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-hospitalWet 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.ukRoutine & 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.
Cataract Referrals
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) cpcc.referrals@mbht.NHS.uk for referrals to University Hospital Morecambe Bay Trust or direct to SpaMedica or another preferred provider. GOS18 template
Post Cataract Service
Practitioners accredited with Primary Eyecare Services can provide post operative cataract checks on Opera for all patients registered with a Lancashire & South Cumbria GP.
Post op cataract service specification: Here
Please Note:
- A GOS sight test fee can be claimed for both the 1st and 2nd eyes. In the rare event a patient is under 60 and not eligible for a GOS sight test then only the post cat fee can be claimed – practices must not charge these patients for a sight test as service must be free at the point of access.
- Practices cannot add post cat patients to opera themselves. If the patient is not visible on your Opera dashboard, use the blue chat bubble in the first instance to ensure the surgical provider has referred to the correct practice. If Primary Eyecare confirm the patient has not been added by the surgical provider, the practice will need to contact the provider to add them before arranging an appointment using the details below.
Blackpool Teaching Hospital – bfwh.eyesecretaries@nhs.net
University Hospital Morecambe Bay – ophthalmologyclinicalbusinessunit@mbht.nhs.uk
Lancashire Teaching Hospitals – eyeward@lthtr.nhs.uk
East Lancashire Hospitals – TBC
iSight – isight.clinics@nhs.net
Fulwood Hall – not onboarded yet
SpaMedica – post-op.team@spamedica.co.uk
CHEC – engagement@chec.uk
Optegra – optegra.postops@nhs.netNB: Practices must send the request from an NHS.net account when sending patient identifiable data.
Opera help & support for cataract services can be found here
When a patient has their UHMB 1st eye post op cataract episode processed through OPERA and wishes to be referred to have surgery for their second eye, please select the new “UHMB ROUTINE 2ND EYE REFERRALS FROM POST OP ON OPERA ONLY” endpoint to send the referral to.
This will stop a duplicate clinical assessment episode being created in the hospital which would be the case if the normal “UNIVERSITY HOSPITAL MORECAMBE BAY – ROUTINE” endpoint was selected instead.
If a patient has had their first eye surgery some time ago and was discharged without the need to have their second eye surgery at the time, then please create a new referral for their second eye when referral for second eye surgery is indicated and send it to the “UNIVERSITY HOSPITAL MORECAMBE BAY – ROUTINE” endpoint as the patient will need an eye clinic assessment.
Any post operative complications should still be sent via the usual route which would likely be the “UHMB (RLI&FGH) EMERGENCY REFERRALS” endpoint.
Community Urgent Eyecare Services
Practitioners accredited with Primary Eyecare Services can provide CUES using the Opera Platform for any patient registered with a Lancashire & South Cumbria GP.
CUES enables patients to be seen in community optical practice for urgent assessment of acute ocular presentations, thereby reducing the burden on the hospital eye service.
Presenting conditions will typically include :-
- Acute visual changes – flashes and floaters, visual distortion, sudden or transient vision loss/reduction, field loss, and diplopia.
- Ocular discomfort – painful, red, sore, sticky, watery, itchy, dry, or irritated eye(s) or eyelid(s).
- Abrasions and foreign bodies – known history of low velocity, non-penetrating, and nonchemical injury.
- Other presentations requiring urgent clinical investigation but not suitable for GOS and not appropriate for eye casualty.
CUES is not optimal for the following presentations:
- Sudden and sustained loss of vision, or vision loss with malaise
- Chemical or high velocity/penetrating eye injuries
- Post-operative complications from recent eye surgery
- Sudden onset diplopia
- Headaches with no visual symptoms
Patients should be redirected to a more appropriate setting unless,
- they have already been redirected into CUES from elsewhere.
- they are unable to access alternatives within suitable timescale.
CUES service specification: Here
Opera help & support for CUES can be found here
Please Note:
- There are no age restrictions for CUES
- Please can all CUES practices ensure that they triage CUES patients and add them to OPERA, then look to find an appointment in the system for the patient by ringing round alternative practices. The triaged episode can then be sent on to the practice which will examine the patient.
- OCT can only be claimed for patients with a sudden drop in vision with central distortion and not for any other presentations.
- The CUES fee covers follow up appointments for the same condition for up to 3 months.
Non-accredited practices should use the find a practice site to refer any patient presenting with symptoms suggestive of an urgent eye condition to a nearby participating CUES practice. Please ring the practice first to check for availability.
FIND A PRACTICE
A list of accredited optical practices currently providing the service is available on the Primary Eyecare Website using the ‘Find a Practice’ tool. This shows the most up to date information.
Glaucoma Repeat Readings (GRR)
Practitioners accredited with Primary Eyecare Services (Wopec Glaucoma Level 1) can provide GRR using the Opera Platform for any patient registered with a Lancashire & South Cumbria GP.
GRR service specification: Here
Non participating practices should refer patients with raised IOP and/or suspicious visual fields (but normal optic discs) to an accredited practice on opera by selecting:- primary care services-> GRR -> select accredited practice.
Glaucoma Enhanced Case Finding (GECF/GRRS)
Practitioners accredited with Primary Eyecare Services (Wopec Glaucoma Level 2 or higher) can provide GECF/GRRS using the Opera Platform for any patient registered with a Lancashire & South Cumbria GP.
Practices accredited to do GECF cannot provide GRR and should process all episodes as GECF.
GECF/GRRS service specification: Here
Non participating practices should refer patients with raised IOP and/or suspicious visual fields and/or suspicious optic discs to an accredited practice on opera by selecting:- primary care services-> GECF/GRRS -> select accredited practice.
For practices not on Opera please consider onboarding, otherwise, contact an accredited practice then send a GOS18 referral to them via NHS.net, confirming receipt. PLEASE DO NOT TELL PATIENTS TO RING ROUND OR JUST TURN UP. You can find local accredited practices by emailing hello@referrals.support.
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
The service should be available to anyone who is recognised by their GP as having a mild, moderate or severe learning disability who are on a local learning disability register. The patient must be registered with a GP practice in the Lancashire and South Cumbria area, or be a Lancashire & South Cumbria resident and not registered with a GP anywhere.
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
- feedback forms completed by the optometrist.
The results of the examination are reported using the agreed appropriate format. WOPEC accreditation is required to provide this service.
The orthoptist team at Blackpool Victoria Hospital are keen to support optometrists and can be contacted at bfwh.orthoptics@nhs.net
Easy Eyecare service specification: Here
Opera help & support for Easy Eyecare can be found here
FIND A PRACTICE
A list of accredited optical practices currently providing the service is available on the Primary Eyecare Website using the ‘Find a Practice’ tool. This shows the most up to date information.
If you require any further information or have any queries regarding the service, please contact Primary Eyecare Services on hello@referral.support and a member of the team will be in touch.
Practitioners accredited with Primary Eyecare Services (Wopec Low Vision) can provide this service using the Opera Platform for any patient registered with a Lancashire & South Cumbria GP.
Patients may be referred in by another optical practitioner, GP, Hospital Eye Service (HES), social services, third sector etc or may self-refer.
Low Vision service specification: Here
Note: the 6 week telephone follow up can be done by admin staff and not a LV practitioner.
Opera help & support for Low Vision can be found here
FIND A PRACTICE
A list of accredited optical practices currently providing the service is available on the Primary Eyecare Website using the ‘Find a Practice’ tool. This shows the most up to date information.
If you require any further information or have any queries regarding the service, please contact Primary Eyecare Services on hello@referral.support and a member of the team will be in touch.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 Team
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
