North West Macular Service
Tel: 0333 321 8844
Fax: 01706 638594
Email:practiceplusgrp.northwestmacular@nhs.net
Website: practiceplusgroupophthalmology.co.ukLongridge Civic Hall
1 Calder Avenue
Preston
PR3 3HJB&Q Bamber Bridge
1 Southrings Business Park
Preston
PR5 6BZB&Q Chorley
Highfields Industrial Estate
Preston
PR7 1QD*** FROM MONDAY 23RD MAY 2022 WET AMD REFERRALS SHOULD BE SENT TO NORTH WEST MACULA SERVICE VIA OPERA***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
Practice Plus Group and local consultant group, Manchester Consultants Eye Partnership (MCEP) provide treatment for macular conditions to patients across the North West of England. In order for referrals to be accurately processed and patients seen within 48hrs of referral, the hospital uses the NW Macular AMD Referral form.
Practice Plus Group are able to treat the following conditions:
- Wet Macular Degeneration (WAMD)
- Diabetic Macular Oedema (DMO)
- Vein Occlusions (VO)
- Neovascular membranes associated with myopia (Myopic CNVM)
They cannot accept referrals for:
- Dry AMD
- Epiretinal Membranes
- Macular Holes
Referrals for wet AMD must not be sent via the CHEC online portal.
Please note that any co-pathology (e.g. glaucoma) should be referred separately – see Routine & Urgent Pathways.
You should always phone to request confirmation of receipt of a faxed referral.
Lancashire Eye Centre
Chorley & South Ribble Hospital
Preston Rd
Chorley
PR7 1PPTriage: 01257 245346 (9am-4.30pm)
*** FROM MONDAY 23RD MAY 2022 ROUTINE REFERRALS FOR PRESTON, CHORLEY & SOUTH RIBBLE PATIENTS SHOULD BE SENT TO THE REFERRAL MANAGEMENT CENTRE (RMC) VIA OPERA***
*** FOR OUT OF AREA PATIENTS WISHING TO BE SEEN IN THIS AREA PLEASE CHOOSE THE PREFERRED PROVIDER AS THE END POINT AND NOT THE RMC ***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
Remember that with ‘routine’ you should assume it will be up to 3 months before the patient is seen so for anything more urgent you should follow the urgent/emergency pathway.
All referrals to the RMC should be completed using the new Ophthalmology Referral Template. This is to ensure transparency across all referrals and to ensure independent patient choice discussions are undertaken for our area. Please use this template in preference to any other format (eg. GOS18) and email to the RMC team, in .pdf or word format, using an NHS.net account. You will receive a confirmation email to indicate your referral is being processed or a return email advising the referral needs amending and resending.
Use of the above template is strongly recommended. It will assist the process of uploading the referrals to the NHS Electronic Referral System (eRS). Using different formats will slow down processing and increase opportunities for error and omissions. If you are unable to use the template, please ensure all the information requested is included in your referral.
NHS Numbers significantly improve speed and accuracy of referral processing, making it safer for our patients. While optical practices do not currently routinely collect NHS numbers, including them in the referral makes an enormous difference. Patients can find their NHS number by the following methods:
- Any prescription copy from the GP, Covid-19 vaccination letters, My GP appt on their smartphone
- www.nhs.uk/nhs-services/online-services/find-nhs-number – will instantly text the NHS number to a mobile phone
Please consider if your practice could collect and record NHS numbers as part of patient registration or booking procedures.
Referrals may be rejected if they are incomplete. The CCG and RMC wish to work with optical practices to implement a safe and efficient system and we will provide support and feedback during the early stages. Please be aware that it may be necessary to reject referrals if insufficient information is provided to enable accurate processing.
Patient Choice regarding surgical providers for cataract surgery will take place with the RMC team and is recorded for audit purposes. Please do not have the choice discussion with the patient or note a preferred provider on the referral form.
Please do not hesitate to contact Samantha Davis, should you require further information on this service.
