eyecare Networks
Two Way - Communication Primary care Ophthalmology
Optometry accepting Responsibility Diary Management
CPD Glasgow Optometric Learning Network [GOLN] GG&C LN Pan GG&C training & development ALL OPTOMETRISTS
Evidence base: GIES / PEARS / Grampian
More appropriate referrals
Modular Training Structure GG&C LN
Optometry Led Community Based
Patient Focussed Care
Rapid Access Patient Convenience Appropriate Care
Prescribing via GPs / IP PGDs GG&C Training Plan
Refresher 1 – Referrals [GOS]
Refresher 2 – Common Eye Conditions [GOS]
Module 1 – Complex Eye Conditions [GOS]
Module 2 – Chronic Disease Management eg Glaucoma [Delegated Care – HES] Top 10 – Acute Presentations!
1. Seasonal allergic conjunctivitis
2. Anterior Uveitis
3. Infective Conjunctivitis
4. Corneal Abrasion
5. Dry Eye
6. Episcleritis
7. Corneal FB
8. HSK
9. Marginal Keratitis
10. PVD
11. Trichiasis Referrals from...... GPs / Optometry / Pharmacy / Other Carers / Self / A&E / HES
GOS Optometric Triage - Examination Assess / Diagnose / Advise / Manage / Treat / Refer
Simple Complex Ref 2 Mod 1 Refer Dry eye Viral Conj MK Blepharitis HSK RD Episcleritis FB Cellulitis Abrasion PVD Scleritis Bact Conj Marg Kerat Wet AMD SAC Ant Uveitis Modular Training Report Form Guidelines Protocols HES / Audit / Codes
Triage - Examination Assess / Diagnose / Advise / Treat / Refer
Patient Group Directives Helpline (First line) Gartnavel Casualty GP Rx Request (pro-forma) PGDs
Stock of topical agents stored in practice Group 1 & 2 patients First line only Ongoing supply via Px request to GP Record usage Store safely IP Optoms can prescribe directly Direct Referral
New Referral Form
Feedback from HES
Complete all Relevant Sections
Always comply with GOS
- Only use applanation tonometry (Perkins or Goldman) for IOP measurement
- Always repeat tonometry & VF for glaucoma suspects
- Always use dilated ‘Volk’ slit lamp bio for all retinal & macular examinations Dr David Mansfield - Update on Inverclyde Royal Eye Casualty Arrangements
The new Casualty Arrangements for Gartnavel General meeting: - Thursday 12th May 2011 @ 6.30 pm - Pond Hotel, Glasgow Questions?