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The HSE’s primary care eye services review, due to be published before the end of the summer, represents a major opportunity to address the geographic inequity in community ophthalmic services and the disconnect between community and hospital-based ophthalmic services, Mr Power told the Medical Independent (MI).
He said a lot of the required structures and staff already exist, but the manner of care delivery has to change, with an emphasis on teamworking and joined-up referral and discharge pathways.
A key change will be ensuring community ophthalmologists no longer work in isolation, and ideally have some hospital clinics to maintain skills and to ensure continuity of care.
Mr Power told MI: “There have been many reports in the HSE that have been published but just sit on the shelf. Obviously we are not naïve and don’t think we will get every aspect addressed from the get-go with this review, but we are very anxious it would be implemented on a phased basis.”
He added: “There are a lot of inequalities of access to ophthalmology services, depending on where you live, especially in the south Dublin area where there are little or no primary care eye services for kids.”
Mr Power said changes in the school eye screening programme and its referral pathway will also be needed.
In addition, he said there has long been a lack of understanding at health policy level about the fact that primary eye care is not delivered by GPs, and that patients with diseases like glaucoma cannot be discharged from the hospital system to GPs.
“It all comes down to getting people working in teams and linking those in the community with the hospitals electronically, because an awful lot of what we do is about measurements,” he said. “With patients with age-related macular degeneration, for example, they are all managed in hospitals, and it is so time consuming and it could be delivered in the community.”