Working with you to make Highland the healthy place to be

Diabetic Retinal Screening Optometrist Model

Conference: Wednesday 10th November 2010,

The Teacher Building, Glasgow

Speaker: Dr Rod Harvey, DRS Board Co-ordinator, NHS Highland

Working with you to make Highland the healthy place to be

NHS Highland Optometrist Model

• Highland region is split by two models of screening.

- North Highland (Pink, Blue and Yellow areas on map) – covered by NHS staff within the Inverness based screening team.

- Argyll & Bute area (Green) mainly covered by High Street Optometrists, except three rural locations outside reasonable travel times, where transport links are poor.

Working with you to make Highland the healthy place to be

NHS Highland Optometrist Coverage Area (Green on Map)

Working with you to make Highland the healthy place to be

NHS Highland Optometrist Model

• Covers 30% of the total Highland patient base for screening.(this equates to 3959 patients) 2009 Highland diabetic population of 13197

• 45 Minutes maximum target time for patients to have to travel for screening in Argyll & Bute area. Agreed at service planning stage.

• DRS visit three sites within Argyll & Bute as they are too far away from the nearest High Street Optometrist practice. Patients also have option of attending the nearest Optometrist.

• Administration team in Inverness manage the call/recall of patients by invitation letter, instead of pre-booked with appointment. Patient arranges appointment directly with an Optometrist of their choice from a list of those registered with the DRS programme.

Working with you to make Highland the healthy place to be

Optometrist Provision Agreement

• Only image capture agreed. Synchronised with the GOS exam in

the first year of inception.

• Fee for capture - £12.00 per examination.

• Slit lamp examinations referred to Ophthalmology.

• Highland grading SLA revised to include Argyll & Bute provision.

• Undertake unit 306 – Imaging and Capture of City & Guilds Diploma.

Recurring DRS Costs for Optometrist Provision

• Examination fee.

• Reimbursement of City & Guilds fees when new candidates join service.

• Assessment time and travel for City & Guilds accreditation.

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SET UP PROBLEMS

• Optometrists connect to Soarian via Internet (VPN)

• Poor network connections for Soarian uploads in certain sites – examinations remain stuck.

• Agreeing security principles for image capture.

• Ensuring appropriate image capture settings andprotocols across a range of camera equipment.

• Maintaining upload times to within 24 hours of image capture taking place.

• Having Optometrists on board to complete City & Guilds qualification.

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ONGOING ISSUES …

• Ensuring patient at right status before upload.

• Disadvantaged in some areas when slit lamp required.

• Security access for independent contractors needs to be managed.

• This model does not provide a solution for slit lamp.

• Reminder letters being sent out when appointment

has been booked.

Working with you to make Highland the healthy place to be

BENEFITS OF OPTOMETRIST MODEL

• Service stability.

• Patient flexibility and access – mix and match approach.

• Optometrist are an integral part of the service.

• Wider coverage suitable for Highland region geography.

• Non maintenance of equipment for DRS.

Working with you to make Highland the healthy place to be

Any Questions?