Presentation Dr Lyn Jenkins Clinical Director Ophthalmology

Presentation § Dr Lyn Jenkins, Clinical Director Ophthalmology § Ms Stella Hornby, Clinical Lead § Dr Jeremy Rose, Clinical Governance Director § Peter Watts Chief Executive § Ursula Anderson, Services Manager

Ophthalmic Primary Care § What ? § Where ? § Why ? § How ? § Who ? 2

The Team § LMG GP Lead § Consultant Ophthalmologist § Independent Clinical Governance Lead § Primary Care Ophthalmologist § Ophthalmic Primary Care Practitioner § Ophthalmic Assistant § Administration Team

WHAT WE PROVIDE NOW § Comprehensive primary care service § Safe and effective care § High levels of patient and referrer satisfaction § A service that’s flexible and capable of rapid expansion § Mature, experienced and established primary care ophthalmology

§Patient Benefits § Urgent appointments seen same day § Waiting times less than four weeks § Excellent patient feedback from surveys § All patients seen by experienced staff § Service sensitive to patient needs

Patient Satisfaction

Patient Satisfaction

Patient Survey Results Key Findings § 99% patients reported no problems with making an appointment § 95% patients were seen on time § 100% patients felt they had enough time with a clinician and their case was discussed adequately with them § 100% patients indicated they wished to come back to our service, rather than a hospital based service

Assured Service Delivery § Responsive and efficient call centre § Adaptable and friendly administration team § Comprehensive IT system § All clinicians specifically trained in the delivery of Ophthalmic Primary Care § All personnel committed to this proven model § Supportive team structure relevant to the requirements of autonomous clinics

Quality of Service to GP’s and Optometrists § “Its an excellent service that delivers value to us and patients alike” § Rachel Firth GP Chesham § “We have been referring to the service for four years and since The Practice got involved we are referring all of our patients to the service” § Peter Petrie GP Gerrards Cross § “We really value the ability to pick up the phone and know that we will get a responsive, immediate and friendly service” § Optometrist Prestwood § “I made an urgent referral and they were seen in my own surgery on the same day, amazing” § GP St Albans

Benefit for Commissioners § 30% cost savings on tariff - more with minor ops/procedures § Demand Management § Flexibility and responsiveness § Active performance management § Comprehensive monthly reports § Positive patient experience § Clinical Governance § Corporate Governance

Developments and Initiatives § Integration with other providers § Education and Training § Skills enhancement § Minor/Intermediate operations and laser treatments

Diabetic Retinopathy § Unscreenables within 1 month § New vessels within 2 weeks § Other diabetic retinopathy or retinal abnormality within 1 month § Treat new vessels within 2 weeks of assessment § Treat maculopathy within 1 month of assessment § Perform digital photography, fluorescein angiography and optical coherence tomography as required at 1 st assessment

Diabetic Retinopathy contd § Develop care pathways for onward referral for vitrectomy, cataract surgery or cyclophotocoagulation § If research proves benefits of VEG Finhibitors, to perform these procedures § To accredit all laser users and provide ongoing training. § Ensure compliance with laser safety rules as laid down by the Radiation and Laser Safety Authority

Cataract Surgery § Provided by appropriately trained clinicians § Locations close to patients § Utilisation of Community facilities § 30% below tariff prices

Clinical Governance • We sink or swim on the quality of the services we deliver. • We put quality first in everything we do. • We are always looking at ways of improving the quality of what we do.

Clinical governance structure THE PRACTICE PLC BOARD CLINICAL DIRECTOR CLINICAL GOVERNANCE COMMITTEE CLINICAL DIRECTOR COO SURGERIES COO SERVICES CLINICAL DEVELOPMENT LEAD ADMIN SUPPORT SURGERIES CG TEAM CLINICAL DIRECTOR COO SURGERIES CLINICAL LEADS ADMIN SUPPORT EYES CG CLINICAL DIRECTOR COO SERVICES CLINICAL LEAD CONSULTANT TEAM OTHER SERVICES CLINICAL DIRECTOR COO SERVICES CLINICAL LEAD TEAM

Our approach We are compliant with Health Care Commission Core Standards through our focus on – The patient domain The workforce domain The organisational domain

The patient domain Patient satisfaction surveys Metrics Audit Complaints Significant events Complaints and Untoward Events

The workforce domain Qualifications and experience Registration and insurance Professional development Education and training Appraisal and mentoring All staff

The organisational domain Logistics – referrals, appointments, letters Environment – clinics, health and safety Equipment – clinicians’ bags, servicing Communications – internal and external Corporate Governance

Clinical Governance Summary Quality really does matter We are always looking to improve Right monitoring and feedback systems Professional and organisational development a priority Proven track record

Conclusions § We do primary care ophthalmology in a primary care environment § We will build and evolve a flexible service with you, for you and your patients § We will deliver high quality patient care with real financial benefits

Referral Procedure § Urgent 1 -2 days please phone before faxing § Soon < 2 weeks § Routine < 4 weeks § Please specify above, and also whether patient requires a visual field or dilated exam. § Referrals received by fax. § Urgents please telephone first on 01494 463144 so that we know to expect the fax. § Alternatively email at eyes@thepracticeplc. co. uk or, write to Eye Service, Lynton House Surgery, 43 London Rd, High Wycombe, Bucks

Reporting § Numbers of Referrals § Referrer § NHS Number § Date of Birth § Date of referral § Outcome of Referral § Date of Appointment § Type of Appointment i. e. first, follow up, glaucoma § Outcome of appointment § Clinician § Diagnosis

Independent Audit 2005 Key Findings § “Service provided is equivalent to if not better than the Oxford Eye Hospital Out Patients Department” § “Management of all patients was found to be of a high standard” Miss Bianca Sallustio Clinical Lead Oxford Eye Department