A new direct referral pathway from community optometrists to ophthalmology services in North East London
North East London (NEL) ICS has set up a single point of access (SPoA) for referrals, following the successful implementation in July 2023 of a SPoA for referrals in North Central London. This follows the NHS England 2023/24 priorities and operational planning guidance, which identified a need to expand and streamline direct access from primary care optometry into hospital and other secondary eyecare services. Optometrists can now send referrals directly to the SpOA, which routes them to the patient’s preferred provider for triage and onward management.
The SPoA is initially hosted by Moorfields Eye Hospital NHS Foundation Trust and funded by NHS England. It uploads referrals onto the electronic referral service (eRS) on behalf of local NHS trusts, including Barts Health NHS Trust (The Royal London Hospital, Whipps Cross University Hospital and Newham University Hospital), Moorfields Eye Hospital NHS Foundation Trust (City Road, Stratford and St Ann’s sites) and Barking, Havering and Redbridge University Hospitals NHS Trust (Queens Hospital, Romford and King George Hospital, Goodmayes). Other NHS providers and NHS-funded independent providers will also be included as onward referral destinations.
The end goal is for community optometrists to independently upload their referrals to the eRS, but whilst the necessary systems are integrated, they are invited to refer to the SPoA via secure nhs.net mail. This pathway will go live and start receiving and uploading referrals from 30 October 2023.
To optimise this pathway, the project team have been collaborating with the NEL Local Optical Committee (LOC) and NEL Integrated Care Board (ICB). We have sent communications to community optometrists via the LOC advising them of the new pathway and outlining the anticipated benefits for both patients and optometrists. These include more efficient referral processing and reduced patient journey time from point of referral to hospital appointment.
We hope to facilitate further service innovations, including centralised triaging, the launch of an advice and guidance service, the provision of targeted optometrist education and referral feedback, and dynamic digital modelling, to improve access to hospital resources.
How will the new pathway work?
Guidance has been circulated to community optometrists on how to refer their patients to enable optimal processing of ophthalmic referrals including specifying urgency, sub-specialty and patient’s hospital preference. We have requested that they attach a GOS18 or equivalent proforma together with any supplementary test results. Criteria for referral will remain unchanged.
The SPoA booking team acknowledge safe receipt of and confirm submission of their referrals. The patient’s GP receives a confirmation of the referral submission including a copy of the clinicalsummary. The referrals are forwarded on to the patient’s preferred care provider where they will undergo triaging to book them into the correct destination clinic.
For accident and emergency and specific urgent referrals, including wet AMD, existing direct referral pathways will continue, facilitated by bespoke proformas and dedicated email inboxes. The diabetic screening service does not form part of this new SPoA pathway.
Secondary care clinicians will have access to their patients’ summary care records through their Trust IT systems, or through The London Care Record (bit.ly/london-care-record). Please contact your local IT services to arrange access to this if not already in place.
Please be patient as we roll out the service to all community optometrists, this may take several months. If you have any queries please contact rcalveley@nhs.net