Westmorland General Hospital
Burton Road
Kendal
LA9 7RGTel: 01539 715250
Email: by NHS.net email to cpcc.referrals@mbht.nhs.uk
Website:https://www.uhmb.nhs.uk/hospitals/westmorland-general-hospital*** From Monday 23rd May 2022 Wet AMD referrals should be sent to the CPCC via Opera selecting URGENT – WET AMD – UNIVERSITY HOSPITAL MORECAMBE BAY as the end point ***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
Westmorland General Hospital (part of University Hospitals of Morecambe Bay NHS Foundation trust) is involved in the management and treatment of wet AMD. In order for referrals to be accurately processed the hospital uses the RCOphth. Referral form.
Wet AMD Referrals should be sent for the attention of the Macula Unit and need to be marked, “Rapid Access Wet AMD”. This will ensure that referrals for wet AMD are clearly visible to the triage staff to prevent delay.
Please note that any co-pathology (e.g. glaucoma) should be referred separately.
Royal Lancaster Infirmary
Ashton Road
Lancaster
Lancashire
LA1 4RPSwitchboard: 01524 65944
Mon – Fri: 9.00am – 5.30pm
Weekend: 9.30am – 3.00pmFurness General Hospital
Dalton Lane
Barrow-In-Furness
Cumbria
LA14 4LFSwitchboard: 01229 870870
Mon – Fri: 8.30am – 5.00pm
Weekend: ClosedCommunity Patient Contact Centre (CPCC)
CPCC
Westmorland General Hospital,
Burton Road
Kendal
LA9 7RGPhone: 01539 716998
Email: by NHS.net email to cpcc.referrals@mbht.nhs.uk*** From Monday 23rd May 2022 Routine & Urgent referrals should be sent to the CPCC via Opera selecting URGENT – UNIVERSITY HOSPITAL MORECAMBE BAY or ROUTINE – UNIVERSITY HOSPITAL MORECAMBE BAY as the end point ***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
Routine and Urgent referrals should be sent to CPCC by NHS.net email. GOS18 template.
When sending referrals to UHMB via CPCC (all routine and urgent but not emergency referrals) please ensure these are sent either through Opera or on a GOS18 / letter headed paper type document. CPCC will no longer accept referrals where the referral is within the body of an email and these will be rejected, possibly delaying treatment for patients.
Referrals will be triaged within 48 hours and assigned to clinics with appropriate urgency.
Conditions such as BRVO and CRVO which need prompt assessment in Medical Retina should be sent to CPCC unless there are emergency complications such as high IOP.
Suspected ocular cancers requiring 2 week assessment are also sent to CPCC.
A detailed referral guidance document is being prepared in collaboration with UHMB.
Routine referrals for optometrists who don’t have NHS.net email accounts can still go by post to the CPCC (with copy to GP).
Contact the LOC to obtain an NHS.net email address if you do not have one.
There are changes being made to the way emergency referrals to University Hospitals of Morecambe Bay are to be sent. The new pathway is live now, however the previous methods of referral to Furness General Hospital and Royal Lancaster Infirmary will still be active until the 17th November, whilst we transition to the new process.
Royal Lancaster Infirmary
Ashton Road
Lancaster
Lancashire
LA1 4RPFurness General Hospital
Dalton Lane
Barrow-In-Furness
Cumbria
LA14 4LFSwitchboard: 01229 870870
Ophthalmology Triage: 01229 614149
Mon – Fri: 8.30am – 5.00pm
Weekend: 9.30am – 2.30pm
OPERA: The new endpoint has been set up and this is the preferred method of referral.
Email: by NHS.net email to ophthalmicemergencyreferral@mbht.nhs.ukAll emergency referrals will need to be sent to ophthalmicemergencyreferral@mbht.nhs.uk – OPERA has been set up with this new endpoint. This is a central booking point for emergency referrals for both Furness General Hospital and for Royal Lancaster Infirmary. The triage team will contact the patient to offer an appointment at either Lancaster or Barrow-in-Furness.
