Ophthalmology

The North of Scotland regional Ophthalmology project was established in 2019, with the following objectives:

• Standardisation of patient pathways for Out of Hours Period – this is now complete in Highland and Grampian, and ongoing elsewhere in the North region

• Optimised technology for regional access to patient medical records, with an opportunity to develop a Regional teleophthalmology on-call service

• Greater use of Tele-Ophthalmology to reduce patient and clinician travel and aid diagnosis and treatment – carried out during covid period for emergency work. 
  • A network of teleophthalmology-enabled community optometrists has been established. This reduces the need for patients to travel for face-to-face consultations in the hospital eye service, and enables treatment to be initiated more quickly for patients in remote communities.
• Optimised training opportunities for doctors and medical staff 
  • This involved the roll out the Ophthalmic Common Clinical Competency Framework (OCCCF), now renamed the Ophthalmic Practitioner Training (OPT). The OPT is a competency-based training programme run 'in house' to train non-medical ophthalmic practitioners in secondary care, enabling them to take on extended roles. The OPT provides three levels of qualification in four different areas of practice (cataract, glaucoma, medical retina and emergency ophthalmology), and is open to optometrists, orthoptists and ophthalmic nurses. The program will be vital in providing the highly skilled personnel needed to delivery ophthalmic care in the future
  • This also provided an opportunity to extend OPT to include community optometrists to provide an expanded role for community optometrists with direct referral and increased treatment options. This would support community optometrists in the delivery of shared ophthalmic care (the care of patients in the community who would otherwise be under the care of the hospital eye service), and provide the necessary clinical experience for those optometrists wishing to obtain Independent Prescribing status. Shared care and independent prescribing significantly reduce the burden on the hospital eye service.
• In addition, we looked at creating a resilient enhanced workforce including a Global Citizen Consultant in Ophthalmology
  • The NoS Ophthalmology project has successfully delivered the first global citizen consultant ophthalmologist. This role provides a complementary subspecialty skill which improves the care for patients in NHS Highland, and delivers a vital general ophthalmic service for the patients of NHS Orkney and NHS Western Isles.

COVID-19 has had a significant effect on the project outputs, however progress has been made and some aspects remain outstanding. The regional project is no longer being coordinated with a Project Manager and Clinical Lead however ways of progressing work within services will be sought