Demographics, referral patterns and management of patients accessing the Welsh Eye Care Service

Eye and Vision, May 2016

Background The Primary Eyecare Acute Referral Service (PEARS) and the Wales Eye Health Examination (WEHE) operate as enhanced optometry services for patients residing in Wales, enabling the examination of a patient presenting with an acute eye problem (PEARS) or the examination of patients at higher risk of eye disease (WEHE). The purpose of the study is to assess the demographics of patients accessing these services, referral patterns and clinical management in one Health Board in Wales (Aneurin Bevan University Health Board). Methods Information from 2302 patients accessing the services was prospectively collected. The following information was obtained: type of examination (PEARS or WEHE), patient age, gender, self-referral or general practitioner (GP) referral and clinical management (no further action, monitor by optometrist or ophthalmic medical practitioner [OMP], refer to the Hospital Eye Service [HES], or refer to GP). Results There were 1791 (77.8 %) PEARS examinations and 511 (22.2 %) WEHE. There were 1379 (59.9 %) females with a mean age of 58.61 (±19.75) and 923 (40.1 %) males with a mean age of 56.11 (±20.42). The majority of patients were self-referrals compared to GP-referrals (1793 [77.9 %] versus 509 [22.1 %] respectively). Sub-analysis indicated similar numbers of self-referrals compared to GP-referrals for the WEHE only (297 [58.1 %] versus 214 [41.9 %] respectively) but greater numbers of self-referrals for the PEARS examinations only (1496 [83.5 %] versus 295 [16.5 %] respectively). For management, 75 % of patients were monitored by their optometrist or OMP, 17 % required referral to the HES and 8 % required referral to their GP. Conclusions Higher numbers of females accessed both PEARS and WEHE services and the majority of patients self-referred. These findings have important implications for public health campaigns both for targeting specific groups (e.g. male patients) and increasing awareness among GPs.

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Demographics, referral patterns and management of patients accessing the Welsh Eye Care Service

McAlinden et al. Eye and Vision Demographics, referral patterns and management of patients accessing the Welsh Eye Care Service Colm McAlinden 0 1 Helen Corson 1 3 Nik Sheen 1 2 Peter Garwood 1 3 0 Public Health Wales , Floor 11 , The Oldway Centre , 36 Orchard Street, Swansea SA1 5AQ , UK 1 Presented as a poster at the Royal College of Ophthalmologists Annual Meeting 2 School of Optometry and Vision Sciences, Cardiff University , Maindy Road, Cardiff CF24 4 LU , UK 3 Public Health Wales , Cwmbran House, Mamhilad Park Estate, Pontypool, Torfaen NP4 0XS , UK Background: The Primary Eyecare Acute Referral Service (PEARS) and the Wales Eye Health Examination (WEHE) operate as enhanced optometry services for patients residing in Wales, enabling the examination of a patient presenting with an acute eye problem (PEARS) or the examination of patients at higher risk of eye disease (WEHE). The purpose of the study is to assess the demographics of patients accessing these services, referral patterns and clinical management in one Health Board in Wales (Aneurin Bevan University Health Board). Methods: Information from 2302 patients accessing the services was prospectively collected. The following information was obtained: type of examination (PEARS or WEHE), patient age, gender, self-referral or general practitioner (GP) referral and clinical management (no further action, monitor by optometrist or ophthalmic medical practitioner [OMP], refer to the Hospital Eye Service [HES], or refer to GP). Results: There were 1791 (77.8 %) PEARS examinations and 511 (22.2 %) WEHE. There were 1379 (59.9 %) females with a mean age of 58.61 (±19.75) and 923 (40.1 %) males with a mean age of 56.11 (±20.42). The majority of patients were self-referrals compared to GP-referrals (1793 [77.9 %] versus 509 [22.1 %] respectively). Sub-analysis indicated similar numbers of self-referrals compared to GP-referrals for the WEHE only (297 [58.1 %] versus 214 [41.9 %] respectively) but greater numbers of self-referrals for the PEARS examinations only (1496 [83.5 %] versus 295 [16.5 %] respectively). For management, 75 % of patients were monitored by their optometrist or OMP, 17 % required referral to the HES and 8 % required referral to their GP. Conclusions: Higher numbers of females accessed both PEARS and WEHE services and the majority of patients self-referred. These findings have important implications for public health campaigns both for targeting specific groups (e.g. male patients) and increasing awareness among GPs. Wales eye care services; Primary eyecare assessment & referral service; Welsh eye care initiative; Welsh eye health examination Background The Primary Eyecare Acute Referral Service (PEARS) and the Wales Eye Health Examination (WEHE) were enhanced optometry based services that had operated for 10 years for patients residing in Wales [ 1 ]. Patients generally either self-refer or are referred by their General Practitioner (GP) to accredited practitioners in community optometry practices. Patients requiring a PEARS examination are able to be seen within 24 h and undergo appropriate investigations at the discretion of the practitioner while patients attending for a WEHE undergo standard predetermined ophthalmic investigations [ 1 ]. These services were funded by the Welsh Government at no cost to the patient, enabling the examination of a patient presenting with an acute eye problem (PEARS) or the examination of patients at increased risk of eye disease (WEHE). The reimbursement was £60 for a PEARS and £40 for a WEHE. In April 2013, these services were amalgamated into the new Eye Health Examination Wales (EHEW) Service with the core aims of the service kept the same as the previous PEARS and WEHE. The services are part of the wider Welsh Eye Care Service (WECS), which also includes the Low Vision Service Wales and Diabetic Retinopathy Service Wales [ 2–6 ]. All the WECS services continue to be updated and further information is available on the website www.eyecare.wales.nhs.uk [ 7 ]. In brief, the PEARS and WEHE service core values have been retained within a new Eye Health Examination Wales (EHEW) service launched in 2013. The EHEW service contains a structured framework that operates on a 3tiered banded system. The Band 1 part of the EHEW service retains all the previous categories of the PEARS and WEHE service in an amalgamated format. The additional Bands 2 and 3 enable community optometrists to further inform or prevent onward referral to the hospital eye service, or carry out a follow up assessment of a patient, respectively. Optometrists and ophthalmic medical practitioners (OMPs) are required to undergo accreditation, which involves successful completion of distance learning lectures with multiple choice questions, and practical Objective Structured Clinical Examinations (OSCEs). The purpose of the present study is to assess the demographics of a sample of patients accessing this service, referral patter (...truncated)


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Colm McAlinden, Helen Corson, Nik Sheen, Peter Garwood. Demographics, referral patterns and management of patients accessing the Welsh Eye Care Service, Eye and Vision, 2016, pp. 14, Volume 3, Issue 1, DOI: 10.1186/s40662-016-0045-7