Best practice library – ophthalmology

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Key overarching resources

GIRFT national report on ophthalmology surgery
Log in to view Model Hospital metrics
Full list of ophthalmology pathways
RCOphth and GIRFT guidance on high flow cataract surgery
NICE guidelines for eye conditions
Access the National Eye Care hub on NHS Futures
Guidance on reducing frequent and unnecessary follow-ups

Sentinel top decile metrics

Metric / recommendationPerformance measure (top decile or national standard)Peri-COVID top decile performance
First eye cataract surgery conversion rate – conversion from first outpatient attendance to cataract surgery95%85%
Risk stratification of patients on the waiting list by each provider using consistent scoring across the ICS
100%100%
Standard flow theatre including complex surgery – 8 cases per 4 hour list8 6
High flow theatre – 10+ cases per 4 hour list108
% patients seen in hospital outpatient clinic (with no significant ocular comorbidity) within 6 weeks of surgery<5%<20%
Referral filtering pathways in place for newly referred community Glaucoma patients 100%75%
Percentage of referrals seen using primary care repeated measures
Percentage of referrals seen using primary care enhanced case finding 
Percentage of referrals seen using Glaucoma referral refinement (including gonioscopy) 
Virtual diagnostic clinics run for follow-up glaucoma patients attending outpatient clinic>30%
Risk assessment completed of delayed Glaucoma follow-up patients attending outpatient clinic
OCT referral filtering pathways for diabetic M1 patients in place
Percentage of patients risk assessed for medical retina patients attending outpatient clinic with delayed follow up
Injection rate – average number of injections per session1612

Cataract

Royal College of Ophthalmologists and GIRFT guidance on High Flow Cataract Surgery

High Flow Cataract Surgery Pathway

Cataract Hubs and High Flow Cataract Lists guidance document March 2021

Restarting and Redesigning of Cataract Pathways in response to the COVID 19 pandemic guidance document

Webinar: National eye care recovery and transformation programme

National report comments on cataract surgery (Click to expand)

Metrics (Click to expand)

Case studies and examples (Click to expand)

Glaucoma

National Eye Care Recovery and Transformation Programme – Glaucoma webinar, 28th September 2021

Referral Management

GIRFT national report recommendation on instituting consistent referral criteria in line with 2017 NICE guideline and referral filtering schemes

GIRFT national report recommendation to adopt model Glaucoma pathways

GIRFT national report recommendation to implement actions of high impact intervention 

Case Study: Manchester Glaucoma Enhanced Referral Scheme (GERS)

Metric: Community hospital delivery setting used for referral filtering for newly referred glaucoma patients

Metric: Referral filtering pathways for newly referred glaucoma patients attending outpatient clinic

Metric: Acute hospital delivery setting used for referral filtering for newly referred glaucoma patients

Clinic Flow

GIRFT national report recommendation for providers to introduce virtual clinics for Glaucoma

The elective care transformation programme handbook for ophthalmology includes best practice guidance for the use of virtual clinics 

Case study: Virtual clinics for managing low-risk glaucoma patients in Leeds

Metric: Virtual clinics run for follow-up glaucoma patients attending outpatient clinic

Clinic Risk

Comment on ensuring adequate follow-up in the GIRFT national report on ophthalmology

Case study: Consultant-led OCT at University Hospitals Birmingham

Metric: Estimated number of delayed glaucoma follow-up patients attending outpatient clinic 

Metric: Risk stratification of newly referred glaucoma patients attending outpatient clinic

Medical Retina (AMD)

Referral Management

GIRFT national report recommendation to develop a national standardised referral pathway for suspected diabetic maculopathy

Metric: OCT referral filtering pathways for diabetic M1 patients

Clinic Flow

Metric: AMD Injection rate -average number of injections per session for AMD

Case study: Community eye clinics in Manchester

Clinic Risk

GIRFT national report recommendation to increase the capacity and productivity of wet AMD pathways

Metric: Estimated number of medical retina patients attending outpatient clinic with delayed follow up

Miscellaneous Documents

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