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Can Do!  Commissioning

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Cataract ‘scoring’ in Sheffield
Many people with an early cataract condition lead a full normal life and can be relatively untroubled by it. However people with more advanced cataracts need the operation as soon as possible to regain their quality of life.Sheffield South West Primary Care Trust has led on the introduction in Sheffield of two successful changes to the cataract pathway.

An important first step with the developed ‘cataract scoring’ system was securing local agreement that community optometrists could directly refer patients needing cataract operations rather than community optometrists having to request the GPs to refer.

The main part of the ‘scoring’ system involves the community optometrist firstly ‘scoring’ the visual acuity (VA) level of the patient and then also ‘scoring’ answers given by the patient to a series of lifestyle questions. These lifestyle questions establish to what degree, if any, the cataract impacts upon the quality of life of the patient.

If the total of the VA score plus the lifestyle score is above a locally agreed benchmark, the patient is referred by the community optometrist for an operation. If the total score is below the benchmark, the community optometrist discusses with the patient that an operation is probably not needed at this time. If the total score is below the benchmark but either the community optometrist or the patient’s GP feels a referral for surgery is still needed, then the referral will go ahead.

The introduction of the cataract scoring in Sheffield was led by the Sheffield South West PCT but has been a successful example of partnership working with the other Sheffield PCTs, Sheffield Teaching Hospitals Foundation Trust, Sheffield Local Ophthalmic Committee and Sheffield Local Medical Committee. It enabled the achievement of the 3 months maximum waits by August 2004 target and current trends indicate a waiting list of 6 weeks by December 2004.This will be further improved upon where possible – a significant improvement in waiting times in Sheffield.

Contact
Nick Ryan, Deputy Director of Service Development & Performance
nick.ryan@sheffieldsw-pct.nhs.uk

Entry added: 19 Oct 04

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