Ensuring patients have equitable access to community ophthalmology (eye) services in NW London

Across NW London a range of different community eye health services are being provided to patients through contracts with local providers. At the moment the way local people access and how GPs refer patients for this kind of treatment varies across eight boroughs: Brent, Ealing, Hammersmith & Fulham, Harrow, Hillingdon, Hounslow, Kensington and Chelsea and Westminster. This has led to inequality and inequitable access for patients

Community eye services allow patients to be seen away from the hospital for review and regular monitoring of eye conditions. This includes identifying patients who have conditions including cataracts (which can affect patients vision) and raised eye pressures which could be a sign of glaucoma. The services help support patients by picking up degenerative eye diseases early. Community services also help with the management of some minor eye conditions (e.g. red eye, non specific irritation to the eye and foreign body and emergency contact lens removal.  

There are a range of different community services in place across NW London, along with a range of hospital eye services.  This can cause some confusion about where a patient should be referred to.  When this happens it is possible that a patient could be referred to the wrong service which may cause a delay in their care.

There is data that shows that in some of our boroughs there is a higher rate of sight loss than the London average.  This suggests that there may be inequalities in how eye health is delivered across NW London.

Review of current services

We have reviewed how we currently provide community eye health services.  This review highlighted that there is inequity in patients being able to access these services.  Some patients access eye health services through their GP and the hospital eye service, whilst other patients are able to access eye health services through dedicated community services. 

What we would like to improve for patients and GPs

Our aim is to ensure that community eye health services are easy for GPs to refer into, providing the same level of access and equitable provision for all patients in NW London.

To make improvement to access and equitability we are exploring a single specification for an optometry led community service in NW London.

Talking to service users

Throughout June we talked to service patients and the public about community eye services – full details of this work can be found in these slides and the update sent to the Joint Health Overview and Scrutiny Committee in July. 

Benefits of a new model of care for NW London

A new model of care for NW London will provide a standard community service across the sector, led by optometrists and delivered through high street optical practices to increase accessibility and visibility of the service.

The community service will deliver the following services for adult patients:

  • Cataract: shared decision-making and direct referrals
  • Glaucoma: referral refinement through second pressure checks
  • Community Eye Care services: support for the diagnosis and treatment of minor eye conditions through optical practices
  • Single point of access

The service model reflects the model for community ophthalmology recommended by the NHS National Eye Care Transformation Programme and the model of care in other parts of the city as good practice.

Accessibility tools

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