Download
eye health network shifting the balance of care n.
Skip this Video
Loading SlideShow in 5 Seconds..
Eye Health Network Shifting the Balance of Care PowerPoint Presentation
Download Presentation
Eye Health Network Shifting the Balance of Care

Eye Health Network Shifting the Balance of Care

111 Vues Download Presentation
Télécharger la présentation

Eye Health Network Shifting the Balance of Care

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. Eye Health Network Shifting the Balance of Care Stephen McPherson Pamela Lowbridge Siene Wai Ng Gordon Porteous Marka Rifat Graeme Shand David Taylor Elaine Thompson Mohan Varikkara Morag Bobacka David Fowler Fiona Francey Steve Graham Jane Harcourt Caroline Hind Monica Hrabovsky Neil Lavery Malcolm McPherson John Olson Charlotte Ward

  2. A sad story

  3. Begs the question • Where should you go if you have an eye problem? • High Street Optometrists • General Practitioner • A& E Department • Hospital Eye Casualty

  4. 6,000 walk ins a year….. Average of 24 (max 33) patients per day

  5. Eye Casualty AuditAugust- September 2006 (n=922) Average 24 episodes per day

  6. Duration of Symptoms

  7. What happened?

  8. Where did true emergencies come from?

  9. Who got it right?

  10. What should have happened? • 44% had ‘simple’ problems which could have been managed by optometrists in the community. • An additional 37% could have been managed in the community if patient pathways involving prescription only medication had been available. • Optometrists knew who to refer.

  11. I have a dream…………..

  12. Scottish Government’s Vision • Optometry, the first port of call They have the knowledge Give them the technology

  13. New GOS Contract April 2006 "Anyone, whether they have red eyes, painful eyes, flashes and floaters, or just need new spectacles, will be able to access the new NHS at their local Optometry practice.“

  14. A network in waiting

  15. Pyramid of Eye Care Specialist led hospital clinic Triage address issues, treat and/or direct Community Optometry General Practice Community Pharmacy

  16. Network 58 Optometry practices Nurse led telephone triage service 0845 number Urgent Referral Clinic Every afternoon 10 slots, directly booked Run by experienced SPR Directly Supervised by Consultant

  17. Wide Consultation

  18. Practical Issues Informing the public Local TV advert Posters: GP eye clinic, hospital and A&E

  19. Professional Issues:Training Optometrists Practical Eye Casualty Sessions Consultant led Patient Pathway Lectures Foreign Body Workshops Consultant and Optometry jointly led

  20. Eye Health Network Audit Access database for all helpline activity Access database for all urgent referral clinic activity Paper records for optometrist

  21. Was it all a dream?

  22. Transitional Arrangements(September-October 2007)

  23. Preliminary Data

  24. Community Optometry Activity Nov 07 to Mar 08 1907 forms • 52% self referred • 19% from GP • 7% from A&E • 4% from pharmacy • 76% managed by optometry • 10% referred urgently to ophthalmology

  25. Helpline Activity • October 2007-August 2008 • 13.9 calls per day • 56% from optometry • 20% from General Practice • 6% from A&E • 85% were given an urgent referral clinic appointment.

  26. Urgent Referral Clinic 10.4 per day (24)

  27. Ophthalmology On-call28.4% reduction

  28. Impact on A&E13.3% reduction

  29. Optometry Agreement2% significantly different 81.4% Agreement 18.6% Disagreement

  30. Value for money?

  31. What happened after 2006?

  32. What’s going on? • PDT for AMD 2004 • DRS 2006 • Cataract redesign 2006-7 • MMC 2007 • Lucentis for AMD 2007

  33. Shifting the balance of care • DRS 2002 • PDT for AMD 2003 • Glaucoma refinement scheme 2004 • GOS contract, OHT discharged, Post-op cataracts discharged 2006 • Eye Health network, AMD injection service, MMC 2007 • OCT DRS 2008

  34. Gold rush?

  35. What next for the Eye Health Network?

  36. An Electronic Eye Health Network

  37. Where information flows,not patients • Local access • Information belongs to all • Patients, primary, secondary care, boards, government • An electronic cloud • Advice only, shared care, triage, appropriate referral • Clinical governance, service planning • Reimbursement • Specialist role • Where information is not enough • Education, training, planning, service redesign • Public health • Quality of care not dependent on where you live • Communication • Politics

  38. Eye Health Network Shifting the Balance of Care Stephen McPherson Pamela Lowbridge Siene Wai Ng Gordon Porteous Marka Rifat Graeme Shand David Taylor Elaine Thompson Mohan Varikkara Morag Bobacka David Fowler Fiona Francey Steve Graham Jane Harcourt Caroline Hind Monica Hrabovsky Neil Lavery Malcolm McPherson John Olson Charlotte Ward