Primary Eye Care North East
Minor Eye Conditions and Treatment Service (MECATs)
Version 1 Feb 2015 (Review annually)
Minor Eye Conditions and Treatment Service (MECATs)
Contents

Flashes and Floaters Pathway

Maculopathy Pathway

Red Eye Pathway

MECS Triage Documentation

Sub-contractor Declaration

North East Urgent Care Provision

Patient Satisfaction Questionnaire MECATS

Some useful Links for information and Patient Leaflet Downloads

Primary Eyecare North East Ltd Safeguarding Policy

Disclosure & Barring Service (DBS) checks

Interpreting Services for Primary Care Contractors
Version 1 Feb 2015 (Review annually)
Flashes and Floaters Pathway
Version 1 Feb 2015 (Review annually)
Maculopathy Pathway
Version 1 Feb 2015 (Review annually)
Red Eye Pathway
Version 1 Feb 2015 (Review annually)
Darlington and Durham Minor Eye Conditions Service (MECATS)
Triage Sheet (Patients with GP’s in Darlington, Durham Dales, Easington and Sedgefield CCGs)
Patient’s Personal Details
First Name:
Last Name:
Address:
Patient’s GP Practice Details
GP Name:
Practice Name:
Address:
Postcode:
Postcode:
DOB:
Phone number:
NHS Number:
Phone:
Fax:
Email:
Date and Time of Referral Received:
Referral From: NHS 111*/Pharmacy*/GP*/Self-referral*/Optometrist*Other?__________________
(*Circle as applicable)
Reason for Referral (please note presenting symptoms):_______________________________________
NB: Contact lens related red eyes can only be seen under MECATS if the patient cannot see their own
contact lens practitioner
Q.1 – Is it Painful?
Eye Pain
Eye Discomfort
Sore/Irritated Eye
Red Eye
Dry Eye
Watery Eye
Eye Lumps/ Bumps
Reduced Vision
Disturbed Vision
Distorted Vision
Double Vision
(check with
Optometrist)
Yes – see within 24hrs
No – go to Q.2
Q.2 – Is there sensitivity to light?
Yes – see within 24hrs
No – go to Q.3
Q.3 - Is there any change in
vision?
Q.4 – Has it developed suddenly?
Yes – see within 48hrs
No – see within 14 days, also check with Optometrist
Yes – see within 48hrs
No – go to Q.5
Q.5 – If gradual, when did it start?
Less than 2 months – see within 14 days
More than 2 months – refer out of pathway for Sight
Test
Less than 6 weeks; sudden; increasing; cloud; curtain
or field loss – see within 24hrs or next appointment
Flashes and / or
Floaters
Q.6 – When did it begin or change
or become worse?
6 weeks to 2 months
stable symptoms
6 weeks to 2 months
increasing symptoms
More than 2 Months
See within 2 weeks
See within 24hrs or next
appointment
Likely to exit service
Notes: This sheet is for guidance only. Always check with an optometrist anyway to refine each decision. If you do not have
an appointment available at your Practice, you must arrange an appointment elsewhere likely at the Practice next chosen by the patient.
Advise the patient to contact you or a Listed Practice at any time if symptoms become worse or concerned at all, or if out of hours for any
MECATS Practice then contact GP or NHS 111 for further guidance. If no other advice is available then patient should know to go to a
hospital A & E Eye Department (sheet available with Contact details for this emergency) or to seek medical advice in any event if the patient
is generally unwell.
Version 1 Feb 2015 (Review annually)
Sub-contractor Declaration
The Agreement is for the provision of:Minor Eye Conditions Assessment and Treatment Services (MECS)
By entering your name and clicking the "Agree" button you confirm that the subcontractor (normally a practice owner) agrees to follow the clinical protocol as
described in the Agreement between the sub-contractor and Primary Eye Care (North
East) Ltd.
In particular you agree that:









All qualifying patients will be processed through the service
The sub-contractor has a current GOS contract.
The sub-contractor is currently compliant with Quality in Optometry (QiO)
Level 1 (GOS compliance) and agrees to work towards QiO NHS Standard
contract sub-contractor compliance.
The sub-contractor requires its performers to have a current DBS (formally
CRB) certificate or will have made application for one.
The sub-contractor agrees to facilitate the agreed patient satisfaction survey.
The sub-contractor complies with any clinical governance arrangements
agreed with Primary Eye Care (North East) Ltd
The clinical protocol has been read by the sub-contractor and provided to all
performers delivering the service
The sub-contractor is responsible for monitoring compliance of performers
providing this service.
Performers will always check entries filled by someone else and then enter
the sign-off number themselves.
The sub-contractor will be responsible for providing the following equipment and
consumables: 





