Gloucestershire Local Optometric Committee
Guidelines for Cataract Direct Referral
May 2005
Criteria for Referral
Patients will be monitored in the community as their cataracts develop until they reach the point where their vision is significantly affected. The referral criteria are 6/12 or worse in either eye. Where the acuity is better than 6/12 but is seriously affecting the visual performance of the patient then referral is permissible, so long as clear reasons for the referral are stated (e.g. Driving). Responsible referral is key to the success of the scheme.
Patient Choice
On making a decision to refer a patient with cataracts, all patients need now to be offered a choice of provider. At this point in time this is either Gloucestershire or Bristol but this will be extended by the end of 2005. Leaflets explaining this choice can be obtained from Kate Bowdler at the Cheltenham and Tewkesbury PCT o 01242 548800.
Whatever choice the patient makes they are still referred by completing the new Direct Referral form, which you need to forward to the relevant hospital. Details for Bristol are on the Choice Leaflet.
Each patient will be handed the patient information page from the referral form and a “Cataract” leaflet, which gives basic information to help the patient begin to understand the process of the surgical procedure. Copies of this leaflet can be obtained from the RNIB by telephoning 01733 375000 and setting up an account. There is no charge for the leaflet except a nominal charge to cover the postage. They will allow orders of up to 200 copies at a time.
The Gloucestershire Referral Procedure
- Fast track Referral
The Fast Track Referral Scheme will continue to offer an efficient user-friendly pathway for all patients with simple cataract. Patients must agree to proceeding with surgery should it be offered. Referral is to Gloucester or Cheltenham hospitals only. A referral fee will be paid.
- Referral to a general clinic
Patients with significant cataract but with ocular co-morbidity or significant secondary issues will also be referred directly but into a general clinic rather than the cataract fast track clinic. Referral is to Gloucester or Cheltenham or any community hospital clinic as requested. However where the appointment is offered is ultimately the decision of the ophthalmologists. A referral fee will be paid.
- Conventional GOS18 Referrals
Patients who need to be assessed by an ophthalmologist but where the primary reason for referral is not cataract please continue to referr via the GP on a GOS18 or referral letter. No fee will be paid.
All Direct referral forms are to be sent to either Gloucester or Cheltenham as is the case now. A fee will be paid for all direct referrals and claimed in the normal way on the relevant claim form. An audit trail must be kept within the practice. No fee will be paid for non-direct referrals via the GP. Referrals will be audited to ensure that the present high quality of referral is maintained.
For your information ophthalmology consultants have clinics at the following hospitals
Mr N PriceCGH, Cirencester, Evesham, Morton-in-Marsh
Mr N KirkpatrickCGH, Cirencester, Bourton-on-the Water
Mr A McNaughtCGH, Evesham, Tewkesbury
Mr G MackintoshGRH, Stroud
Mr J NairneGRH, Lydney
Mrs B HarneyGRH, Tetbury
Mr J FerrisGRH, Stroud, Tetbury
Mr R JohnstonCGH, GRH, Stroud
Mr R CeasarCGH/GRH
All Cataract Referral is to be via the Community Optometrist.
It is intended that all referral for cataract will be by the community optometrist. If a patient goes to see their GP having notices a reduction in their vision and their GP suspects that this is due to cataracts, then the patient will be given a letter of referral and advised to see their optometrist/OMP.
The New Referral Forms
The revised cataract form will be available by contacting Nick Price’s Secretary on 08454 222524
However enclosed in your pack today is a floppy disc with the referral guidelines and the referral form so that you will be able to print the forms as required. The form and the guidelines for referral will also be available for down loading from the Gloucestershire LOC website in the near future.
The GP is sent a copy of the referral for reference and information only. No response from the GP is required.
Two copies go to the hospital; one for the ophthalmologist and one for audit.
One copy is kept by the optometrist.
Fee Claim
The Direct Referral Claim form is completed for each referral and submitted to The Optical Team at the Victoria Warehouse tel 01452 300222 Ext 2666 as done previously.
Registration for Cataract Scheme
All optometrists need to be registered to refer directly. This can be done by contacting Kate Barnes at Glos PCT on 01452 389475