1. MECS Evening
July 2019

2. This presentation is available for you to use in staff training

3. Wolverhampton MECS We’ve learnt a lot since 2014
Nearly MECS patients
Earning £££ for local optometry

4. CGPLs
Welcome to Simone

5. NEWS - Urgent Referrals
Capacity in ARC (ERU)

6. Urgent Referrals
From Monday 8th July 2019, all patients with emergency and urgent eye conditions will be seen in the Eye Referral Unit at the Wolverhampton and Midlands Counties Eye Infirmary, giving patients access to a team of eye experts.
This service will operate between the hours of;
8.00am – 5pm Monday – Friday
8.00am – 4pm Saturday / Sunday

7. Urgent Referrals
For emergency or urgent eye conditions outside of these hours, patients will be seen in the Emergency Department (ED).

8. The figures

9. Why Do They Matter?
QUALITY

10. Fortunately, health is BIG NEWS!
June 2018 – Former PM Teresa May announces £20billion funding plan for NHS
Fun quiz!
Q1. Do you know who this is? Answers at the end of the presentation?

11. Health Context: NHS needs to reform

12. Optics has a connection to all of these
BIG TICKET ISSUES
Optics has a connection to all of these

13. Ophthalmology under pressure

14. Ophthalmology pressures

15. GP pressures

16. Why Do The Figures Matter?
Opportunities will increase if we step up
QUALITY

17. Service ‘norms’

18. MECS ‘Average’ Outcomes
Y4Q4
4 years
Discharge
66%
64.5%
Follow up (AQS<7%)
13%
13.4%*
Routine referral to GP only 5%
4.3%
Routine ref to Ophthalmology via GP (AQS<10%) 7%
6.0%
24 hour Referral to Ophthalmology
6.5%
72 hour Referral to Ophthalmology
4.5%
Urgent Total (AQS<12%)
10%
11%
Suspect Wet AMD Fast Track 0%
0.7%
*Note majority of follow ups are discharged so overall discharge approx 75%

19. Urgency
How many MECS appointments do you think should be triaged 24 hour urgency?

20. MECS - Urgency …surely most can be routine not urgent? Y4Q4 Urgent 52%
48%
…surely most can be routine not urgent?

21. MECS – Presenting Symptoms (triage)
Y4Q4
Sore eye
27%
Red eye
17%
FnF
15%
Painful eye
10%
Other 6%
Dry eye 7%
Lid problem
Loss of vision 4%
Suspect FB 3%
Visual field defect 1% CL 0%

22. MECS Outcomes
Referral Habits...

23. MECS Outcomes 12% 8% 3% 6% Y4Q2 Y4Q3 Y4Q4 Y5Q1 59% 65% 66% 15% 14% 13%
Discharge
59%
65%
66%
Follow up (AQS<7%)
15%
14%
13%
12%
Routine referral to GP only 5% 4%
Routine ref to Ophthalmology via GP (AQS<10%) 7% 8%
24 hour Referral to Ophthalmology 9% 3%
72 hour Referral to Ophthalmology 6%
Urgent Total (AQS<12%)
10%
Suspect Wet AMD Fast Track 1% 0%

24. 24 / 72
There were about 15 practitioners that made all their referrals by the 24 hour pathway in this period

25. PROMS

26. Overall

27. If this service was not available where else would you have attended
Yr4
A&E
31.45%
Declined to answer
1.53% GP
52.77%
Pharmacy
4.03%
Walk in Centre
10.21%

28. Follow Up Y4Q3-4 = 300 follow ups 44% not written up
(48% over life of service)

31. Referrals By Practitioner
How to interpret the figures?
Compared to ‘your peers’ over nearly 5 years

32. MECS Outcomes 12% 8% 3% 6% Y4Q2 Y4Q3 Y4Q4 Y5Q1 59% 65% 66% 15% 14% 13%
Discharge
59%
65%
66%
Follow up (AQS<7%)
15%
14%
13%
12%
Routine referral to GP only 5% 4%
Routine ref to Ophthalmology via GP (AQS<10%) 7% 8%
24 hour Referral to Ophthalmology 9% 3%
72 hour Referral to Ophthalmology 6%
Urgent Total (AQS<12%)
10%
Suspect Wet AMD Fast Track 1% 0%

33. Making Your Referrals Appropriate Pathway
Ensure Patient Details are Correct
Write a Good Referral

34. Making Your Referrals Appropriate Pathway
Many urgent referrals should be 72hr
Make sure colleagues are aware of the Referral Assessment Service, all routine referrals are consultant triaged
MECS is a management service not a referral service and you should be developing your patient management skills
You don’t have to refer every abnormality

35. Making Your Referrals Appropriate Pathway
Ensure Patient Details are Correct
Incorrect name, DoB address cause endless problems
If the phone number is not correct WEI will not be able to contact the patient!

36. Making Your Referrals Appropriate Pathway
Ensure Patient Details are Correct
Write a Good Referral
Clear reason for referral
No essays please
State which clinic you would like

37. The Others Issue(s) PART 1 PART 2 Triage ‘others’
This is an issue for staff training
PART 2
Outcomes ‘others’

38. Others Part 2 - Outcomes PART 2 About 15% of outcomes are ‘others’
Simone’s audit shows more than half of these can easily be classified using the dropdowns
Only about 10% are rare and may not have a dropdown

39. Cataract
Optomanager update end August
Nuffield Post Op

40. DSPT
Have you done it?
Please let us know!

41. PCG
This is the last week to express an interest for the new service and claim part-funding for the qualification
One place per practice
Practices active in the services