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70% of Temple St Hospital eye patients on the waiting list could be treated in community

About 70 per cent of the 1,351 children on the ophthalmology waiting list in Temple Street Children’s University Hospital could be treated in the primary care setting, the Medical Independent (MI) has been informed.

The HSE’s review of primary care-based ophthalmic services, due to be published by the end of the summer, aims to address the current situation, where services are geographically inequitable and primary care and hospital eye services disconnected. A priority of the review is to address immediate primary care paediatric eye service issues in the Dublin area, as highlighted by the Temple St waiting list audit, Mr Brian Murphy, HSE Head of Planning, Performance and Programme Management, Primary Care, and Assistant National Director for Primary Care, told MI.

“About 40 per cent of those cases involved strabismus. We do know a lot of this can be done in primary care. We are doing a similar audit in Crumlin and the early indications are that it is not too dissimilar, and we are looking at how these services can be provided in the community,” he said.

Mr Murphy gave an update on the long-awaited review during a closed session at the ICO Annual Conference.

The HSE convened the Primary Care Eye Services Review Group (PCESRG) in August 2014 to review all primary care eye services and to determine the needs of the population. It is also reviewing the current service in terms of quality, safety and consistency and identifying issues for action throughout 2015-2016.

ICO representatives sit on the 17-member Review Group, together with representatives from various HSE departments.

The Group’s report will provide a clear blueprint, with recommendations for the delivery of primary care ophthalmic services. This will ensure a high-quality, safe and consistent service for patients, said the College. The HSE has committed €1 million in funding in the HSE National Service Plan 2015 towards the implementation of the report.

Mr Murphy said the Group’s report is at an advanced stage, but the final recommendations have not yet been agreed. He confirmed the review would be published by the end of the summer or early autumn at the latest. “A lot of work has been done but the report is still a work in progress. We are more than anxious to get it right. It is the first review, to my knowledge, of the primary care eye services. We want to get it right and make sure the recommendations are doable. We have had a huge consultation process,” Mr Murphy commented.

He acknowledged that increased staff and resources would be necessary to improve primary care eye services, but maintained that reorganisation of current services and better referral pathways and screening will be vital. Mr Murphy stressed that ICT will have a key role to play, but admitted there are current issues with accommodation and equipment.

“We have to change the processes, get other professionals involved, like optometrists, eye nurses and healthcare assistants, at an appropriate level, and look at clinical governance, with a big emphasis on teamwork,” he said.

New ICO President Mr William Power told MI that integration of acute and primary care ophthalmology services is essential to allow for the rebalancing of access and delivery of eye care services from the acute hospital to primary care setting. The most recent waiting list figures from the National Treatment Purchase Fund (NTPF) show that, as of the end of April, there are 10,754 people waiting for inpatient ophthalmic treatment — the highest of any specialty — while 30,685 are waiting for an outpatient appointment.

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