If your emergency referral requires same day assessment e.g. retinal detachment, then please telephone 01229 614149 before sending the referral. Again, this is the contact number for the central booking and triage team who can offer an appointment at either Lancaster or Barrow-in-Furness.
The phone lines are open Monday to Friday 08:30 – 17:00 and Saturday to Sunday 09:30 – 14:30. Outside of these hours, an email is sufficient as emails are picked up from 08:30 in the morning Monday to Friday and 09:30 Saturday and Sunday. If a patient requires emergency care outside of the triage hours, where they cannot wait for referral to be triaged the following day, you should be raising this to the on-call doctor. You can do this by calling the hospital switchboard on 01229870870 and asking to be connected to the on-call ophthalmology doctor. If you are unable to reach the on-call doctor, then the patient can be directed to accident and emergency departments at Furness General Hospital or Royal Lancaster Infirmary.
Westmorland General does not have an Emergency Eye Clinic – do not send urgent cases.
Practices without NHS.net email, please use 7Zip encryption (click link for user guide) and contact the LOC secretary or the eye department for an agreed password.
Community Patient Contact Centre (CPCC)
Email: cpcc.referrals@mbht.NHS.uk
Tel: 01539 716998*** From Monday 23rd May 2022 Cataract referrals should be sent to the patients choice of provider via Opera ***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
Cataract referrals should be sent direct to the patients preferred provider. This can be via the Community Patient Contact Centre (CPCC) for referrals to University Hospital Morecambe Bay Trust or direct to SpaMedica or another preferred provider. GOS18 template
IES and BCT www.primaryeyecare.co.uk
Better Care Together commissioned via Primary Eyecare Services.
Info for non-accredited Optoms – this relates to Glaucoma Repeat Readings and MECS for those in MB who are not part of the services.
If you are considering HES referral for any of the following conditions then please consider referral to a MECS provider as an alternative:
- Flashes & Floaters / visual aura (eg if it is not possible to perform dilation during your clinic)
- Red eye – Eye infections, Allergic eye conditions
- Corneal abrasions and foreign body removal (non-penetrating)
- Lid Lumps, blepharitis & dry eye
Of course, you are likely to manage the majority of these conditions in your own clinic, without onward referral. This route is only for those patients who you consider require additional care.
MECS does not usually deal with diplopia, ptosis, severe pain, severe or complete loss of vision.
Find a Practice – Search for your nearest participating optical practice (primaryeyecare.co.uk)
Please give a written referral to the patient stating that they require a MECS appointment, not a full eye exam.
Emergencies must get referred direct to ophthalmology (see Emergency referrals section).
*** From Monday 23rd May 2022 GRR referrals should be sent to an accredited practice via Opera ***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
Info for non-accredited Optoms – this relates to Glaucoma Repeat Readings for those in MBay who are not part of the services.
Please do not refer any patient into HES on the basis of raised IOP alone.
GRR is used if you detect raised IOP (>23mmHg) or a visual field defect suggestive of glaucoma without glaucomatous disc changes or narrow angles.
Find a Practice – Search for your nearest participating optical practice (primaryeyecare.co.uk)
Please send a written referral with the patient explaining that you require GRR. Include your initial IOP measures (and method), field plots and assessment of discs & angles.
All glaucomatous discs and angles-closure risk patients go to HES as usual.
The following page details the Low Vision, ECLO, Voluntary and Statutory services available in Morecambe Bay.
NONE OF THESE RESOURCES REQUIRE SOMEONE TO BE REGISTERED SIGHT IMPAIRED / SEVERELY SIGHT IMPAIRED IN ORDER TO RECEIVE ASSISTANCE.
Low Vision Service: A clinically informed evaluation of the impact of sight loss on an individual and identification of a variety of strategies to meet the resulting challenges. Making best use of remaining vision using magnifiers, lighting, visual aids, and sight training strategies.
