Lecture 8: referral procedures and shared care Flashcards
What are the GOC professional standards regarding referral?
7.2 done in a timescale that does not compromise patient safety and care
What is the legislation for optometrist responsibily for referral?
According to this, when should an optometrist not refer?
opticians ACT 1989
relating to injury or disease of the eye (set up in 1999)
-acting on the advice or instructions of a registered medical practitioner in testing the sight of such a person or supplying/fitting an optical appliance
-the optom should report to the practitioner any findings of injury or disease of the eye which the practitioner may be unaware
What steps should the optometrist take in referring a person to a registered medical practitioner?
-advise the person to consult the practitioner
-give the practitioner named by the person a written report of the findings indicating injury or ideas of the eye
-where actions appear urgent, optom should take measures to inform the registered medical practitioner immediately
What should the optometrist do if the px refused referral to the medical practitioner?
record this and the grounds which the person gives for his unwillingness to consult a registered medical practitioner
What should an optometrist record if he doesn’t think its suitable to refer someone?
(i) a sufficient description of the injury or disease from which that person appears to be suffering
(ii) his reason for deciding not to refer on that occasion
(iii) details of advice tendered to the patient;
(iv) an account of any action taken under the provisions of rule 7
(b) if appropriate, and with the consent of the person consulting him, shall inform that person’s general medical practitioner of those matters recorded in accordance with rule 6(a).
What is the exception to the duty to refer to the registered medical practitioner?
(i) a person other than a registered medical practitioner who provides and who has the appropriate qualifications or expertise to provide medical or clinical treatment for the injury or disease
(ii) a person or body whose function is to refer or to organise the referral of persons who having consulted a registered optometrist or dispensing optician appear to be suffering from an injury or disease of the eye to a registered medical practitioner
What should be included in the referral?
(i) that he has made the referral and the date of the referral
(ii) a sufficient description of the injury or disease from which that person appears to be suffering
(iii) details of any advice or medical or clinical treatment tendered to the patient
provide written report of findings to px:
(i) his grounds for thinking that the person may be suffering from injury or disease of the eye
(ii) the urgency of the case
(iii) where the referral is made to a person falling within rule 7(b)(ii), instructions as to whether the patient should be referred to:
(a) a registered medical practitioner
(b) a person who is not a registered medical practitioner, in which case the instructions shall include what qualifications or expertise that person must have.
Why should we consider shared care in optometry?
volume
future demand
accessibility for care
px experience
cost
Ageing population
What are some examples of shared care schemes?
Glaucoma Repeat Readings Scheme (GRR)
Children Diagnostic Vision Scheme (CVDS)
Post Operative Cataract Service (POCS)
Minor Eye Conditions Service (MECS)
What are the advantages of shared care schemes?
Raises the profile of the profession:
-Patients - Not just glasses
-Other professions
Treatments/investigations completed locally
Treatments individualised
What are the potential risks of shared care schemes?
Postcode lottery of services
Confusion for practitioners
What speed of referrals can you get?
routine : within 18 weeks
urgent: within 1 week treatment in 2 weeks)
emergency: within 24 hours
What does a good referral include?
-date
-full name of referring optometrist and practice address
-full details of px (name, address, phone no, date of birth)
-provisional diagnosis
-indication of urgency
-supporting signs and symptoms
-reports of relevant tests, including copies of data
-consent
