2. Dudley Direct Cataract Referrals Optometrist Accreditation for Cataract choose and book Presented by: Sue Lane, Dudley PCT Humphrey Yorke, Dudley LOC Charles Barlow, Dudley LOC 19 th April 2005

3. Direct Cataract Referrals Understanding “Choose and book” Assessing Patient eligibility Patient Choices Administration Following up the booking Payments

4. Patient Choices What? Where? When? Patient choice if they want surgery Patient choice of provider Patient choice of appointment date

5. Patient Choice Decisions 1. Patient Does Not want to proceed with surgery Choice of provider not required Noted in records (including score from clinical guidelines) GP informed 2. Patient Wishes to proceed with surgery Choice of provider offered 3. Patient wishes to take time to consider surgery Choice of provider offered

6. Helping the patient to choose Discuss general information on cataract surgery Issue RNIB leaflet Understanding Cataract. Issue NHS Leaflet A Guide to Choice & Booking in Cataracts Issue Cataract Provider Information Leaflets

7. Patients wanting to choose later Ensure patient ’ s contact information is correct Patient goes away and discusses with family and friends and thinks about choice Patient then contacts Optometrist with choice If patient has not chosen after 7 days – Optometrist must contact patient for decision If patient cannot be contacted or fails to choose, then annotate records accordingly

8. Patient Chooses Provider 1. Referral Form C1 Completed 2. Patient completes and signs reverse of C1 3. Optometrist advises patient to telephone provider and book their own appointment at a suitable time. 4. Patient contacts chosen hospital for appointment.

9. Administration Completed C1 is faxed to provider ASAP after choice decision Completed C1 is also faxed to GP GP will then complete form C2 & forward to provider C1 is photocopied for payment submission Original C1 is stored with the patient record for audit purposes.

10. Following up the booking If the Patient fails to make a booking, the provider will contact the patient. If patient declines appointment, the provider will notify optometrist. The Optometrist must then contact the patient within 7 days to discuss re-referral. Optometrist informs Provider & GP of new decision Fax original C1 back to provider, clearly annotated re-referral

11. Payment C1 is photocopied (confidential clinical information can then be removed) Collate C1 ’ s in batches for forwarding to PCT with GOS1 ’ s Complete 2 GOS Voucher scheme forms as per GOS1 ’ s Post/Deliver to usual PCT address Payment will be made the following month.

12. Patient Choice Pathway GP sees patient with cataract and refers them to an accredited optometrist OR Patient attends routine eye examination with non-accredited optometrist and is referred to an accredited optometrist Accredited optometrist undertakes sight test. Optometrist identifies whether surgery would be beneficial & if the patient wishes to proceed with surgery and if the referral guidelines are met Patients not wanting surgery Noted in records and GP notified Patients not wishing to make choice immediately The patient’s telephone/contact information is checked to ensure they can be contacted. Choice information given to patient. Patient discusses choice with family and friends Patient not chosen Optometrist contacts patient after 7 days. Patient cannot be contacted or fails to choose Annotate records, no further follow-up required Optometrist completes Referral form C1 & faxes to provider ASAP Patient signs reverse of C1 to confirm choice offered and consenting to referral & information exchange Optometrist informs patient to book appointment directly with appropriate provider. The patient contacts the chosen hospital to book the appointment at a convenient time Patient wishes to proceed with surgery Choice information given to patient. Patient Makes choice of provider Patient contacts the optometrist to inform them of choice.

13. F A Q ‘ s Does The Patient have an NHS ST if referred from a non accredited Optometrist? Yes – If they are entitled – Only if referred from another practice Do they have to be dilated? That is entirely at the discretion of the practitioner – A routine examination is required as per the College guidelines on best practice.

14. F A Q ‘ s Can we refer Diabetics? They can be referred through the scheme if there is no Retinopathy. If there is Retinopathy they should be referred through the normal pathway explaining direct referral is not appropriate Do I have to follow up the patients myself? At the discretion of the practitioner – it may be delegated to a member of staff.

15. F A Q ‘ s What happens to Optometrists new to the area or newly qualified Optometrists? Any Optometrists can be accredited by attending an accreditation session. These will be held at least 3 times a year and details can be obtained from the PCT or the LOC Can Locums be accredited? Yes, as long as they attend an accreditation session.

16. F A Q ‘ s What do we do for patients who come to see us who do not live in Dudley? Exactly the same You offer them the choice of providers in their area – on the sheet in the info pack for the whole of the BBC region. Faxing the C1 and your claim for payment in the normal way

17. F A Q ‘ s Why hasn ’ t my patient received an appointment yet? Because they haven ’ t phoned for an appointment – did they forget? or did you forget to RE-INFORCE the point? THE OPTOMETRIST MUST ENSURE THE PATIENT UNDERSTANDS THEY HAVE TO PHONE TO BOOK THEIR OWN APPOINTMENT

18. F A Q ‘ s Any more questions? Any further queries contact myself or Sue Lane Do not forget to hand in your completed accreditation forms Thank you & Goodnight