Referrals from community optometrists to the hospital eye service in Scotland and England

Shah, Rakhee; Edgar, David F.; Khatoon, Abeeda; Hobby, Angharad; Jessa, Zahra; Yammouni, Robert; Campbell, Peter; Soteri, Kiki; Beg, Amaad; Harsum, Steven; Aggarwal, Rajesh; Evans, Bruce J.W.

Abstract

Objectives: This audit assesses communication between community optometrists (COs) and hospital eye service (HES) in Scotland and England. Methods: Optometric referrals and replies were extracted from six practices in Scotland and England. If no reply was found, replies/records were copied from HES records. De-identified referrals, replies and records were audited against established standards, evaluating whether referrals were necessary, accurate and directed to the appropriate professional. The referral rate (RR) and referral reply rate (RRR) were calculated. Results: From 905 de-identified referrals, RR ranged from 2.6 to 8.7%. From COs’ perspective, the proportion of referrals for which they received replies ranged from 37 to 84% (Scotland) and 26 to 49% (England). A total of 88–96% of referrals (Scotland) and 63–76% (England) were seen in the HES. Adjusting for cases when it is reasonable to expect replies, RRR becomes 45–92% (Scotland) and 38–62% (England) with RRR significantly greater in Scotland (P = 0.015). Replies were copied to patients in 0–21% of cases. Referrals were to the appropriate service and judged necessary in ≥90% of cases in both jurisdictions. Accuracy of referral ranged from 89 to 97% (Scotland) and 81 to 98% (England). The reply addressed the reason for referral in 94–100% of cases (Scotland) and 93–97% (England) and was meaningful in 95–100% (Scotland) and 94–99% (England). Conclusions: Despite the interdisciplinary joint statement on sharing patient information, this audit highlights variable standard of referrals and deficits in replies to the referring COs, with one exception in Scotland. Replies from HES to COs are important for patient care, benefitting patients and clinicians and minimising unnecessary HES appointments.

• Journal Article Type: Article
• Acceptance Date: Jul 28, 2020
• Online Publication Date: Aug 6, 2021
• Publication Date: Sep 1, 2022
• Deposit Date: Sep 15, 2022
• Publicly Available Date: Sep 16, 2022
• Journal: Eye (Basingstoke)
• Print ISSN: 0950-222X
• Electronic ISSN: 1476-5454
• Publisher: Springer Nature [academic journals on nature.com]
• Peer Reviewed: Peer Reviewed
• Volume: 36
• Issue: 9
• Pages: 1754-1760
• DOI: https://doi.org/10.1038/s41433-021-01728-2
• Keywords: Ophthalmology, optometrists, health referrals, optometric referrals, Health occupations, Health services
• Public URL: https://uwe-repository.worktribe.com/output/9987399
• Publisher URL: https://www.nature.com/articles/s41433-021-01728-2
• Additional Information: Received: 17 December 2020; Revised: 5 July 2021; Accepted: 28 July 2021; First Online: 6 August 2021; : RS is an elected council member of the Association of Optometrists (AOP), one of the funding bodies. RS’s role in the audit was not as a representative of the AOP, but as a researcher. The funding bodies were not involved in writing, analysis or publication of this work.