Eye Clinic Liaison Officer (ECLO): The link between primary and secondary care clinical services and non-clinical support services for people with sight loss. ECLO’s provide emotional support, practical advice, impartial information, guidance, and advocacy and connect with other community resources.
Local Council: Statutory support and rehabilitation via Rehabilitation Officers for the Visually Impaired (ROVIs).
Voluntary & Community Organisations: Charities and other groups that provide a wide range of support services.
Barrow-in-Furness & Grange-over-Sands
Galloways Low Vision Service
Hosted by Vision Support Barrow & District (VSBD)
VSBD Vision Support Centre
67-69 Cavendish Street,
Barrow in Furness,
LA14 1QD
Phone: 01229 440556
Also available at:
Peninsula Medical Centre
Kents Bank Road,
Grange-over-Sands,
LA11 7DJ
Contact: Ros Killip (Dispensing Optician)
Email: galloways.lowvision@nhs.netPlease use Galloways referral form
Paediatric Low Vision
- Contact ‘Sight Advice South Lakes’ (Kendal), or ECLO
ECLO
Location: VSBD Vision Support Centre – see above.
- Paul Laing (VSBD)
Email: paul.laing@vsbd.org.uk
Local Voluntary/Community
-
Vision Support Barrow and District (VSBD) vsbd.org.uk
Local Council – Lancashire County Council Sensory Impairment Team
Cumbria County Council Health & Care Services
Tel: 0300 303 2704
ROVI: Martin IkastKendal Area
Galloways Low Vision Service
Hosted by Sight Advice South Lakes
The Bradbury Centre
116 Highgate,
Kendal,
LA9 4HE
Phone: 01539 769055
Contact: Jonathan Deegan (Optometrist) and Tim Ward (Assistive Technology Officer at SASL)
Email: galloways.lowvision@nhs.net
Please use Galloways referral form
Paediatric Low Vision:
- Contact ‘Sight Advice South Lakes’ as above, or ECLO.
ECLO
Location: Westmorland General Hospital or SASL – see above.
- Sarah Stoddard (SASL)
Email: sarah@sightadvice.org.uk
Local Voluntary/Community
-
Sight Advice South Lakes – see above sightadvice.org.uk
Local Council – Lancashire County Council Sensory Impairment Team
Cumbria County Council Health & Care Services
Tel: 0300 303 2704
ROVI: Martin IkastLancaster & Morecambe
Galloways Low Vision Service
‘Brew Me Sunshine’,
12 Victoria Street
Morecambe,
LA4 4AH
Phone: 01524 414846
Contact: Claire Kinley (Optometrist)
Email: galloways.lowvision@nhs.net
Please use Galloways referral form
Paediatric Low Vision
- Contact Galloways as above, or ECLO
ECLO
Location: Royal Lancaster Infirmary + Galloways – see above
- Sharon Thomas (Galloways)
Email: sharon.thomas40@nhs.net, sharon.thomas@galloways.org.uk
Local Voluntary/Community
-
Galloways – see above Galloways.org.uk
Local Council – Lancashire County Council Sensory Impairment Tea
Lancashire County Council Sensory Impairment Team
Tel: 03001236720
Website: csc.acscustomerservices@lancashire.gov.uk
Referral form: needs assessment to aid independent living. Note: Patients do not need to be registered sight impaired to be entitled to an assessment from the council.National Charities
Sightline
Charity based in NW England offering a free telephone-based befriending service designed to reduce loneliness and isolation for anyone living with a visual impairment.
Guide Dogs
Support to live actively, independently, and well with sight loss
RNIB
Inspiring people with sight loss to transform their personal experience
Macular Society
There is no need to face macular disease alone
Glaucoma UK
Supporting people to live well with glaucoma
Blind Veterans
Helping blind ex-Service people lead independent and fulfilling lives
Deaf Blind UK
Showing people that there can be a life beyond deafblindness
SeeAbility
Supporting people who have learning disabilities or autism
Sense
For everyone living with complex disabilities
Hydroxychloroquine Retinal Monitoring
The RCOphth guidelines¹ regarding retinal monitoring for hydroxychloroquine retinopathy were updated again in December 2020 and no longer recommend baseline ‘screening’.
