The Sligo model for cataract surgery involves Sligo Hospital Ophthalmology Department working with optometrists in the community to treat post-operative cataract patients. It uses an integrated streamlined electronic patient record system to ensure an accurate flow of patient information between the hospital and the community services.
The HSE Primary Care Eye Services Review Group Report (PCESRG), published in June 2017, sets out the way forward for a significant amount of eye care services to be delivered in a Primary Care setting. This will ensure that hospital services are focused on patients who require more specialist diagnostics or treatments.
The recommendations from the PCESRG Report complement the Model of Care developed by the National Clinical Programme for Ophthalmology, also published in 2017. The Model of Eye Care addresses the delivery of ophthalmology services and the integration between the three arms of eye care, namely care provided in the acute setting, care provided in the primary care setting and care delivered at the first point of contact for patients.
The PCESRG Report sets out models of care and referral pathways for the management of most common eye care conditions. It also includes recommendations on standard operating procedures and training of existing staff. Increasing activity through the use of community optometrists is a key recommendation. It proposes a review of contractual arrangements with optometrists to allow them to see children over 8 years of age for routine assessments and treatments and to provide services for certain glaucoma, cataract and dry eye related macular degeneration patients.
The recommendations of the Report are being implemented by the HSE on a phased basis as resources allow. Implementation to date has focused on establishing paediatric eye care teams in Community Healthcare Organisations (CHOs) 6 and 7 as well as expanding the paediatric eye care team in CHO 9. Once established, these teams can take on the management of many eye conditions from acute ophthalmology services. Progress with the teams will inform the future roll-out of teams in other parts of the country. Implementation is also focusing on exploring the roll-out of the Community Ophthalmic Services Scheme to children over 8 years.