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 * * * 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?.