Information Guide Community Ophthalmology Service Newbury and District, North and West Reading, South Reading and Wokingham CCGs 1
CONTENTS STATEMENT FROM THE MANAGING DIRECTOR... 3 HEALTHHARMONIE AND EVOLUTIO PARTNERSHIP... 5 COMMUNITY CONDITIONS AND PROCEDURES... 7 SECONDARY CARE CONDITIONS AND PROCEDURES... 9 REFERRAL ROUTES/METHODS... 10 INCLUSION AND EXCLUSION CRITERIA... 11 REFERRAL TO TREATMENT TIMEFRAMES... 12 PRESCRIPTION... 12 ONWARD REFERRED PATIENTS... 12 2WW REFERRED PATIENTS... 13 HOST SITES... 13 TRANSFERRED PATIENTS... 13 REFERRAL FORM... 14 GENERAL PATHWAY... 17 OCULAR REFINEMENT PATHWAY... 18 COMMUNICATION... 20 CONTACT INFORMATION... 21 FEEDBACK... 21 CONTACTS LIST... 22 2
STATEMENT FROM THE MANAGING DIRECTOR HealthHarmonie work in partnership with CCGs to provide Community services for patients. We understand the pressures on commissioners and primary care services to deliver high quality patient care, offer patient choice and to achieve this in a cost-effective way. Patient safety and satisfaction is at the core of. We are registered with the CQC and deliver safe and efficient services for all patients. Our Medical Director Joe Jordan FRCOG FRCPI (HonDL) and Clinical Leads are leaders in their fields and actively endorse the quality standards provided by HealthHarmonie. We provide high-quality Community Services for our GPs and Optometrists to ensure a more efficient care pathway timeframe for their patients. Our Business HealthHarmonie have been working in partnership with healthcare Commissioners and providers for over 10 years, we currently are the provider of Community Services for the 47 CCGs, including: Luton Birmingham South Central Birmingham Cross City Sandwell and West Birmingham Stoke Nottingham South Staffordshire Walsall East Cheshire Bradford Telford and Wrekin Lincolnshire Newcastle Times and Locations of Our Clinics HealthHarmonie will undertake Community Ophthalmology Services within local and accessible GP and Optometrist locations within the 4 West CCGs. Please see within our pack the host locations for this service. As the service embeds we will be looking for additional hosting sites to ensure our patients greater flexibility of locations and choice. HealthHarmonie aim to ensure patients do not travel more than 3 miles for their appointment, that there are good transport links, that our secured locations have ample parking and enable weekdays, evenings and weekends clinic timetables to suit patient s busy lifestyles. Language HealthHarmonie s service provide an interpretation service. 3
Advantages of utilising the Community Services Advantages for the Patient Seen by highly trained and experience Ophthalmology clinician Patient is seen within a Primary Care setting Patient treated within 20 days from receipt of referral Locations of clinics are flexible and provide patient with choice Flexible appointment slots to fit in with the patient s lifestyle evening and weekends Free and accessible car parking facilities Clinics held in comfortable and familiar surroundings Strong clinical performance and governance Advantages for the GP/Optometrist Rapid response times to patient, within 20 days of referral for appointment Outcome reports sent back within 48 hours of the appointment via Docman Provides patients with varied options for care pathways Direct referral pathways into secondary care for 2WW patients and patients requiring secondary care identified during their care pathway with HealthHarmonie Experienced clinicians within their respective fields. Strong Clinical Governance with adherence to and audit against NICE guidelines Friendly staff Patient education and involvement in care pathways Interpreter facilities available Access to shared electronic medical record/sage and Information Governance compliant referral methods 4
Patient Safety and Satisfaction Patient Safety and Satisfaction is at the core of at HealthHarmonie. We ensure monthly clinical and operational audits are performed on 10% of all patients seen within the service to maintain our high-quality standards. All patients have the ability to complete a satisfaction survey with us achieving a 30% completion rate every month. This feedback will be shared with you via quarterly newsletters and be used to consistently improve the service we provide to you and your patients. We look forward to you and your patients utilising the service, enabling greater choice for the patients during their care pathway. Kindest Regards Mary Corridan, Managing Director HEALTHHARMONIE AND EVOLUTIO PARTNERSHIP HealthHarmonie are working in partnership with Evolutio Care Innovations for the delivery of the Community Ophthalmology Service. This partnership has been formed to ensure smooth and localised personal delivery of the service, utilising the latest technology to underpin the patient pathway from referral to treatment. We believe as a direct result of this partnership, you and your patients will see the following benefits: Localised Service - Evolutio is based within Henley on Thames and work actively within the field of Ophthalmology, providing effective referral support and clinical triage services. This will bring improved local knowledge and accessibility for you and your patients. Localised Knowledge - Evolutio have an in-depth understanding of the local health economy which supports the smooth integration and whole system approach to the delivery of this service Specialist Experience - Evolutio provide innovation to the field of ophthalmology, offering seamless electronic integration across the eye care pathway, provision of an integrated shared electronic medical record and full integration with NHS e-referral. 5