It is for the drug prescriber, commonly a Rheumatologist, Dermatologist or GP, to determine the patient’s risk and refer to the local ophthalmology department for HCQ monitoring.The need for referral is based on the following:
- Duration of treatment
- Low risk patients require monitoring after 5 years
- High risk patients require monitoring after 1 year
- High risk factors:
- Dose >5mg per kg
- Concomitant tamoxifen use
- Reduced eGFR (less than 60ml/min)
- Taking chloroquine
Local Medical Retina teams need all the information above in any referral. The LOC recommends that Optometrists who consider their patients need to be referred for monitoring write to the drug prescriber requesting consideration of the above clinical detail. If the Optometrist feels that a direct referral is more appropriate it would be helpful to establish that a referral has not already been made by another clinician (eg GP) in order to avoid duplication.
HCQ monitoring in the HES does not replace regular sight testing and will not assess for any other pathology. Refer via the usual channels for all other conditions.Local hospital optometry colleagues may be able to assist with queries:
UHMB: Sophie Grisenthwaite s.grisenthwaite@mbht.nhs.uk¹Royal College of Ophthalmologists Guidance https://www.rcophth.ac.uk/wpcontent/uploads/2020/12/Hydroxychloroquine-and-Chloroquine-Retinopathy-Monitoring-Guideline.pdf
- Duration of treatment
These services are commissioned by NHS England and NHS Improvement and will be provided by local optical practices via the optometry federation and Primary Eyecare Services Ltd (PES) with the support of the Local Optical Committee (see list of accredited practices).
It is for patients registered with a GP practice in the following CCGs:
- Morecambe Bay
- Blackpool
- Fylde & Wyre
- Greater Preston
- East Lancashire
- West Lancashire
- Chorley and South Ribble
- Blackburn with Darwen
The purpose of the Learning disabilities and autism Eye Care Pathway is to increase the number of sight tests in patients diagnosed with learning disabilities and autism.
People with learning disabilities and autism are ten times more likely to have eye problems but are less likely to receive timely and appropriate care, than the rest of the population.
This commissioned service is a service with reasonable adjustments for someone who would not be able to use a standard eye test. This includes pre-appointment visits, completion of a functional vision assessment if needed, longer appointment time with an accredited practitioner in learning disabilities and autism and feedback forms completed by the optometrist. The results of the examination are reported using the agreed appropriate format. Only accredited practitioners (optometrists or OMPs) would provide this service.
If a Practice wants to provide these services, what should they do?
Practices that wish to deliver this service will need to complete the expression of interest form linked here EOI PwLD NHSE
Already on OPERA?Once the practice has expressed an interest on the above form, this will provide PES with the required information to enable practices access to the service modules as they go live. Practices will need to ensure that their practitioners have uploaded their WOPEC certificates to their practitioner profile so they can deliver the services. Not sure how to do this – guide linked here.
No WOPEC certification?If you have practitioners that haven’t delivered these services previously, and therefore have no certification to date, they will need to complete the WOPEC accreditation for the service. All practices who wish to deliver the services must ensure that the optometrists complete the Local Optical Committee Support Unit Optometry Postgraduate Education Centre (LOCSU/WOPEC) training and accreditation programme for patients with learning disabilities and autism.
Not signed up to OPERA?If the Practice has completed the expression of interest but has not registered on the OPERA platform to date, please read the guide linked Practice Onboarding – OPERA (optom-referrals.org) and onboard your practice. The Practice will need to complete this process and be approved by PES. Once this has been completed, they too will gain access to the service module once the service goes live in their area, and they can then register their practitioners to enable service delivery using Inviting a Practitioner to access your Practice Opera account – OPERA (optom-referrals.org) guidance.
If you require any further information or have any queries regarding the service, please contact us on our hello@referral.support email address and a member of our team will be in touch.
