1. MECS Peer Discussion

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

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

4. 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

5. 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?

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

7. 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?

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

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

10. 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

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

12. 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

13. 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

14. 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

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

16. 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?

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

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

19. Vital importance of reporting through Optomanager

20. 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?

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

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

23. Discussion Complaint 3 Investigate
Full reporting through Optomanager system

24. 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?

26. 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?

27. 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?

28. 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?

29. 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

30. 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?

31. Post Consultation Scenario
Importance of completing questionnaires?
Follow Ups