Providing the full range of Local
Enhanced Services:
The case of Manchester
Karen O’Brien
Associate Director Primary Care
Commissioning
Background
• NHS Manchester
• Success with other Contractors
• Demographics
• OptomEyes
The Why!
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Current financial pressures, i.e. secondary care demand
Access
Primary Care Development
Relationships
Ethos:
• To reduce the number of inappropriate referrals to
secondary care for the confirmation of diagnosis and enable
prompt treatment.
• To ensure the patient pathway is as short as possible whilst
offering choice of service access.
The How!
• Engagement with LOC
• Business Case for PCT
• Development of Service Specification – Accreditation
• Procurement, Contract award, monitoring and payment
• Contract Performance
What have we commissioned?
Better care
Better patient
experience
Better value for
money
Glaucoma Referral Refinement
Service Aims:
• To identify patients with glaucoma - measurement of
intraocular pressure , examination of the optic nerve
or/and any changes in the discs, and including a visual
field test from an optometry practice commissioned to
provide this service for the appropriate patient referral.
• Confirm the risk of disease and thus improve the
accuracy of referrals.
• 11 practices providing this service
Cataract Referral Refinement
Service Aims:
• To identify patients with cataract that requires
surgery
• To reduce the number of inappropriate referrals to
secondary care.
• To ensure the patient pathway is as short as possible
whilst offering choice of service access.
• 44 practices accredited
Diabetic Retinal Screening
Service aim:
• To obtain from the Provider a screening and grading
service for diabetic retinopathy using digital based
photography, in line with the National Screening
Programme Model
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36 practices with a Manchester contract providing a
service to approximately 23,000 patients with diabetes
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Service commissioned over five PCTs with approximately
60,000 patients with diabetes
Ocular Hypertension
Service Aims:
• To confirm the measurement of Intraocular Pressure
(IOP) for patients.
• To identify patients with an *IOP >21mmHg* and within
scheme limits by an accredited optometrist, from an
optometry practice commissioned to provide this service
for the appropriate patient referral for the diagnosis of
suspected ocular hypertension (OHT).
• 41 practices accredited
Challenges
• Communication
• Accreditation
• Documentation
• Remuneration
• Workload
Reality Check!
• Opportunities - other enhanced services
• The White Paper
• GP Consortia
Thank you
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Local Optometric Committee & Liaison Group
Manchester Royal Eye Hospital
NHS Manchester – Optometry Team
All the optometrists providing excellent services
Contact details:
• Karen.obrien@manchester.nhs.uk
• Kate.kinsey@manchester.nhs.uk
• Judith.smith@manchester.nhs.uk
Any Questions?