Applanation Tonometer
Volk/ Headset indirect ophthalmoscope
Equipment for epilation
Threshold fields equipment to produce a printed report
Amsler Chart
Equipment for FB removal
I will provide evidence to support this declaration if requested by Primary Eye Care
(North East) Ltd. The person entering their name should be the sub-contractor or their
authorised representative.
Version 1 Feb 2015 (Review annually)
Performer declaration
I declare:
I have read and will follow the clinical protocol for this service.
I have passed the WOPEC PEARs distance learning and practical skills
assessment, provided by LOCSU, and will provide evidence to Primary Eye Care
(North East) Ltd
I am aware of my own limitations and will not compromise patient safety
If requested I will provide Primary Eyecare (North East) Limited with a copy of my
Disclosure & Barring Services (formerly known as the Criminal Records Bureau)
report
Version 1 Feb 2015 (Review annually)
North East Emergency Eye Care provision
October 2014
Sunderland Eye Infirmary
24 hour nurse led eye casualty
Telephone via switchboard 0191 5656256
24hr doctor on call urgent telephone referral via switchboard
Wet AMD Fast Track FAX: 0191 569060
Newcastle Eye Centre, RVI
Doctor led Eye ED 8.30-16.30 weekdays, 9-11.30 Saturday
Telephone: 0191 2825583
24hr doctor on call urgent telephone referral via switchboard
Wet AMD Fast Track FAX: 0191 2826269
James Cook, Middlesbrough
Nurse Practitioner led eye casualty within main ED 7.45-20.00; patients are brought back at
17.00-18.00 for the doctor
Telephone: 01642 854096
Main ED/Optom/GP direct fax referral - triaged to dr fast track clinic 9-5 weekdays
Fax: 01642 282682
24hr doctor on call urgent telephone referral via switchboard
Wet AMD Fast Track FAX: 01642 282682
Darlington Memorial Hospital (and Durham)
Main ED/Optom/GP direct fax referral - triaged to dr urgent care clinic 9-5 weekdays
Telephone: 01325 743194
Fax: 01325 743803
24hr doctor on call urgent telephone referral via switchboard
Wet AMD Fast Track FAX: 01325 743762
Version 1 Feb 2015 (Review annually)
Patient Satisfaction Questionnaire
PENE Minor Eye Conditions Assessment and Treatment Service
You have been able to access a Minor Eye Conditions Assessment and Treatment
Service (MECs) appointment with your local optometrist for an eye condition which
you have recently suffered.
To ensure that the service has been set up to meet your needs, we are keen to hear
your views regarding your experience of the service, and would therefore ask that
you take a few minutes to fill in this short questionnaire.
Practice visited:
...................................................................................................................
1. Who referred you to the Minor Eye Conditions Assessment and Treatment
Service?
GP

Pharmacy

Optometrist

Self

NHS 111

2. How did you feel when you were told that you could be seen by a local
optometrist for your condition?

Happy
Concerned

Not Applicable

3. Were you given all the information you required to book an appointment
with an optometrist?
Yes

No

Not Applicable

4. From the time of your GP or Optometrist appointment when a decision to
refer you to the MECs service was made, how long did you wait for a MECs
appointment?
0-24 hours

More than 14 days
25-48 hours

3-14 days

Were you satisfied with this length of time
Version 1 Feb 2015 (Review annually)
Yes / No

5. Were you happy with the level of choice of optometrists you were offered?

Yes
No

6. Did you find the journey to see the optometrist easier than it would have been
travelling to the hospital for an appointment?

Yes
No

7 In terms of the service that the optometrist provided?
Yes
No
a) Did the optometrist explain the details of the condition you were
suffering?


b) If medication was prescribed, did the optometrist fully explain
the reasons why you should use it?


c) Did you feel able to ask any questions regarding your
condition?


d) Were your questions answered satisfactorily?


e) Did you feel that you were offered a professional service?


f) Overall, were you happy and confident with the service
provided?


Please tick one box
8. What age range to you fit into?

0-25

26-40


Female
41-55
9. Are you?