Lancashire Eye Centre
Chorley & South Ribble Hospital
Preston Rd
Chorley
PR7 1PPEmergency Triage: 01257 245346 (Mon-Fri 9am-4.30pm)
Emergency Email:eye.emergencies@lthtr.nhs.uk (for same day triage by nurse)
Urgent Email: mlcsu.ophthalmologyurgent@nhs.net (non-emergencies to be seen within 6 weeks – using nhsmail only)
Switchboard: 01772 716565 available 24hrs (ask for Operator)*** FROM MONDAY 23RD MAY 2022 URGENT REFERRALS FOR PRESTON, CHORLEY & SOUTH RIBBLE PATIENTS SHOULD BE SENT TO THE REFERRAL MANAGEMENT CENTRE (RMC) VIA OPERA***
**Emergency referrals should be sent to Lancashire Teaching Hospitals via Opera**
* FOR OUT OF AREA PATIENTS WISHING TO BE SEEN IN THIS AREA PLEASE CHOOSE THE PREFERRED PROVIDER AS THE END POINT AND NOT THE RMC *
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
PLEASE DO NOT SEND THE SAME REFERRAL TO BOTH THE EMERGENCY AND URGENT ADDRESSES AS THIS IS CAUSING MULTIPLE BOOKINGS WITH SECONDARY CARE
All Emergency referrals should be made via the dedicated triage phone line when open. Please only phone switchboard out of hours or weekends, this will take you to an automated system where you should say “Operator” to be put through to switchboard.
The Emergency email is checked regularly throughout the working day between 9am -5pm Mon-Fri.
Outside clinic times, if the patient needs immediate medical assessment then phone the hospital switchboard and speak to the on call eye doctor (Usually an Associate Specialist or Specialist Registrar, not a Consultant) to make arrangements. You will usually also be asked to email referral details.
*****During office hours patients will be seen at the new Ophthalmology Unit in Chorley. Outside office hours the on call doctor will advise whether the patient needs to attend A&E at Preston or Chorley as appropriate.*****
All referrals to the RMC should be completed using the new Ophthalmology Referral Template. This is to ensure transparency across all referrals and to ensure independent patient choice discussions are undertaken for our area. Please use this template in preference to any other format (eg. GOS18) and email to the RMC team, in .pdf or word format, using an NHS.net account. You will receive a confirmation email to indicate your referral is being processed or a return email advising the referral needs amending and resending.
Use of the above template is strongly recommended. It will assist the process of uploading the referrals to the NHS Electronic Referral System (eRS). Using different formats will slow down processing and increase opportunities for error and omissions. If you are unable to use the template, please ensure all the information requested is included in your referral.
NHS Numbers significantly improve speed and accuracy of referral processing, making it safer for our patients. While optical practices do not currently routinely collect NHS numbers, including them in the referral makes an enormous difference. Patients can find their NHS number by the following methods:
- Any prescription copy from the GP, Covid-19 vaccination letters, My GP appt on their smartphone
- www.nhs.uk/nhs-services/online-services/find-nhs-number – will instantly text the NHS number to a mobile phone
Please consider if your practice could collect and record NHS numbers as part of patient registration or booking procedures.
Referrals may be rejected if they are incomplete. The CCG and RMC wish to work with optical practices to implement a safe and efficient system and we will provide support and feedback during the early stages. Please be aware that it may be necessary to reject referrals if insufficient information is provided to enable accurate processing.
Please do not hesitate to contact Samantha Davis, should you require further information on this service.
*** FROM MONDAY 23RD MAY 2022 CATARACT REFERRALS FOR PRESTON, CHORLEY & SOUTH RIBBLE PATIENTS SHOULD BE SENT TO THE REFERRAL MANAGEMENT CENTRE (RMC) VIA OPERA***
*** FOR OUT OF AREA PATIENTS WISHING TO BE SEEN IN THIS AREA PLEASE CHOOSE THE PREFERRED PROVIDER AS THE END POINT AND NOT THE RMC ***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera & currently there is no change to how you submit and receive post cataract reports)
All referrals to the RMC should be completed using the new Ophthalmology Referral Template. This is to ensure transparency across all referrals and to ensure independent patient choice discussions are undertaken for our area. Please use this template in preference to any other format (eg. GOS18) and email to the RMC team, in .pdf or word format, using an NHS.net account. You will receive a confirmation email to indicate your referral is being processed or a return email advising the referral needs amending and resending.
