1. Presentation Dr Lyn Jenkins, Clinical Director Ophthalmology
Ms Stella Hornby, Clinical Lead
Dr Jeremy Rose, Clinical Governance Director
Peter Watts Chief Executive
Ursula Anderson, Services Manager

2. Ophthalmic Primary Care
What ?
Where ?
Why ?
How ?
Who ? 2

3. The Team LMG GP Lead Consultant Ophthalmologist
Independent Clinical Governance Lead
Primary Care Ophthalmologist
Ophthalmic Primary Care Practitioner
Ophthalmic Assistant
Administration Team

4. What We Provide Now Comprehensive primary care service
Safe and effective care
High levels of patient and referrer satisfaction
A service that’s flexible and capable of rapid expansion
Mature, experienced and established primary care ophthalmology

5. Patient Benefits Urgent appointments seen same day
Waiting times less than four weeks
Excellent patient feedback from surveys
All patients seen by experienced staff
Service sensitive to patient needs

6. Patient Satisfaction

7. Patient Satisfaction

8. Patient Survey Results Key Findings
99% patients reported no problems with making an appointment
95% patients were seen on time
100% patients felt they had enough time with a clinician and their case was discussed adequately with them
100% patients indicated they wished to come back to our service, rather than a hospital based service

9. Assured Service Delivery
Responsive and efficient call centre
Adaptable and friendly administration team
Comprehensive IT system
All clinicians specifically trained in the delivery of Ophthalmic Primary Care
All personnel committed to this proven model
Supportive team structure relevant to the requirements of autonomous clinics

10. Quality of Service to GP’s and Optometrists
“Its an excellent service that delivers value to us and patients alike”
Rachel Firth GP Chesham
“We have been referring to the service for four years and since The Practice got involved we are referring all of our patients to the service”
Peter Petrie GP Gerrards Cross
“We really value the ability to pick up the phone and know that we will get a responsive, immediate and friendly service”
Optometrist Prestwood
“I made an urgent referral and they were seen in my own surgery on the same day, amazing”
GP St Albans

11. Benefit for Commissioners
30% cost savings on tariff - more with minor ops/procedures
Demand Management
Flexibility and responsiveness
Active performance management
Comprehensive monthly reports
Positive patient experience
Clinical Governance
Corporate Governance

12. Developments and Initiatives
Integration with other providers
Education and Training
Skills enhancement
Minor/Intermediate operations and laser treatments

13. Diabetic Retinopathy Unscreenables within 1 month
New vessels within 2 weeks
Other diabetic retinopathy or retinal abnormality within 1 month
Treat new vessels within 2 weeks of assessment
Treat maculopathy within 1 month of assessment
Perform digital photography, fluorescein angiography and optical coherence tomography as required at 1st assessment

14. Diabetic Retinopathy contd
Develop care pathways for onward referral for vitrectomy, cataract surgery or cyclo-photocoagulation
If research proves benefits of VEG Finhibitors,
to perform these procedures
To accredit all laser users and provide ongoing training.
Ensure compliance with laser safety rules as laid down by the Radiation and Laser Safety Authority

15. Cataract Surgery Provided by appropriately trained clinicians
Locations close to patients
Utilisation of Community facilities
30% below tariff prices

16. Clinical Governance deliver. We put quality first in everything we do.
We sink or swim on the quality of the services we
deliver.
We put quality first in everything we do.
We are always looking at ways of improving the
quality of what we do.

17. Clinical governance structure CLINICAL GOVERNANCE COMMITTEE
THE PRACTICE PLC BOARD
CLINICAL DIRECTOR
CLINICAL GOVERNANCE COMMITTEE
CLINICAL DIRECTOR
COO SURGERIES COO SERVICES
CLINICAL DEVELOPMENT LEAD
ADMIN SUPPORT
SURGERIES CG
TEAM
CLINICAL DIRECTOR
COO SURGERIES
CLINICAL LEADS
ADMIN SUPPORT
EYES CG
CLINICAL DIRECTOR
COO SERVICES
CLINICAL LEAD
CONSULTANT
TEAM
OTHER SERVICES
CLINICAL DIRECTOR
COO SERVICES
CLINICAL LEAD
TEAM

18. Our approach
We are compliant with Health Care Commission Core Standards through our focus on – The patient domain The workforce domain The organisational domain

19. The patient domain
Patient satisfaction surveys Metrics Audit Complaints Significant events Complaints and Untoward Events

20. The workforce domain
Qualifications and experience Registration and insurance Professional development Education and training Appraisal and mentoring All staff

21. The organisational domain
Logistics – referrals, appointments, letters Environment – clinics, health and safety Equipment – clinicians’ bags, servicing Communications – internal and external Corporate Governance

22. Clinical Governance Summary
Quality really does matter We are always looking to improve Right monitoring and feedback systems Professional and organisational development a priority Proven track record

23. Conclusions
We do primary care ophthalmology in a primary care environment
We will build and evolve a flexible service with you, for you and your patients
We will deliver high quality patient care with real financial benefits

24. Referral Procedure Urgent 1-2 days please phone before faxing
Soon < 2 weeks
Routine < 4 weeks
Please specify above, and also whether patient requires a visual field or dilated exam.
Referrals received by fax.
Urgents please telephone first on so that we know to expect the fax.
Alternatively at
or, write to Eye Service, Lynton House Surgery, 43 London Rd, High Wycombe, Bucks

25. Reporting Numbers of Referrals Referrer NHS Number Date of Birth
Date of referral
Outcome of Referral
Date of Appointment
Type of Appointment i.e. first, follow up, glaucoma
Outcome of appointment
Clinician
Diagnosis

26. Independent Audit 2005 Key Findings
“Service provided is equivalent to if not better than the Oxford Eye Hospital Out Patients Department”
“Management of all patients was found to be of a high standard”
Miss Bianca Sallustio
Clinical Lead Oxford Eye Department