Ophthalmic Primary Care: The Warrington Model

Primary care and ophthalmology in the United Kingdom

“…Oster et al 39 explored the potential role for optometrists in the clinical appraisal of new referrals to the hospital and found a high level of diagnostic accuracy. The multidisciplinary model in hospital based ophthalmic primary care services has been reported to be in use in Warrington, 40 Liverpool, 41 and London. 42 The Warrington study, although evaluating the model as a whole and not concentrating on its skill mix aspect, reported a maximum waiting time of 2 weeks, no unsatisfactory responses via a patient satisfaction questionnaire, a majority of GPs satisfied by the service to different degrees via a GP questionnaire, and considerable saving in consultant time in eliminating the need to allocate priority.…”

“…In the hospital, primary care is delivered in (1) general A&E departments by casualty doctors, [50][51][52] (2) ophthalmic A&E departments by junior ophthalmologists, 53 (3) hospital based primary care centres by ophthalmologists, nurses, optometrists, and orthoptists, [40][41][42] (4) primary care outreach clinics in community hospitals with staffing similar to (3), 42 and (5) outpatient departments 54 55 by all grades of ophthalmologists.…”

Hospital-based primary care centres in opthalmology

“…Pecker et al 15 have reported the successful establishm ent of a rapid access secondary care clinic, with the waiting time for new outpatien t appoint ments being reduced from 40 to 2 weeks. They also reported that 66% of patients seen in their clinic were diagnosed , treated, listed and discharge d on their first visit, requiring no further follow-up .…”