Maria Sattar, ophthalmic director at Bishop Auckland since February 2017, explains why the store’s MECS (minor eye conditions service) scheme is so popular with patients and practitioners.
Bishop Auckland has been making a success of EOS since 2015, when North Durham CCG (Clinical Commissioning Group) commissioned a range of schemes.
MECS is the most popular, but the store also has contracts for children’s pathway, glaucoma (intraocular pressure, repeat readings service, ocular hypertension), and cataract referral refinement (which also comes through Durham Dales, Easington and Sedgefield CCG).
Flying through the roof
Maria says: ‘MECS seems to be flying through the roof – we’re seeing around 10 patients a day. When someone rings up for an appointment we direct the call through to our clinical department, where we have designated people who triage using triage forms. Depending on what the problem is, referrals need to be seen within 48 hours, if they’re classed as urgent, or 14 days, if they’re classed as routine.
‘We’ve found that as long as the people triaging have adequate training and are confident about it, it’s very easy to manage and usually works very well. If they’re ever in doubt, a clinician is more than happy to speak to them to clarify.’
Currently, certain appointments are set aside for MECS appointments – although patients wanting an appointment immediately will be seen if there is availability. However, going forward, the store is considering implementing a weekly, full-day MECS clinic with a designated MECS optician.
High level of awareness
Maria believes the store’s impressive service is partly due to a high level of awareness of the MECS scheme, both from the general public and other health professionals. She says: ‘GP practices, pharmacies and the NHS 111 helpline are all aware that we provide the service and they advise people to come directly to us. We also get word of mouth recommendations from patients.’
Staff engagement has been crucial to the success of the scheme. The store’s 58 staff are very much on-board, partly thanks to the many in-store training sessions, which have helped implement the process and procedures.
Maria says the clinicians really appreciate the variety that EOS brings to the job, as well as the opportunity to challenge themselves clinically.
‘We have opticians who’ll jump at the chance to see an EOS patient,’ she says. ‘With MECS, you get so much variation it’s unbelievable. Yes, you do get days when you get five dry eye patients in a row, or people with an eyelash that needs removing, but there’s the other side of it, too. We’ve found a number of amazing things, including retinal detachments, undiagnosed systemic diseases, glaucomas and eye lid cancers.
‘The other day I saw a patient who’d had a brain tumour removed seven months ago, and she’d just lost the vision in one eye. She came to us because she thought it was caused by an eye infection and didn’t know where else to go. In fact, it was loss of vision due to corneal opacification but not picked up due to loss of sensation over the years. I referred her urgently to hospital.’
Opening up avenues
The store supports and encourages staff to do further training to support their EOS provision. Out of the eight fully-qualified resident optometrists (including two ophthalmic partners), all are approved for MECS and cataract referral refinement, six for IOP repeat readings four for children’s pathway and three for OHT monitoring. Two optometrists are also doing additional qualifications in glaucoma. ‘It opens up more avenues for them,’ Maria explains.
The store has had an OCT (optical coherence tomography) machine for more than two years now, which is very popular with the optometrists. It’s used to monitor retinal lesions and at the request of clinicians. The local triage team at Primary Eyecare (North East) also refers patients in for OCT under the MECS scheme.
Maria is delighted with the success of the current schemes, which she sees as a win-win situation both for patients, who are potentially seen more quickly and by the right clinician first time, and practitioners.
The provision of EOS, she says, simply makes the job more rewarding. ‘You get the satisfaction of fixing a problem, rather than just routine appointments,’ she says.
‘You’re helping people, and that’s the main fulfilment clinicians get. That’s why we welcome it.’
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