Male
Version 1 Feb 2015 (Review annually)

56-70

70+
10. How would you describe your Ethnicity?
Asian or
Asian British



Bangladeshi

any other Asian
background
Indian
Pakistani
Mixed



White & Asian

any other Mixed
background
Black or
Black British



African
Caribbean
any other Black
background
White & Black African
Other Ethnic Group


Chinese

I do not wish to disclose
this information
any other ethnic group
White & Black
Caribbean
White



British
Irish
any other White
background
11. Do you have any further comments that you would like to make?
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
…………………………………………………………………………………………..
THANK YOU FOR TAKING THE TIME TO FILL IN THIS QUESTIONNAIRE.
Please return this survey to a member of practice staff
Version 1 Feb 2015 (Review annually)
Some useful Links for information and Patient Leaflet Downloads:The College of Optometrists:
http://www.college-optometrists.org/
http://www.college-optometrists.org/en/membership/my-membership/for-yourpatients/patient-leaflets/index.cfm
http://lookafteryoureyes.org/
The Royal College of Ophthalmologists:
http://www.rcophth.ac.uk/
http://www.rcophth.ac.uk/page.asp?section=365&sectionTitle=Information+Booklets
AOP Flashers and Floaters Px advice and Wet AMD rapid access form
http://www.aop.org.uk/practitioner-advice/business-practice/practice-literature/practiceleaflets
Medicines Support Unit for Optometrists:
http://www.nric.org.uk/IntegratedCRD.nsf/MSU_MedicinesLegislationandOptometrist
?OpenForm
International Glaucoma Association:
http://www.glaucoma-association.com/
http://www.glaucoma-association.com/can-u-c-2-drive-campaign/download-the-eyewaycode.html
The Macular Society:
http://www.macularsociety.org/
http://www.macularsociety.org/How-we-help/Information-leaflets
SeeAbility:
https://www.seeability.org/
https://www.seeability.org/our-specialisms
The Eyecare Trust:
http://www.eyecaretrust.org.uk/
http://www.eyecaretrust.org.uk/eye_information_main.php
LOCSU:
http://www.locsu.co.uk/
RNIB:
http://www.rnib.org.uk/
http://www.rnib.org.uk/eye-health
Sunderland & North Durham Royal Society for the Blind:
http://www.sundrsb.org.uk/
http://www.sundrsb.org.uk/services/resources/
Stop Smoking Advice and Leaflet
http://www.nhs.uk/smokefree
http://resources.smokefree.nhs.uk/local-marketing-support/referral-management/clientleaflets/
Advice on healthy eating - Live Well
www.nhs.uk/Livewell/Goodfood/Pages/eight-tips-healthy-eating.aspx
Protecting Your Eyes from Blue Light
Version 1 Feb 2015 (Review annually)
www.macularsociety.org/about-macular.../Protecting-your-eyes
Information on AREDS findings and Anti-oxidant Supplements
https://www.nei.nih.gov/amd/summary
Leaflet on Anti-oxidant Supplements
http://medicines.necsu.nhs.uk/wp-content/uploads/2014/03/Patient-Leaflet-Vitamin-mineralsupplements-for-ARMD.pdf
Reference guide to consent for examination or treatment
www.dh.gov.uk
Capacity Act, Healthcare Professionals code of practice summary
www.publicguardian.gov.uk
There are other Links embedded in these Websites that may lead to other useful
Version 1 Feb 2015 (Review annually)
Primary Eyecare North East Ltd
Safeguarding Policy
Overview
Primary Eyecare North East Ltd (“the Company”) has been established to specifically
act as the lead for a network of local optical practices (“subcontractors”) dedicated to
delivering excellent eyecare in the local community. The Company will also utilise a
non-clinical subcontractor, Webstar Health.
The Company is committed to safeguarding vulnerable people and supports the
objective in the Mandate from the Government to NHS England for April 2013 to March
2015 to improve safeguarding practice in the NHS for both children and vulnerable
adults. The Company supports the safeguarding agenda in the context of tackling
health inequalities.
The Company recognises that the commissioner is statutorily responsible for ensuring
providers of services it commissions provide a safe system to safeguard children and
adults at risk of abuse or neglect.
Safeguarding governance
The Company will appoint a named clinical governance and performance lead who
will act as the Company’s safeguarding lead for children and vulnerable adults. This
lead is contacted through reporting a safeguarding incident on the OptoManager IT
platform, provided by the Company’s non-clinical subcontractor, Webstar Health.
Webstar Health is a well-established company based in England and is a registered
data processor with the ICO. Webstar Health meets the requirements of the NHS
Information Governance Toolkit Level 2. It provides similar systems for pharmacy,
optometry and general medical services to NHS organisations in England.
The Company will appoint a deputy to the clinical governance and performance lead
in the event of the lead becoming unavailable. The clinical governance and
performance lead will keep the Company’s Board of Directors notified of safeguarding
