MECS Peer Discussion

MECS Peer Discussion It has become a mandatory part of the MECS contract that each accredited optometrist attends ONE of these events.

Triage Scenarios 1 What’s the process for triaging a patient?

Discussion What’s the process for triaging a patient? Who do you complete a triage form for? Ensure all sections complete Use patient’s own words Determine urgency Book appointment Accurate data, time, dates to Optomanager Optom sign off (optom may query, change urgency, etc) Retain form in records

Triage Scenarios 2 Patient presents with a red painful eye You assess that they need a 24 hour appointment But have no appointments in your practice for 3 days What are you required to do now?

Discussion Patient presents with a red painful eye What advice do you give? Alternative providers www.eyecarewm.co.uk Leaflet A & E Care on stretching timelines…software records everything

Triage Scenarios 3 Patient presents with mild ocular irritation and wateriness What is the triage urgency? (48 hr) As you have an appointment immediately available, the receptionist classifies the patient as 24 hour urgency. Is this appropriate and why?

Discussion Watery irritable eye What is the triage urgency? (48 hr) What issues arise if you classify with inappropriate timescale?

Triage Scenarios 4 I had a cataract operation last month, my eye is now red and painful

Discussion Cataract surgery Recent surgical cases generally not appropriate for MECS Best procedure is to inform consultant Occasionally there may be an emergency and MECS might be needed for a same-day referral, this is unusual

Triage Scenarios 5 – You’re on the Phone! What advice do you give? (Line of questioning) My vision has been blurred recently

Triage Scenarios 5 – You’re on the Phone! What advice do you give? My vision has been blurred recently The blur came on last week

Triage Scenarios 5 – You’re on the Phone! What advice do you give? My vision has been blurred recently The blur came on last week Its only my left eye

Triage Scenarios 5 – You’re on the Phone! What advice do you give? My vision has been blurred recently The blur came on last week Its only my left eye All the top part of my vision is blurred

Discussion You’re on the Phone! Central importance of triage form Skilled questioning Ongoing training & feedback to team

Complaint 1 You referred a patient with elevated IOP 14 weeks ago They pop in and tell you they have not heard from the hospital What do you do? Do you have any other responsibilities?

Discussion Complaint 1 they have not heard from the hospital investigation? Re-referral? alternative route?

Discussion Complaint 1 Do you have any other responsibilities? Vital importance of reporting through Optomanager Complaints Incidents Service Issues

Vital importance of reporting through Optomanager

Complaint 2 A patient complains that his eye problem got worse because you did not refer urgently. What do you do? What other responsibilities do you have?

Discussion Complaint 2 patient complaint NHS complaint process Record on Optomanager as complaint with full details

Complaint 3 A GP practice phones to report that your email was not received, you think that the GP email address is incorrect. What do you do?

Discussion Complaint 3 Investigate Full reporting through Optomanager system

Case 1: Is this MECS? Questions 40 year old female attends your practice because she thinks she has a contact lens stuck in her right eye The patient attends your practice regularly for check ups (aftercares) but purchases contact lenses online Questions Is this MECS? If so, why? Is it relevant if the aftercare is in date?

Case 2: Is this MECS? Questions Is this MECS? If so, why? 55 year old female had a sight test 2 months ago, told Optometrist she was having sore eyes at night. Diagnosed with dry eyes and recommended ocular lubricants for dry eyes, patient went to GP and was given Hypromellose drops which she uses “regularly” Patient presented to practice today, still complaining of sore eyes Questions Is this MECS? If so, why?

Case 3: Is this MECS? 51 year old male attends for a routine sight test No symptoms reported on history and symptoms (no headaches/flashes/floaters/diplopia/pain etc.) At the end of history and symptoms, the Optometrist asks “is there anything else you would like to tell me about your eyes?” Patient says he has had a lump under his right eyelid for the past 2 months, not tender but it is annoying him Questions Is this MECS? If so, why?

Case 4: Is this MECS? 46 year old male was seen 10 weeks ago under MECS for foreign body sensation in his right eye. Diagnosed with trichiasis and epilated two lashes from his lower eyelid He came in today complaining of the same issue, wanting an appointment. He was happy last time with the service and the convenience of being seen at his local opticians, as he was previously seen at the hospital for eye related issues Questions: Is this MECS? If so, why?

Case 5: Is this MECS? 20 year old female saw her GP for red eyes which started 2 weeks ago, was given Chloramphenicol 4x/day in both eyes for 5 days She attends your practice 3 days after seeing the GP as the drops haven’t helped and the eyes are still red, swollen and very itchy

Case 5: Is this MECS? Questions Is this MECS? If so, why? What is your diagnosis based on the history and symptoms? What is your management? Is this person eligible for medications through the service? What are the requirements on the ‘front desk’ staff once the consultation is complete?

Post Consultation Scenario Importance of completing questionnaires? Follow Ups