Eyecare pathways - developing local models

From a clinical perspective, lead ophthalmologists work with community optometrists to develop and agree protocols for diagnosis, treatment and ongoing care for patients with the long term conditions of glaucoma, age related macular degeneration and low vision.

This ensures that optometrists are able to demonstrate, or acquire, the full range of knowledge and skills required, enabling ophthalmologists to delegate appropriate tasks within a locally agreed shared care scheme. To enable this to be put into place, local training programmes were devised and undertaken. Within the pilot scheme, each site developed their own training programme to meet their local circumstances and which could become models for further refinement and ultimately for wider adoption.

Pilot sites ensured that all optometrists were invited to be involved in the scheme. However, only those who wished to pursue the training and gain the necessary level of competence were eligible to participate in the ongoing scheme and become recognised as practitioners with a special interest.

From an organisational perspective, the pilots also explored the opportunities for new ways of working and providing services in more convenient locations and improving the skills mix of professionals involved.

This provided the opportunity to effectively establish a baseline of their current position and start to address capacity and demand planning. Involvement of all staff in process mapping sessions provided the opportunity to bring all those involved in the process together to discuss the actual reality of the current situation. They began identifying improvements such as:

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