incidents.
All incidents relating to the safeguarding of adults of children within a service provided
by the Company will be reported by subcontractor practice staff to the appointed
subcontractor practice safeguarding lead (see below) and/or the Company’s clinical
governance and performance lead. Advice will be sought where necessary.
Version 1 Feb 2015 (Review annually)
All serious incidents compromising the safety and welfare of children and vulnerable
adults are to be reported by the subcontractor to the clinical governance and
performance lead. The Company holds separate Complaints and Serious Incidents
Policies, designed to complement this policy.
The Company will work with the commissioner and designated professionals and adult
safeguarding leads for support and advice as required.
At the reasonable written request of the commissioner the Company will provide
evidence to the commissioner no later than ten days from request confirming that it is
addressing any concerns raised by relevant multi-agency reporting systems.
Safeguarding locally
Issues relating to the safeguarding of vulnerable adults and children will be considered
carefully in line with local safeguarding policies. Local safeguarding policies for adults
and children will be available on the Local Optical Committee website with links to
relevant websites and information on local contacts (this will include the relevant CCG
policies).
The clinical governance and performance lead will work with local authorities, local
GPs and patient groups, the police and third sector organisations as part of overall
safeguarding procedure. In particular the Company will engage with and support the
work of the Local Safeguarding Children Boards (LSCBs) and Safeguarding Adults
Boards (SABs). The Company understands the key role of LSCBs and SABs in
highlighting required improvements with regards safeguarding and will act accordingly
as necessary. In addition, the Company recognises the role of Health and Wellbeing
Boards working locally in ensuring the needs of children and vulnerable adults are
being met.
The Company will participate in developing any local multi-agency safeguarding
quality indicators and/or plan. This update of the policy notes the current contact emails for safeguarding issues and advice.
England.qualityandsafetyddt@nhs.net and england.safeguarding-cntw@nhs.net. To
raise any safeguarding concerns, for the Eye Care Referral Refinement (Intra Ocular
Pressure Referral Refinement and Cataracts Pre-Operative Assessment) please use
the England.qualityandsafetyddt@nhs.net, and for further advice visit
http://www.safeguardingdurhamadults
Prevent
The Company understands that NHS Prevent requires healthcare organisations to
safeguard and protect vulnerable individuals potentially at risk of radicalisation as part
of the Government’s overall CONTEST counter-terrorism strategy. The Company
supports the three key objectives for the Prevent strategy stated within the Department
of Health’s Prevent Guidance and toolkit:
Objective 1: respond to the ideological challenge of terrorism and the threat we face
from those who promote it
Version 1 Feb 2015 (Review annually)
Objective 2: prevent people from being drawn into terrorism and ensure that they are
given appropriate advice and support
Objective 3: work with sectors and institutions where there are risks of radicalisation
which we need to address.
The Company considers that Prevent is fundamental to the overall safeguarding
agenda as it offers an important platform for its subcontractors to support individuals
at risk of radicalisation.
The Company’s clinical governance and performance lead will be the named prevent
lead. The prevent lead will ensure the Company fulfils its obligations as a provider to
enhance safeguarding through Prevent.
The Company’s prevent lead will liaise with the local HealthWRAP facilitators to attend
the service’s annual training event to deliver HealthWRAP as part of Prevent.
The Company will notify the commissioner by writing as soon as is practical or within
no later than ten operational days following a change to the identity of the prevent
lead.
Subcontractor requirements
The Company has a number of safeguarding requirements its subcontractors must
meet in order to deliver the service. Subcontractors must:
Maintain their own Safeguarding Policies in accordance with Optical Confederation
and local guidance (accessible to all practice staff).
Appoint a contact internally for safeguarding related issues.
Ensure all practice staff are aware of appropriate behaviours when working with
children and young people in accordance with College of Optometrist guidelines.
Ensure each accredited practitioner has completed DOCET learning for ‘Safeguarding
Children and Safeguarding Vulnerable Adults’ (funded by the Department of Health
via the College of Optometrist) and submit evidence to the Company.
