Emergency eye care services have seen large increases in demand over the last 10 years, with over 500,000 cases recorded in England in 2018-2019. Many common (urgent and minor) acute eye conditions, are not sight or life threatening and can be managed safely outside of the emergency care setting. There is enormous variation in the delivery of emergency eye care across the UK. Historically, the service model used in each area was determined by perceived need of the local patient demographic, the NHS provider’s choice of best hospital model and the local commissioner’s choice of alternative pathways from both NHS and independent providers.
Truly sight or life-threatening emergencies need immediate attention and are more likely to have a better outcome when treatment is initiated as early as possible. Commissioners must ensure provision of adequate access to specialist emergency care for such patients, regardless of geographic location or time of day. This multidisciplinary guidance provides advice on robust triage based on risk-prioritisation at all first points of contact in the system, including triage protocols for services and commissioners to discuss and agree for their local area. Although written before the Covid-19 pandemic, the guidance could not be more relevant in light of the recent rapid development of more remote working practices and integrated care delivery across regional networks.
All commissioned changes in service provision should be audited to assess the cost effectiveness and quality across the whole pathway. You can read the guidance summary here and the full guidance here.