1. Ophthalmic referral pathways 2014/2015

2. 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

3. 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:
Planned hospital care – Outpatients, Elective operations
Urgent and emergency care – A&E, non-elective operations
Rehabilitation care
Community health services
Mental health and learning disability services

4. 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!

5. Local Ophthalmology services
We 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

6. What are we spending money on?
Type of service
Approximate cost
Day 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

7. 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

8. What ideas do we have? Scheme How can you be involved?
Glaucoma Refinement level 1a
Multiple providers
Glaucoma Refinement level 1b
Stable Glaucoma Monitoring*
Specialist providers operating through a hub and spoke model in each locality
Pre-cataract assessment*
4 week post-cataract assessment*
Primary Eyecare Assessment and Referral scheme
* Requires agreement from local Ophthalmologists

9. What ideas do you have?

10. 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