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Research shows community eye care schemes are successful for all stakeholders

14 December 2016 Return to news listings

Glaucoma Pachymetry 200x250New research funded by the College of Optometrists has found that enhanced eye care schemes are viewed positively by those involved, including commissioners, patients and providers.

The qualitative study, published by BMJ Open explored the views of patients, community optometrists, General Practitioners (GPs), commissioners and ophthalmologists. The research covered a minor eye conditions scheme (MECS) in the London boroughs of Lambeth and Lewisham and a glaucoma referral refinement scheme (GRRS) in Manchester. The study was conducted by researchers from City, University of London and the Manchester Royal Eye Hospital and is a follow up to previous qualitative evidence also developed through the College of Optometrists’ Enhanced Scheme Evaluation Project (ESEP) also published in BMJ Open.

The latest research findings were:

  • 99% of MECS patients would recommend the service.
  • 99% (GRRS) and 100% (MECS) of patients were satisfied with the examination conducted by their optometrist.
  • Optometric training for both schemes was valuable and appropriate but should be ongoing.
  • Ophthalmologists expressed very positive views and widely acknowledged that these new care pathways would reduce unnecessary referrals into hospital eye services and shorten patient waiting times.
  • Commissioners felt both schemes met or exceeded expectations in terms of quality of care, allowing patients to be seen quicker and more efficiently.
  • 95% of patients in both schemes had confidence and trust in their optometrist.
  • No major negatives were reported, although both schemes were limited to patients resident within certain postcode areas and some inappropriate GP referrals occurred. It was notable that communications with hospitals was praised in GRRS but was variable, depending on the hospital, for MECS.

Mike Bowen, Director of Research for the College of Optometrists said; “This research provides important evidence on the viability and effectiveness of these schemes and it shows the benefit of optometrists working to provide extended primary care eye services. These findings are especially important because this is the first multi-stakeholder study of enhanced eye care services to include the views of patients and commissioners.”

The College of Optometrists’ ESEP aims to provide evidence about optometrist’s involvement in community schemes. Previous publications include an in-depth analysis of the introduction of a MECS in south-east London published in BMJ Open and the first systematic review of the evidence on the effectiveness of these schemes, published in the College’s international research journal Ophthalmic & Physiological Optics (OPO).

The College’s ESEP will continue to provide further evidence about the health economics and potential cost-savings of the enhanced schemes in Lambeth and Lewisham and Manchester in 2017.


Notes to editors

1. The National Health Service (NHS) General Ophthalmic Services (GOS) provides for routine sight testing across England and Wales through community optometry. In parallel to the availability of GOS, a number of community services are delivered by optometrists. MECSs are recently introduced community schemes, which aim to reduce A&E and GP workloads. MECS are free services and are available to patients over the age of 16. The eye conditions covered by the London boroughs of Lambeth and Lewisham scheme are:

  • Red eye
  • Eyelid conditions
  • Dry eyes or gritty and uncomfortable eyes
  • Irritated or inflamed eyes
  • Sticky discharge or watery eyes
  • Ingrown eyelashes
  • Foreign bodies in the eye
  • Some types of flashes and floaters
  • Recent and sudden loss of vision.

MECS do not provide sight tests.

As part of the Manchester glaucoma referral refinement scheme (GRRS), patients with suspected glaucoma or ocular hypertension following a standard GOS sight test are referred to accredited community optometrists. These accredited optometrists work to an agreed set of referral criteria and, depending on whether or not patients meet these criteria, either refer the patients to the HES or discharge them.

2. The College of Optometrists is the professional, scientific and examining body for optometry in the UK, working for the public benefit. Supporting its 15,000 members in all aspects of professional development, the College provides pre-registration training and assessment, continuous professional development opportunities, and advice and guidance on professional conduct and standards, enabling our members to serve their patients well and contribute to the wellbeing of local communities.

3. The College-funded Enhanced Scheme Evaluation Project (ESEP) was launched in 2012 to evaluate different community-based eye care service models in order to assess effectiveness, including the Minor Eye Conditions Scheme (MECS) in south-east London and the Glaucoma Referral Refinement Scheme (GRRS) in Greater Manchester. The project is led by researchers from City, University of London and the Manchester Royal Eye Hospital.

4. The College of Optometrists has introduced a new opportunity for members, organisations and the public to support the College’s research work. The College is inviting donations to allow individuals and organisations to play a part in its work to develop evidence that is capable of advancing the profession, reduce preventable vision loss and providing accessible, high quality, eye care for all. To contribute to the Research Fund, visit the College’s donation page.



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