Use of the above template is strongly recommended. It will assist the process of uploading the referrals to the NHS Electronic Referral System (eRS). Using different formats will slow down processing and increase opportunities for error and omissions. If you are unable to use the template, please ensure all the information requested is included in your referral.
NHS Numbers significantly improve speed and accuracy of referral processing, making it safer for our patients. While optical practices do not currently routinely collect NHS numbers, including them in the referral makes an enormous difference. Patients can find their NHS number by the following methods:
- Any prescription copy from the GP, Covid-19 vaccination letters, My GP appt on their smartphone
- www.nhs.uk/nhs-services/online-services/find-nhs-number – will instantly text the NHS number to a mobile phone
Please consider if your practice could collect and record NHS numbers as part of patient registration or booking procedures.
Referrals may be rejected if they are incomplete. The CCG and RMC wish to work with optical practices to implement a safe and efficient system and we will provide support and feedback during the early stages. Please be aware that it may be necessary to reject referrals if insufficient information is provided to enable accurate processing.
Patient Choice regarding surgical providers for cataract surgery will take place with the RMC team and is recorded for audit purposes. Please do not have the choice discussion with the patient or note a preferred provider on the referral form.
Please do not hesitate to contact Samantha Davis, should you require further information on this service.
Only accredited practitioners accredited can provide post operative cataract checks.
Post Cataract Providers List – updated 01/03/21
Community Health & Eyecare Ltd
1-6 Star Building
Caxton Road
Fulwood
Preston
PR2 9BSHead Office: 08000 151 321
Clinical Helpline: 0330 100 4753
Patient Administration Line: 0330 100 4730
Email:c.hec@nhs.net
Web:www.communityeyecare.uk
Area Engagement Team: engagement@chec.ukAvailable: Mon-Fri 9am-5pm
Info for non-accredited Optoms – this relates to Glaucoma Repeat Readings and MECS for patients with a GP in Preston, Chorley or South Ribble who are not part of the services.
*** FROM MONDAY 23RD MAY 2022 MECS REFERRALS FOR PRESTON, CHORLEY & SOUTH RIBBLE PATIENTS SHOULD BE SENT TO THE REFERRAL MANAGEMENT CENTRE (RMC) VIA OPERA***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
If you are considering HES referral for any of the following conditions then please consider referral to a MECS provider as an alternative:
- Patient must be aged 18yrs or older.
- Any loss of vision even if short Dilation – Px not to drive
- Flashes/Floaters Dilation – Px not to drive
- Px reports sudden onset field defect Dilation – Px not to drive
- Pigmented Retinal Lesions Dilation – Px not to drive
- Ocular Pain
- Red Eye
- Foreign Body
- CL removal from another opticians
- Dry Eye
- Blepharitis
- Watery Eyes
- Ingrowing Eyelashes
- Lumps & Bumps near eye
MECS does not usually deal with diplopia, ptosis, severe pain, severe or complete loss of vision.
Please refer the patient using the new routine or urgent pathway and tick the MECS box. The referral will be triaged and a MECS appointment will be arranged with an accredited practice.
CHEC have also produced a patient information leaflet about the service which you may find useful.
Emergencies must get referred direct to ophthalmology (see urgent referrals section)
Info for non-accredited Optoms
*** FROM MONDAY 23RD MAY 2022 GRR REFERRALS FOR PRESTON, CHORLEY & SOUTH RIBBLE PATIENTS SHOULD BE SENT TO THE REFERRAL MANAGEMENT CENTRE (RMC) VIA OPERA***
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
GRR is used if you detect raised IOP (>23mmHg).
Please follow the Routine or Urgent pathway, referrals for raised IOP should not be sent to the GP. The patient will be triaged and offered an appointment with an accredited practitioner for refinement or with secondary care if more appropriate.
Emergencies must get referred via on-call on the day.
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:
Asma Adam (LTHTR)¹Royal College of Ophthalmologists Guidance https://www.rcophth.ac.uk/wpcontent/uploads/2020/12/Hydroxychloroquine-and-Chloroquine-Retinopathy-Monitoring-Guideline.pdf
- Duration of treatment
This pathway will be rolled out on 17th March 2022.
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. 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.