1. Providing the full range of Local Enhanced Services: The case of Manchester Karen O’Brien Associate Director Primary Care Commissioning

2. Background NHS Manchester Success with other Contractors Demographics OptomEyes

3. The Why! Current financial pressures, i.e. secondary care demand Access Primary Care Development Relationships Ethos: To reduce the number of inappropriate referrals to secondary care for the confirmation of diagnosis and enable prompt treatment. To ensure the patient pathway is as short as possible whilst offering choice of service access.

4. The How! Engagement with LOC Business Case for PCT Development of Service Specification – Accreditation Procurement, Contract award, monitoring and payment Contract Performance

5. Better care Better patient experience Better value for money What have we commissioned?

6. Glaucoma Referral Refinement Service Aims: To identify patients with glaucoma - measurement of intraocular pressure, examination of the optic nerve or/and any changes in the discs, and including a visual field test from an optometry practice commissioned to provide this service for the appropriate patient referral. Confirm the risk of disease and thus improve the accuracy of referrals. 11 practices providing this service

7. Cataract Referral Refinement Service Aims: To identify patients with cataract that requires surgery To reduce the number of inappropriate referrals to secondary care. To ensure the patient pathway is as short as possible whilst offering choice of service access. 44 practices accredited

8. Diabetic Retinal Screening Service aim: To obtain from the Provider a screening and grading service for diabetic retinopathy using digital based photography, in line with the National Screening Programme Model 36 practices with a Manchester contract providing a service to approximately 23,000 patients with diabetes Service commissioned over five PCTs with approximately 60,000 patients with diabetes

9. Ocular Hypertension Service Aims: To confirm the measurement of Intraocular Pressure (IOP) for patients. To identify patients with an *IOP >21mmHg* and within scheme limits by an accredited optometrist, from an optometry practice commissioned to provide this service for the appropriate patient referral for the diagnosis of suspected ocular hypertension (OHT). 41 practices accredited

10. Challenges Communication Accreditation Documentation Remuneration Workload

11. Reality Check! Opportunities - other enhanced services The White Paper GP Consortia

12. Thank you Local Optometric Committee & Liaison Group Manchester Royal Eye Hospital NHS Manchester – Optometry Team All the optometrists providing excellent services Contact details: Karen.obrien@manchester.nhs.uk Kate.kinsey@manchester.nhs.uk Judith.smith@manchester.nhs.uk

13. Any Questions?