Double vision tests produce visible savings

1 February 2012

Encouraging optometrists to re-test patients for suspected glaucoma can have a dramatic impact on referrals to hospital-based eye services, one commissioner has found.

Glaucoma can account for around 20 per cent of ophthalmology outpatient appointments, a figure on the rise since the publication of NICE guideline 85 in 2009 and set to rise further as the population ages.

The picture is complicated further because the non-contact tonometry tests used by most optometrists frequently produce incorrect or inconsistent results – leading to unnecessary referrals.

Bexley Care Trust in south-east London has responded by developing an enhanced service which pays optometrists to re-test, allowing them to refine their response to suspected glaucoma and producing a 33% fall in referrals for the condition.

The General Ophthalmic Services contract only funds one test but Bexley saw the potential benefits for both NHS budgets and patients in funding additional tests.

After allowing for the costs of refresher training in the specific technique (Goldmann Applanation Tonometry) that optometrists are required to use in re-testing, the initiative delivered annual savings of £32,000. The re-tests were typically 62% cheaper than the hospital eye service tariff.

David Parkins, optometrist and clinical quality lead on Bexley clinical commissioning cabinet said: “Local optometrists have been very supportive of the scheme and patients like it as well. It is all about Right Care and we are currently expanding coverage across south-east London to increase effectiveness. Patients do not stay within boundaries for their eyecare and therefore schemes need to cover larger population areas.”

The innovation is seen as a boon for patients, many of whom are spared the anxiety of waiting for a confirmed diagnosis and a hospital visit.

This case study can be found on the NHS Evidence website.

A video interview with David Parkins is available on the NHS Networks Youtube channel.


Case study
Article Type
Case Studies
Changing services Case Studies

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