From 29th June 2026, the Lancashire and South Cumbria Eye Care Navigation Service (ECNS) is launching, introducing a new referral endpoint for routine GOS18 referrals on the IT platform, OPERA.
The Launch Presentation Slides can be viewed here and a recording of the launch event will be shared soon
What’s changing?
- Routine GOS18 referrals
- Select: “ROUTINE GOS18 REFERRALS ECNS – LANCS AND SC – NOT FOR CUES OR GERS” in OPERA
- Choosing any other routine endpoint will also automatically be redirected into ECNS for clinical triage
- Urgent GOS18 referrals
- Continue selecting a specific provider endpoint as usual
- These will be automatically redirected into ECNS for clinical triage
- Emergency referrals
- No change – continue to use existing local emergency pathways
- Referrals for community services (e.g. CUES, GERS, Low Vision Service).
- No change – continue referring to a named provider after a no choice conversation
- Children’s referrals – Please choose named providers as normal (Blackpool and Fylde and Wyre Practices will note new endpoints for these).
As part of the rollout of the Eye Care Navigation Service (ECNS) in Lancashire and South Cumbria, all participating practices are required to use secure communication methods when sharing patient information.
We understand that some practices are not yet using the recommended IT platform, OPERA and may have different levels of access to secure email. Please follow the guidance below depending on your setup:
What you need to
If your practice:
- Is not using the IT platform, OPERA, and
- Does not have an nhs.net email address
You must register to use KnowBe4 (formerly Egress) as soon as possible to securely send and receive patient information.
Please find the link here –
KnowBe4 Switch | Authentication
Accessing Encrypted Emails – a Guide for non NHSmail users
If you already have an Egress log in, you can sign in using your existing log in details.
If your practice:
- Is not using the IT platform, OPERA, but
- Does have an nhs.net email address
You should send referrals securely via NHSmail to the ECNS hub at: cnech.pecservices@nhs.net
Why this is important
Using a secure, approved communication method is essential to:
- Protect patient confidentiality
- Meet NHS information governance requirements
- Ensure safe and timely delivery of the Eye Care Navigation Service
If you have any questions or require further support, please contact Primary Eyecare Services via email at hello@referral.support with ‘L&SC Eye Care Navigation Service’ in the subject header.
Spa Medica
5th Floor
Whelmar House
Southway
Skelmersdale
WN8 6NRTel: 0161 838 0870
Fax (secure): 0161 839 1423 / 0161 835 1704Email: spamedica.referrals@nhs.net
Website: https://spamedica.co.ukAvailable Mon-Fri 8am-6pm, Sat 8am-4pm.
WET AMD REFERRALS SHOULD BE SENT TO SPAMEDICA VIA OPERA
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
SpaMedica is involved in the management and treatment of wet AMD. Referrals into the service can be made by your usual referral template or using the RCOphth. Referral form. 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.
You should always phone to request confirmation of receipt of a faxed referral.
iSIGHT
West Lancashire Community Eye Clinic Triage
Martland Mill
Mart Lane
Burscough
L40 0SDiSight triage fax no: 01695 664029
iSight tel contact number: 01695 664020
Email: isight.clinics@nhs.netROUTINE REFERRALS FOR WEST LANCS PATIENTS SHOULD BE SENT TO ISIGHT VIA OPERA
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
iSight now triage and arrange appointments for all non-emergency referrals. The referral letter is faxed to the iSight triage service. GOS18 template
To avoid confusion, it is recommended that the optometrist does not send the GP a copy (this will be taken care of by iSight).
All paediatric referrals should go via GP.
Southport & Formby District General Hospital
Town lane
Kew
Southport
Merseyside
PR8 6PNTel (triage) : 01704 705218
Fax : 01704705229
Out of hours switchboard : 01704 547471**Emergency referrals should be sent to Southport & Formby District General Hospital via Opera after ringing the triage line**
URGENT REFERRALS FOR WEST LANCS PATIENTS SHOULD BE SENT TO ISIGHT VIA OPERA
(Note: you can still use the below pathway if you have yet to complete onboarding to Opera)
During clinic hours, telephone triage and follow through with a fax referral. Outside clinic times, if the patient needs immediate medical assessment then phone the hospital switchboard and speak to the 1st on call eye doctor (Usually an Associate Specialist or Specialist Registrar, not a Consultant) to make arrangements. You will usually also be asked to fax referral details.
Cataract Referrals
All cataract referrals for patients with a West Lancashire GP should be sent to iSight via Opera.
If you are unable to use Opera please use a GOS18 template and email to isight.clinics@nhs.net in pdf, word or jpeg 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.
Patient Choice regarding surgical providers for cataract surgery will take place with iSight.
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.
- 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.
Please do not hesitate to call 01695 664020, should you require further information on this service.
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
University Hospital Morecambe Bay
Lancashire Teaching Hospitals
iSight
Fulwood Hall
SpaMedica
CHEC
Optegra
East Lancashire Hospitals
Excel Lampitco (Ophthalmology) Excel.Lampitco@elht.nhs.uk,
Olivia Hanna (Bank Nursing) Olivia.Hanna@elht.nhs.uk,
Hannah White (Ophthalmology Day Case) Hannah.White@elht.nhs.uk,
Jason Goinden (Ophthalmology) Jason.Goinden@elht.nhs.ukNB: 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
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/GERS)
Practitioners accredited with Primary Eyecare Services (Wopec Glaucoma Level 2 or higher) can provide GECF/GERS 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/GERS 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/GERS -> 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.Locality lead Neil Pearson may be able to assist with queries: Neil Pearson (Locality Lead)
¹Royal 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.
Sight Loss Directory : January 2026 updated version – See annex listing all the Tier 1 ophthalmology sub-contractors who provide the community Low Vision service.
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 West Lancashire.
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.
Community Low Vision Service
Lead community provider: Primary Eyecare Services
Available through participating optical practices, andGalloways Society (Sefton & West Lancs)
Primary care ophthalmic referrals via OPERA
Website: galloways.org.uk
Email: referrals.galloways@nhs.net
Phone: 01772 744 148
Location: Various/RemoteGlen Sheader – Low Vision Lead
ECLO
Southport & Ormskirk DGHs (Please use RNIB Referral from, or letter detailing similar)
- Nicola Savage (RNIB)
Email: nicola.savage@rnib.org.uk
Hospital Low Vision Service
Adult and Paediatric Low Vision Service at Mersey and West Lancashire Teaching Hospitals NHS Trust
Locations: Southport & Formby DGH & Ormskirk DGH
Phone: 01704 704969
Karen Knowles (Lead Orthoptist)
karen.knowles2@MerseyWestLancs.nhs.ukReferrals: soh-tr.patientaccess@merseywestlancs.nhs.uk
Please use the attached referral form
Local Voluntary/Community
-
Galloways – see above Galloways.org.uk
Local Council
Lancashire County Council Sensory Impairment Team
Tel: 0300 123 6720
Email: csc.acscustomerservices@lancashire.gov.uk
Website: lancashire.gov.uk/health-and-social-care/living-with-a-disability/living-with-sensory-loss/
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.Sefton Council – Rehabilitation (ROVI) through Galloways
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
- Nicola Savage (RNIB)