Project overview

There is insufficient capacity in secondary care to assess and manage eye care patients in Wales. In December 2019, nearly 115,000 patients in the R1 category (risk of irreversible sight loss if patient target date is missed) were waiting for a hospital eye appointment in Wales. 38% of those patients exceeded their target date.

Demand on eyecare services is increasing through an ageing population and increased risks linked to other diseases, particularly diabetes. The application of digital technology to tackle unmet clinical needs has seen growing prominence in health and social care, delivering substantial improvements in prudent care.

This project aims to alleviate unsustainable pressures on current ophthalmology services through digital innovation. With Welsh Government support, Cardiff and Vale University Health Board have developed a service framework in which registered high street optometrists assume the management of designated high-risk eye patients.

Accelerate's involvement

Accelerate is supporting Cardiff academics, Optometrists, and Cardiff & Vale UHB staff to evaluate a revolutionary clinical model to facilitate specialised eye care services in community settings. Through a series of novel pilot services, Accelerate will help manage up to 9000 designated patients across 5 domains of care: New Glaucoma Referrals, Follow up Glaucoma Referrals, Wet Age Related Macular Degeneration, Diabetic Retinopathy and Unscheduled Eye Casualty.

Skilled Optometrists in community practices will use state-of-the-art imaging technology, dedicated software and electronic patient records to enable diagnosis by acute care ophthalmologists viewing digital data uploaded from remote locations.

Complex cases will be referred to acute services for appropriate care. Evaluation of pilot data by Cardiff academics will include comparisons with usual care along with patient and practitioner experiential and outcome measures and health economics appraisals. Findings will inform sustainable rollout of shared care ophthalmic services, pan Wales.

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