The influence of the new general ophthalmic services (GOS) contract in optometrist referrals for glaucoma in Scotland

Ang, Ghee Soon; Ng, Wai Siene; Azuara‐Blanco, Augusto

doi:10.1038/sj.eye.6703045

Cited by 55 publications

(81 citation statements)

References 14 publications

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“…Outcomes from this data included education sessions for the recruited optometrists. Ang et al, 9 who demonstrated that after changes to the GOS contract in 2006, there was an increase in the true positive rate of glaucoma referrals (from 18.0% 'preguideline' to 31.0% 'postguideline', P ¼ 0.006) in Scotland. The overall quality of referrals, however, has increased following the widespread implementation of the guidelines in 2009.…”

Section: Discussionmentioning

confidence: 99%

The Portsmouth-based glaucoma refinement scheme: a role for virtual clinics in the future?

Trikha

MacGregor

Jeffery

et al. 2012

Eye

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Background Glaucoma referrals continue to impart a significant burden on Hospital Eye Services (HES), with a large proportion of these false positives. Aims To evaluate the Portsmouth glaucoma scheme, utilising virtual clinics, digital technology, and community optometrists to streamline glaucoma referrals. Method The stages of the patient trail were mapped and, at each step of the process, 100 consecutive patient decisions were identified. The diagnostic outcomes of 50 consecutive patients referred from the refinement scheme to the HES were identified. Results A total of 76% of 'glaucoma' referrals were suitable for the refinement scheme. Overall, 94% of disc images were gradeable in the virtual clinic. In all, 11% of patients 'attending' the virtual clinic were accepted into HES, with 89% being discharged for community follow-up. Of referrals accepted into HES, the positive predictive value (glaucoma/ocular hypertension/suspect) was 0.78 vs 0.37 in the predating 'unrefined' scheme (95% CI 0.65-0.87). The scheme has released 1400 clinic slots/year for HES, and has produced a d244 200/year cost saving for Portsmouth Hospitals' Trust. Conclusion The refinement scheme is streamlining referrals and increasing the positive predictive rate in the diagnosis of glaucoma, glaucoma suspect or ocular hypertension. This consultant-led practicebased commissioning scheme, if adopted widely, is likely to incur a significant cost saving while maintaining high quality of care within the NHS.

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Section: Discussionmentioning

confidence: 99%

The Portsmouth-based glaucoma refinement scheme: a role for virtual clinics in the future?

Trikha

MacGregor

Jeffery

et al. 2012

Eye

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“…We and other groups have shown the service benefits from this. 18 Encrypted mail is freely available across the NHS in the United Kingdoms. Similar encrypted email technology can easily and cheaply be adapted for the purpose of using secured hypertext transport protocols (HTTPs) to encrypt information as has already been used internationally for telemedicine.…”

Section: Discussionmentioning

confidence: 99%

Using electronic referral with digital imaging between primary and secondary ophthalmic services: a long term prospective analysis of regional service redesign

Borooah

Grant

Blaikie

et al. 2012

Eye

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Purpose Demands on publicly funded ophthalmic services worldwide continue to increase with new treatments, waiting time targets, working time limits, and restricted budgets. These highlight the necessity to develop innovative ways of utilising existing capacity more effectively. Method A new regional, fully electronic ophthalmic-referral service with digital imaging was trialled using existing information-technology (IT) infrastructure.

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“…Optometrists are able to repeat tests and procedures when necessary by performing a supplementary examination 27. Ang et al 28 investigated the influence of the new NHS contract on glaucoma referrals in Scotland. After the introduction of the new general ophthalmic services (GOS) contract, there was a statistically significant increase in true-positive referrals (from 18.0% to 31.7%; p = 0.006) and a decrease in false-positive referrals (from 36.6% to 31.7%; p = 0.006).…”

Section: Discussionmentioning

confidence: 99%

Glaucoma detection: the content of optometric eye examinations for a presbyopic patient of African racial descent

Shah¹,

Edgar

Spry

et al. 2008

British Journal of Ophthalmology

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The influence of the new general ophthalmic services (GOS) contract in optometrist referrals for glaucoma in Scotland

Cited by 55 publications

References 14 publications

The Portsmouth-based glaucoma refinement scheme: a role for virtual clinics in the future?

The Portsmouth-based glaucoma refinement scheme: a role for virtual clinics in the future?

Using electronic referral with digital imaging between primary and secondary ophthalmic services: a long term prospective analysis of regional service redesign

Glaucoma detection: the content of optometric eye examinations for a presbyopic patient of African racial descent

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