Evolutio will be undertaking the referral management and clinical triage section of the contract, utilising innovative technology to provide an integrated pathway across primary, community and secondary care. GP s can refer into the service using NHS e-referral, whilst optometrists can refer electronically behind the security of the N3 network through e-refer, a bespoke IT platform to allow electronic referrals from optometrists into community services (referrals are also accepted via fax and NHS Mail). Evolutio s team of in-house triage team of experienced clinical optometrists and ophthalmologists review and summarise each referral against locally defined pathways and threshold policies to establish the most appropriate clinic type and urgency. Through the use of integrated systems, Evolutio and HealthHarmonie are able to ensure direct onward referrals for patients into acute providers where appropriate from point of triage and during their care pathway i.e. following a consultation within the community service, ensuring minimal delay to patient care and eliminating any further referral management during the patients care pathway. Together, we provide the foundation infrastructure, clinical expertise and sustainable platform to grow, rethink and revolutionise community ophthalmology provision. 6
COMMUNITY CONDITIONS AND PROCEDURES Please find below a list of procedures included within the Community Ophthalmology Service. EYELIDS AND ORBITS Trichasis Meibomian gland dysfunction Allergies Eczema Cysts** Concretions Epiphora Dry eyes Dacrocystitis Blepharitis CONJUNCTIVA SCLERA Inflammation Pinguecula Cysts** Episcleritis, scleritis VITREOUS Flashes and floaters Posterior vitreous detachment Opacities 7
ANTERIOR CHAMBER Anterior uveitis CORNEA Abrasion Recurrent abrasion syndrome Dry eye Endothelial abnormality Dystrophy RETINA Pigmented abnormalities Dry AMD Vein exclusion Arterial occlusion Retinal break Disc abnormality Schisis Macular hole Epiretinal membrane **Please note IFP policies apply to these conditions *** Community Service will see patients aged 16 or above 8
SECONDARY CARE CONDITIONS AND PROCEDURES EXTERNAL EYE/CORNEA Keratitis Corneal dystrophy Keratoconus Pterygium PAEDIATRICS All Cases OCULOPLASTIC Suspected Malignancy Orbital Lesion Ectropion Entropion Eyelid Scarring Ptosis as per policy Artificial eyes/anophthalmic sockets GLAUCOMA All Cases 9
RETINA AMD Other Macular Disease Uveitis Retinal Dystrophy Retinal vascular disease Suspected Malignancy OTHER Cataract Posterior capsular opacity Under 16s REFERRAL ROUTES/METHODS There are many ways in which you can refer into the Community Ophthalmology Service Referral Method Preferred Method for Referral Details to be used E- Refer Direct electronic referral between yourself and us. Please call Evolutio to discuss connection If Practice is unable to refer via this methods other options include: NHS.NET EMIS LCHevolutio@nhs.net Please contact Nicole McQueen to set up shared agreements within EMIS Secure Fax 0333 240 7729 Post Evolutio The Dairy Stonor Park Henley-On-Thames RG9 6HF 10
INCLUSION AND EXCLUSION CRITERIA Inclusion Patients over age of 16 NHS registered patients registered within Newbury & District, North and West Reading, South Reading and Wokingham CCGs Patients presenting with conditions listed as above Exclusion Surgery that is deemed Cosmetic Suspected Malignancy Patients under 16 Orthoptist Conditions listed in Secondary Care Procedures 11
REFERRAL TO TREATMENT TIMEFRAMES Our service timeframes are detailed below: Description Treatment times from receipt of referral Timeframe 20 days Triage of referral GP Outcome reports issued post appointment Identified suspicious cases Within 24 hours of receipt 48 hours after patient appointment by Docman Report issued immediately post patient appointment with verbal confirmation of receipt by GP Practice Information passed immediately via direct 2WW pathway to secondary care Histology results and reports 14 days post excision PRESCRIPTION HealthHarmonie will provide the patient with a prescription of 28 days or such shorter period for a full course of medication as appropriate. As specified by the Commissioner, the patient s GP will be responsible for completing any further prescription needs required for the treatment of the patient s condition. ONWARD REFERRED PATIENTS HealthHarmonie have established onward referral pathways with local Secondary Care providers. The responsibility of onward referrals from point of triage or during patient s Community Care Pathway will be actioned by HealthHarmonie, patient offered choice and informed of the next stages of their care. The patient s GP and/or Optometrist will be informed of any onward referral by HealthHarmonie via post Consultation report 12
