REDESIGNING OPHTHALMOLOGY REFERRAL PATHWAYS IN COVENTRY AND WARWICKSHIRE

Previously, ophthalmology referral pathways varied across the region, with different systems in place based on former clinical commissioning group boundaries. This led to confusion, limited patient choice, and added administrative burdens on GPs who had to manage referrals from optometrists.

When the NHS England Midlands regional team commissioned a new electronic eye care referral system, it provided the ICB with an opportunity to streamline the referral process, enhance patient choice, and reduce inefficiencies across the system. The ICB aimed to redesign the ophthalmology referral pathways to offer patients more choice, reduce the burden on GPs, and improve the efficiency of the referral process.

What We Did

Coventry and Warwickshire Integrated Care Board (ICB) appointed NHS Arden & GEM CSU’s healthcare transformation team to lead the project with a goal of implementing the changes within six months. The new model was designed around a central hub-based approach, which aimed to improve consistency across Coventry and Warwickshire.

The project followed a structured three-phase approach:

1. Assessing the current approach: The team began by analysing existing referral processes across the region. This included understanding the scale of the service, identifying inefficiencies, and highlighting the limitations around patient choice. Data from optometrists and providers were used to develop a baseline for the service, allowing the team to identify areas for improvement.
2. Establishing the Central Hub and Electronic Referral System: Using the baseline data, the team designed a new model for referrals. The ophthalmology coordination service (OCS) was set up to manage referrals centrally, receiving all referrals from optometrists using the new electronic referral system, Cinapsis. The OCS team contacts patients to offer treatment options based on their priorities, which are then processed using the national electronic referral system.
3. Rollout of the new pathway: The final phase involved rolling out the new referral pathway. The ICB worked closely with stakeholders including the Local Optical Committee (LOC), optometrists, secondary care providers, and NHS England to ensure smooth implementation. Training was provided to all optometrists and providers to ensure they could use the new system effectively.

Outcomes

The redesigned referral pathway has resulted in quicker referrals to appropriate providers for both routine and urgent cases, improving patient access to care. Not only do patients now have greater choice in where and when they can access treatment, the new system has reduced the administrative burden of managing ophthalmology referrals, as optometrists can now refer directly to secondary care providers, bypassing GPs.

From a digital perspective, the new system offers improved visibility and more robust data regarding referrals and service provision, ensuring that clinicians and administrators have accurate, up-to-date information.

Next Steps

While the project has already delivered significant improvements, there are plans to continue refining and expanding the new referral pathway. The ICB will continue to work closely with key stakeholders, including the LOC and optometry practices, to ensure the new pathway is continuously optimised and refined. The ICB will also explore potential system enhancements based on feedback from users, including improvements in referral tracking and patient communication.

Further engagement with secondary care providers will help increase the number of providers on the new system, improving patient access to a wider range of treatment options.

And, continuous monitoring and evaluation will be carried out to ensure the system delivers long-term improvements in patient care, efficiency, and administrative effectiveness.