We have developed guidance for commissioning, with the Royal College of Ophthalmologists. It has been written by leading eye care clinicians, with support from experienced clinical commissioners at the National Association of Primary Care, Royal College of General Practitioners and the Department of Health’s Right Care Team.
This guidance document applies to commissioning services for adult-onset glaucoma and adults who are at risk of developing glaucoma. It aims to improve the health and wellbeing of people and communities, support local service redesign to ensure the provision of high quality, cost-effective services that meet the needs of the local population, and take into account patient experience. This guidance is a resource to assist commissioners, clinicians and managers deliver high quality and evidence and outcome-based healthcare across England and beyond.
The Cataract Commissioning Guidance has been written in response to public concern that wide variations across the country in commissioning policy for the treatment of cataract is effectively creating a "postcode lottery" and may be denying or delaying access to cataract surgery to some patients who need it. We hope that this guidance will assist those who commission cataract services and those who provide care for patients with cataract. We hope too, that it will help patients and members of the public to understand and contribute to the debate about how cataract services should be provided in the future.
Every part of the country should have access to a low vision service. Low vision affects every aspect of someone’s life, from the ability to prepare food to recognising friends’ faces. Older people with low vision are more likely to be depressed and to fall. The primary aim of low vision services is to enable people with loss of vision to regain or maintain as much independence and autonomy as possible.
Demand for eye casualty services appears to be rising yet as many as 78% of cases attending eye casualty are deemed ‘non serious’. To achieve a significant shift of urgent eye care from hospital to primary care settings commissioners should ensure that there is adequate availability of urgent (same day or next day) appointments in the primary care service and educate the public and referring clinicians to use them as the first port of call for urgent eye conditions.
AMD is the biggest cause if sight loss in the UK. Without urgent treatment it can cause rapid sight loss. Patients may need monthly monitoring appointments for a considerable time and the length of time patients are in treatment can vary from three months to two years or more. The biggest challenge for an AMD service is to ensure patients receive those follow up appointments on time so minimise preventable sight loss. Innovative services are meeting this challenge in different ways.