2WW REFERRED PATIENTS The Community Ophthalmology Service does not accept 2WW patients. If a patient is accepted into the service and during their care pathway a suspicious case is identified, HealthHarmonie have direct pathways into the local 2WW secondary care pathway. All 2WW patients will be referred into secondary care directly by HealthHarmonie with their GP informed within 24 hours of identification. HOST SITES HealthHarmonie will be undertaking the Community Ophthalmology service in clinically appropriate settings of Minor Surgery Suites and Treatment Rooms in the host sites listed below. HealthHarmonie alongside the four CCG s clinical team have undertaken Infection Control audits in line with CQC standards. Woosehill Surgery - Wokingham University Health Centre - Reading West Community Hospital - Thatcham Optometrist Sites TBC within first 3 months of service delivery Please Note: Further sites will be added to the service throughout its lifespan with clear communication provided to GP and Optometrist Practices. TRANSFERRED PATIENTS HealthHarmonie will have written to your patients who are currently within a care pathway with The Practice Group, to inform them of the changes to the management of their condition. HealthHarmonie will send you electronic versions and full packs of Patient Leaflets providing key information on the Community Ophthalmology Service and patient transfer information for those patients who are currently within a care pathway with The Practice Group for their eye condition. Service Posters are available for display within all practices, if you wish for this information please contact us on the details provided below. 13
REFERRAL FORM Page 14 of 23
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GENERAL PATHWAY Please note: Patient will see a Consultant for their First Initial Consultation to ensure correct pathway first time Page 17 of 23
OCULAR REFINEMENT PATHWAY Page 18 of 23
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COMMUNICATION Page 20 of 23
HealthHarmonie will ensure prompt & regular communication with all referring GPs and Optometrists. This will be completed via: Outcome reports issued within 48 hours post patient appointment Quarterly Newsletters Practice/Locality Meetings Individual Practice Key Performance Indicator Reports Bi annual Surveys to GPs Training/Education Events CLIENT RELATIONSHIP TEAM HealthHarmonie have a dedicated Client Relationship Team who are readily available to answer any questions from referring Practices & GPs. This is headed by our Client Relationship Manager: Client Relationship Manager Name: Email: Colleen Brown Colleen.brown@healthharmonie.co.uk Telephone: 0121 201 0196 CONTACT INFORMATION SERVICE MANAGER: Rebecca Frankenburg BOOKING TEAM = 0203 708 7860 CLINICAL ADVICE LINE = 0333 015 6677 EMAIL = LCHevolutio@nhs.net FEEDBACK Page 21 of 23
HealthHarmonie encourage feedback from GPs, Optomestrists and Patients. Feedback can be provided to our Clinical Governance Department using the contact details below. Clinical Governance Manager Name: Email Clinical Governance Manager governance@healthharmonie.co.uk Telephone: 0121 201 0197 COMPLAINTS & INCIDENTS HealthHarmonie have a robust Complaints & Incidents procedure and take full ownership of any complaint/incident received into our service. All cases are investigated by our Head of Operations & Medical Director. Timeframes Acknowledge of Complaint = 3 working Days Investigation of Complaints = 21 working days Final Response Letter = 28 working days Lessons Learned All complaints & incidents have lessons learned completed as a mandatory requirement that feed into our Service Improvement action plans. On occasions HealthHarmonie may share investigation outcomes & shared learning with Practices & the CCG. Sharing of Complaints/Incidents HealthHarmonie will report complaints/incidents received into the service with the CCG as part of our monthly reporting OTHER FEEDBACK AVENUES HealthHarmonie receive feedback on our service via other avenues including Patient Satisfaction Surveys completed at 30% of monthly activity GP Surveys issued bi annually Compliments CONTACTS LIST Page 22 of 23
Name Title Telephone Number HealthHarmonie Team Email Address Mary Corridan Andrew Jackman Nicole McQueen Managing Director Commercial Director Operations Director 0121 454 7779 Mary.corridan@healthharmonie.co.uk 0121 454 7779 Andrew.jackman@healthharmonie.co.uk 0121 201 0194 Nicole.mcqueen@healthharmonie.co.uk Rebecca Frankenburg Samantha Paterson Hayley Cutler Colleen Brown Patient Service Team Clinical Advice Line Service Manager 0203 708 7860 rebecca.frankenburg@evolutio-uk.com Clinical Governance Manager Operations Manager 0121 201 0197 Governance@healthharmonie.co.uk 0121 513 0828 hayley.cutler@healthharmonie.co.uk Client Relationship Manager 0121 201 0196 Colleen.brown@healthharmonie.co.uk Patient Service Team 0203 708 7860 LCHevolutio@nhs.net Clinical Support Team 0333 015 6677 LCHevolutio@nhs.net Jo Farrimond Finance Manager 0121 201 0192 Jo.farrimond@healthharmonie.co.uk Page 23 of 23