Headlines & Highlights Angela Chicamisse Programme Manager South Manchester Diabetic Retinopathy Screening Service SMDRSS, the past year… Headlines & Highlights Angela Chicamisse Programme Manager

Issues to discuss Programme performance Service improvements SMDRSS Programme performance Service improvements Day to Day service management Contractual issues (PCT-Optom SLA) National pathway changes Future provision

Programme Performance SMDRSS New National Standards EQA recommendations implemented Incident reporting and follow-up of failsafe issues Team staffing

Service Improvements Failsafe – robust processes to minimise risk SMDRSS Failsafe – robust processes to minimise risk Vector Medical Retina reconfiguration – improving HES clinical data completeness Minimising list of exclusions Better data quality & validation Review of SMDRSS core team functions & processes

Day to Day Core Service Management SMDRSS Current S.Mcr diabetic population=73400 74000 invitations, 35000 reminders, 22000 no response, 4700 DNA letters, 3000 DNA reminders/NR, 110000 results, 3500 copy results 5000+ letters per week Average 400 calls per week – 15% abandonment rate Monthly uploads from 290 GP practices Process 200 referrals to HES and 450 DNAs & cancellations per month

Core Service issues Unnecessary reminders Inappropriate DNA letters SMDRSS Unnecessary reminders Inappropriate DNA letters Unknown missing images/episodes Inappropriate appointments Images not graded Screening inactive or ineligible patients Adds to the inefficiencies within the service

DRS Service Contract The DRS service comprises: SMDRSS The DRS service comprises: measuring a patients visual acuity; taking a minimum of two digital photographs per eye in accordance with National Screening Committee Guidelines; undertaking a First Full Disease Grade in respect of each of the digital photographs obtained from a Patient or as may otherwise be required by the Commissioner; recording the Retinopathy Grade in respect of such First Full Disease Grade; where required by the Commissioner, the Relevant Associate PCT or SMDRS, undertaking a Second Full Disease Grade in respect of the digital photographs obtained from a Relevant Patient; recording the Retinopathy Grade in respect of such Second Full Disease Grade; where authorised, undertaking SLBIO immediately following digital imaging in respect of those Patients where the images are Ungradeable

Provider obligations: equipment, premises private consultation area access to a broadband connection fully sourced and operational digital retinal camera – PASA approved IT hardware high resolution monitors notify SMDRS within twenty four (24) hours of any serious faults in DRS software system

Provider obligations: services notify the Programme of any changes in the identity of the Qualified Personnel prior to such changes taking place (minimum of 30 days notice of a Qualified Personnel leaving) ensure that only Qualified Personnel provide the Services QP is C&G qualified or enrolled on the course – and completes within 2 years Keep the Programme notified about that personnel’s progress on the relevant course If miss deadlines, the Commissioner can require such personnel to be removed from the Provider’s list of Qualified Personnel

Provider obligations: services provide any necessary information relating to the Provider’s provision of the Services as may be required by SMDRS Manager from time to time; input as soon as reasonably possible all necessary information onto the diabetic retinopathy screening software system and inform the Commissioner or the Relevant Associate PCT of any changes to the Patient Information; input onto the central database the details of any Patient appointments which it has completed and any Patients that did not attend their appointment with the Provider;

Provider obligations: services not allow an unreasonable waiting list or backlog to develop (it being agreed that for the purpose of this clause, 60 days is to be considered a reasonable period of time); provide a choice of appointment times to its Patients; not link sight tests with the provision of the Services If screening another Practice’s patient, not solicit further business from that Patient (e.g. a sight test) Not solicit referral of patients from GP practices, health centres, diabetes clinics, etc does not preclude a Provider from carrying out the Services to its own Patients at the same time as it conducts a sight test in respect of that Patient for the convenience of the Provider’s own Patients;

Qualified Personnel: obligations 2 images each eye, FDG, immediate SLBIO, patient consent Minimum 500 imagesets, online EQA test sets, C&G qualification, maintain competence & accreditation Comply with national timescales & targets Do not solicit business

Core Service issues Unnecessary reminders Inappropriate DNA letters SMDRSS Unnecessary reminders Inappropriate DNA letters Unknown missing images/episodes Inappropriate appointments Images not graded Screening inactive or ineligible patients Adds to the inefficiencies within the service how can we improve? 14

SMDRSS Communications

SMDRSS Communications

Going forward…. SMDRSS Objectives 2012-13 Remove inefficiencies Eliminate risks More robust contract performance management We need your cooperation!! Remember…. National screening service, National standards 19

National pathway changes SMDRSS National programme – new name NDESP National Diabetic Eye Screening Programme Eliminate variation in pathways between programmes in England – no ‘postcode lottery’ Will bring consistency, comparable data, better benchmarking Avoid confusion, minimise risks 20

Local Changes Implement NDESP common pathway Grading protocol Local name change Transition to a new provider, new location New Commissioners New contract

Finally Bear in mind…. We have a very busy year ahead Wider changes within the NHS Keep up the good work!

Thank you Any questions?