Shared Care Flashcards
Why is shared care a good idea?
Reduces number of pxs going to HES
Reduce NHS wait times
Increase px choice
More convenient for px
OOs have relevant equipment/expertise/appointments
OO job satisfaction
What is needed to perform shared care?
Extra qualifications
Formal (HES pathway) and informal pathways (relationships with GP/pharmacies)
What did the Bristol glaucoma study find?
No visual field difference found between the two groups
(Half seen at HES, half in primary care)
What did the Stockport Cataract Scheme find?
Doing a post cat appointment in practice means pxs can get specs at the same time.
What does the diabetic retinopathy monitoring scheme in Rhondda Cynon Taf achieve?
Monitors ungradeable DR (unable to grade at screening) up to moderate R2/M1, and stable R3.
Dilated fundus exam with OCT, volk and modified EDTRS grading
Reduced waiting time (42 to 3.2 weeks)
In modified EDTRS grading of diabetic retinopathy, what does R2 mean?
Moderate retinopathy (Pre-proliferative)
In modified EDTRS grading of diabetic retinopathy, what does M1 mean?
Borderline maculopathy
In modified EDTRS grading of diabetic retinopathy, what does R3 mean?
Proliferative retinopathy
What is the Gloucestershire community ophthalmic link?
OO access to HES images and notes
What does the Cardiff Uni Teach and Treat clinic cover?
Glaucoma
Med Ret (wet AMD)
Hydroxylchloroquine monitoring
How many pxs are discharged from med ret T&T clinic?
50%
What can be done at the T&T glaucoma clinic?
OHT diagnosis
Change current treatment
HES follow ups
New referrals
When would a glaucoma T&T px need to be seen at the HES?
For glaucoma diagnosis (needs to be confirmed by consultant)
What can be done at the T&T med ret clinic?
New referrals
Monitoring
When would a med ret T&T px need to be seen at the HES?
If treatment needed
What does the hydroxychloroquine monitoring service do?
Monitors anyone at risk of hydroxychloroquine retinopathy
Photos, OCT and fundus autofluorescence
What can be treated via the IP OO pathway?
Anterior uveitis
Keratitis
Post cat CMO
Chronic dry eye (not responding to normal management)
Episcleritis
Most anterior eye disease
What is WGOS1?
Normal ST
Must give general health advice (e.g. stop smoking)
What is WGOS2?
Must be WECS accredited
Acute care
Further investigation
Follow up from WGOS1
What is WGOS3?
Low vision postgrad cert
Able to register as SI/SSI if dry AMD caused
What is WGOS4?
Referral refinement/monitoring
Need med ret or glauc prof certs
What is WGOS5?
IP
