Ophthalmic referral pathways 2014/2015

Who are the CCG? Responsibility for buying local health services transferred as of 1st April 2013 from Primary Care Trusts to groups of local clinicians known as Clinical Commissioning Groups (CCGs) North East Hampshire and Farnham CCG has been formed to plan the provision of healthcare for the 220,000 people registered at GP practices in Rushmoor, Farnham and parts of east Hart council areas We have 24 member GP Practices And a budget of £230 million

What do we commission? The CCG, with its constituent membership of 24 GP Practices, invests approximately £230m annually in health and care services for this population, including: Planned hospital care – Outpatients, Elective operations Urgent and emergency care – A&E, non-elective operations Rehabilitation care Community health services Mental health and learning disability services

How does this affect you? As well as commissioning Hospital based Ophthalmology services we are also able to commission Local Enhanced Services from Primary Care Contractors such as yourselves … and that’s why we have invited you here today!

Local Ophthalmology services We anticipate that by the end of the 2013/2014 financial year our CCG will have spent £4.8 million on Ophthalmology services at Frimley Park Hospital. Ophthalmology is our third most expensive elective (planned) speciality. Ophthalmology service redesign is a key priority for the Planned Care team in 2014/2015

What are we spending money on? Type of service Approximate cost Day cases £1,700,000 Telephone appointments £20,000 First Outpatient appointments £536,000 Follow up Outpatient appointments £1,358,000 Outpatient procedures £1,073,000

Ophthalmology service redesign Utilisation of primary care Optometric experience and skills Utilisation of local service contracts and expansion of existing Local Enhanced Services: Wet ARMD referral (Surrey Optometrists) Direct Cataract referral (Surrey Optometrists) IOP referral refinement (Hampshire Optometrists) Redesign in collaboration with the Frimley Park Hospital Ophthalmologists Redesign in collaboration with Guildford and Waverley CCG and Surrey Heath CCG Utilisation of best practice and national guidance

What ideas do we have? Scheme How can you be involved? Glaucoma Refinement level 1a Multiple providers Glaucoma Refinement level 1b Stable Glaucoma Monitoring* Specialist providers operating through a hub and spoke model in each locality Pre-cataract assessment* 4 week post-cataract assessment* Primary Eyecare Assessment and Referral scheme * Requires agreement from local Ophthalmologists

What ideas do you have?

Next steps The LOC will support us in developing service specifications to share with you Glaucoma Refinement due to launch April PEARS scheme scoping to commence Stable Glaucoma, pre and post cataract assessment due to launch autumn/winter By the end of the 2014/2015 financial year we hope to have significantly improved the community based Ophthalmic services available to our patients