1. B SOL C LUSTER LEPN What do we want service mapping to tell us?

2. W HAT DO WE NEED TO KNOW ?  What are we spending on eye health services and what are we actually buying? Programme budgeting ~ £61million (2.5%) out of Cluster annual budget of ~ £2.4billion How does this breakdown by sector/ provider/treatment or service?  What choice of providers exist? Ease of access?  Are services for certain eye care problems effectively integrated across health and social care?  What do patients/carers and the local community think about eyecare services?  How does this all compare to what we know about needs? What are the gaps/duplication in provision?

3. D ISCUSSION /I SSUES R AISED I N GROUP DURING P ROCESS M APPING (HEFT/S OLIHULL ) Do A&E send to BMEC Do other providers send to BMEC for eye A&E Optometrist have to provide sight test and claim even if GP refers for opinion as no enhanced services mechanism exists Retinopathy screening, not fully understood Hospitals don’t always receive referrals letters on time, so patients have to go to a general clinic before they can attend the right clinics Coventry Triage system. Pathway for PEARS How many referrals from general clinic to AMD Three month trial for Avastin Muscular Oedema, what do we do? Percentage of patients in secondary care for cataract but not treated Are all the pathways being followed correctly High number of DNAs for all children clinics Ask orthoptics to future meetings Bham/Solihull do not know they can refer to orthoptics??? Coding at HEFT

4. I WISH ……. To improve DNA in children’s appointments. To keep Dry AMD out of hospital and refer to low vision services. To have a referral triage. To have a triage system for ophthalmology referral. To develop PEARS. To stop wasting appointments and get referral right right first time. To offer patients the best choices at the right point of contact with the NHS. To increase the care optometrists can provide by giving more education and training. To have a seamless patient pathway. To have the same pathways delivered across Birmingham and Solihull. To re-launch the cataract and AMD pathways. To have a community glaucoma clinic. To have reliable data from HES. To educate Opticians, GPs and consultants about the right care at the right point of care. To give optometrist access to choose and book. To educate patients to improve the prevention of many eye diseases. To improve GP chose and book to ensure patients are referred to the right clinic first time. To increase 3 rd sector contribution.