Report any situation where it is known a child is not accessing education to the clinical
governance and performance lead who will aid in referral to the appropriate local
authority.
The Company’s Safeguarding Policy in conjunction with the Complaints and Serious
Incidents Policy is designed to ensure that its service delivery maintains a
comprehensively patient focus at all times.
As such, all subcontractor staff and service users are guaranteed that using these
procedures as a whistle blowing process appropriately will not prejudice their own
Version 1 Feb 2015 (Review annually)
position or prospects. Please see the Company’s Whistleblowing Policy for more
information.
The company’s Safeguarding Policy will be reviewed annually in April and amended
in order to comply with evolving local multi-agency policies and commissioner
safeguarding requirements.
Version 1 Feb 2015 (Review annually)
12th September 2014
Disclosure & Barring Service (DBS) checks
From 1 April 2013 all new applicants for a GOS performers list have to have an
Enhanced Disclosure and Barring Service check carried out. This was previously
called an Enhanced CRB check. GOS regulations do not require routine updating,
however section 5.11 of the NHS Standard Contract, General Conditions does require
proof of clinicians holding an Enhanced DBS certificate and PE(NE) may request a
copy of this certificate to ensure compliance.
The difference between a DBS and a CRB certificate is that it is transportable. It
belongs to the individual and therefore it is their responsibility to ensure it is maintained
when participating in community services.
A DBS check is nothing more than a snapshot in time. Health organisations have
deemed that for DBS checks to be "valid" they should be repeated every three years.
If you have not had an enhanced CRB/DBS check carried out in the last three years,
you must now do so to participate in community services.
Costs
An enhanced DBS costs £44, but you can’t apply for an enhanced one on
yourself. https://www.gov.uk/disclosure-barring-service-check/overview
You need an “umbrella body” to do this, and they charge for the ID checking and
processing of information – This means the total cost will be in the region of £60 per
check.
Those working in corporate organisations should first check with their company in case
they have a preferred supplier.
AOP have a preferred supplier who will provide the combined check and processing
for £53.60
http://www.aop.org.uk/member-services/member-benefits/disclosure-and-barringservice-checks
www.ddc.uk.net also provides Enhanced checks for £56 online and £65 paper based.
However please note, this is only an example and we can not guarantee the efficiency
of these services.
Version 1 Feb 2015 (Review annually)
NECS (North East commissioning service) will provide this service.
Application forms should be requested by sending an appropriate email to the general
HR enquiry email address NECSU.Recruitment@nhs.net clearly marked as DBS
application in the Subject heading.
Signing up to a PENE community service contract verifies your role and allows
performers to use this service in DDT/CNTW (Durham Darlington Tees / Cumbria
North Tyne and Wear). You will need to ask a GOC registered optometrist working in
DDT/CNTW to perform the role of verifying your evidence before you send this off with
your completed application form to be further verified and counter-signed by NECS.
IMPORTANT INFORMATION
DBS update service https://www.gov.uk/dbs-update-service
This service lets applicants keep their DBS certificates up to date online and allows
employers to check a certificate online. You can register online as soon as you have
your application form reference number. You can ask for the number when you apply
for your DBS check, or you can wait and register with your certificate number when
you receive your DBS certificate.
If so, you must do so within 14 days of the certificate being issued.
Registration lasts for 1 year and costs £13 per year (payable by debit or credit card
only).
Version 1 Feb 2015 (Review annually)
INTERPRETING SERVICES FOR PRIMARY
Durham,
Darlington and
Tees
Sunderland
South Tyneside
EVERYDAY
LANGUAGE
SOLUTIONS
(ELS)
Language
interpreting,
translation, Deaf
& Hard of
Hearing support
ITL
(LANGUAGE)
ITL
(LANGUAGE)
Everyday Language Solutions (ELS)
Carbury House
Concorde Way
Preston Farm Industrial Estate
Stockton on Tees TS18 3TB
Tel: 01642 603203
Fax: 01642 603403
www.everydaylanguagesolutions.co.uk
0845 055 2197
0845 055 2197
0191 499 8122
NORTHERN
SIGN (SIGN)
Gateshead
APNA GHAR
ITL
(LANGUAGE)
0191 4564141
0845 055 2197
0191 499 8122
NORTHERN
SIGN (SIGN)
Newcastle
LANGUAGE
North & East
EMPIRE
(LANGUAGE &
SIGN)
Newcastle West LANGUAGE
EMPIRE
(LANGUAGE &
SIGN)
North Tyneside LANGUAGE
EMPIRE
(LANGUAGE &
SIGN)
Northumberland LANGUAGE
EMPIRE
(LANGUAGE &
SIGN)
Version 1 Feb 2015 (Review annually)
0845 370 2002
0845 370 2002
0845 370 2002
0845 370 2002