Merthyr patients pilot new local NHS glaucoma service

Glaucoma patients in Merthyr are the first to trial a new primary care-based assessment service from Cwm Taf Morgannwg University Health Board (CTM UHB), the first of its kind in the UK.

The health board has launched the pilot service at Specsavers in Merthyr Tydfil’s Market Square, to make it as easy and convenient as possible for local NHS glaucoma patients to be monitored.

Supported by funding from the Welsh Government’s Health and Social Services Transformation Fund, Cwm Taf Morgannwg UHB purchased and installed specialist equipment at the store, and is writing to all eligible patients, with the first attending last month.

Monitoring people’s glaucoma is important as people’s eyesight can irreversibly deteriorate with the condition if it is not treated. This new service is making sure lower risk patients are assessed at convenient, local opticians’ practices while those at higher risk will continue to attend their hospital-based eye clinics.

These lower-risk patients are assessed by an optometrist at the Merthyr Specsavers practice, with the results shared in real time with CTM UHB’s specialist, consultant-led ophthalmology service for review. If any deterioration is identified, the team will then arrange for the patient to see a consultant at a hospital-based eye clinic. If not, the patient will continue to be regularly reviewed locally.

The technology being used to share patients’ information is a first in the UK for eye care due to the way full scans and videos of the optic nerve, macula and visual fields taken during assessment are available instantly for the hospital-based specialists to review.

The Merthyr service is now run at various times, including weekends. The plan is to roll out a similar pilot service over the next two months at Davies & Jones Optometrists in Porth and Talbot Green and Mountain Ash Optical Centre. This will then be extended, subject to its success, after March next year.

The service is all about providing the best, most appropriate and timely patient care. Lower risk patients will have more convenient appointments while still being in the care of NHS ophthalmologists, while higher risk glaucoma patients will still attend the hospital-based eye clinics, with all being seen more quickly. It is estimated that around 4,000 glaucoma patients in the CTM area can be effectively assessed in the community.

Cwm Taf Morgannwg UHB’s locum ophthalmic consultant who led the project, Andrew Feyi-Waboso, said shared glaucoma care brings excellent care closer to the patients who need it.

“The feedback from patients is very positive,” he said.

“The service uses the capacity and skills of local optometrists in the community to relieve the burden on secondary care, with modern electronic sharing of patient information with secondary care providing them with seamless, timely, high quality eye care. Hospitals can then concentrate on seeing higher risk patients knowing lower risk patients are being seen on time in the community.

“This is the future of glaucoma care, and we will be at the forefront of this service model here in Wales.”

Optometrist Kelly Pitchford, who conducts the assessments at Specsavers in Merthyr, completed a six-month placement with Mr Feyi-Waboso as part of her specialist glaucoma qualification required to conduct the tests at the practice.

“This is such an important service for patients, who need to be thoroughly assessed annually to avoid sight loss,” she said.

“The eye-drops patients are given as part of the test mean they can’t drive for four hours afterwards, so convenience is a major factor, as they have to arrange to be brought by someone else. So they have been really pleased to be able to come here for their clinic, which is so much closer to home.”

Monica James from Trecynon was one of the first patients to be assessed at Specsavers.

“Because of the drops I’ve had to put in, my husband drove me today. We were able to park easily and it’s not too far to walk,” she said.

“It is reassuring to know the tests have gone to the hospital straight away and I just think it’s brilliant coming here, it saves all the travel going to hospital.”

Local NHS glaucoma patients suitable for this new service are asked to expect a letter from CTM UHB explaining the new arrangements for their assessments, after which the local optician practices will contact them to arrange a convenient appointment.