Ophthalmic referral pathways 2014/2015

Who are the CCG?

• Responsibility for buying local health services transferred as of 1st April 2013 from Primary Care Trusts to groups of local clinicians known as Clinical Commissioning Groups (CCGs)

• North East Hampshire and Farnham CCG has been formed to plan the provision of healthcare for the 220,000 people registered at GP practices in Rushmoor, Farnham and parts of east Hart council areas

• We have 24 member GP Practices• And a budget of £230 million

What do we commission?

The CCG, with its constituent membership of 24 GP Practices, invests approximately £230m annually in health and care services for this population, including:1. Planned hospital care – Outpatients, Elective operations2. Urgent and emergency care – A&E, non-elective

operations3. Rehabilitation care4. Community health services5. Mental health and learning disability services

How does this affect you?

As well as commissioning Hospital based Ophthalmology services we are also able to commission Local Enhanced Services from Primary Care Contractors such as yourselves … and that’s why we have invited you here today!

Local Ophthalmology servicesWe anticipate that by the end of the 2013/2014 financial year our CCG will have spent £4.8 million on Ophthalmology services at Frimley Park Hospital.

Ophthalmology is our third most expensive elective (planned) speciality.

Ophthalmology service redesign is a key priority for the Planned Care team in 2014/2015

What are we spending money on?

Type of service Approximate costDay cases £1,700,000

Telephone appointments £20,000

First Outpatient appointments £536,000

Follow up Outpatient appointments £1,358,000

Outpatient procedures £1,073,000

Ophthalmology service redesign• Utilisation of primary care Optometric experience and skills• Utilisation of local service contracts and expansion of existing Local

Enhanced Services:– Wet ARMD referral (Surrey Optometrists)– Direct Cataract referral (Surrey Optometrists)– IOP referral refinement (Hampshire Optometrists)

• Redesign in collaboration with the Frimley Park Hospital Ophthalmologists

• Redesign in collaboration with Guildford and Waverley CCG and Surrey Heath CCG

• Utilisation of best practice and national guidance

What ideas do we have?Scheme How can you be involved?Glaucoma Refinement level 1a Multiple providersGlaucoma Refinement level 1b Multiple providersStable Glaucoma Monitoring* Specialist providers operating through

a hub and spoke model in each locality

Pre-cataract assessment* Specialist providers operating through a hub and spoke model in each locality

4 week post-cataract assessment* Specialist providers operating through a hub and spoke model in each locality

Primary Eyecare Assessment and Referral scheme

Specialist providers operating through a hub and spoke model in each locality

* Requires agreement from local Ophthalmologists

What ideas do you have?

Next steps

• The LOC will support us in developing service specifications to share with you

• Glaucoma Refinement due to launch April• PEARS scheme scoping to commence• Stable Glaucoma, pre and post cataract assessment due to

launch autumn/winter

By the end of the 2014/2015 financial year we hope to have significantly improved the community based

Ophthalmic services available to our patients