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Referral Pathways
Enhanced Services
News
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Resources
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GOS / PCSE
About Us
- LOC Committee Members
- About the LOC
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Emergency Referrals

Emergency Referrals

For information on routine referrals and specific pathways, please see the relevant ICB area in the drop down menus above.

Essex Referrals Pathway Emergency Download

More information

College of Optometrists Emergency & Urgent referral guidance
There are also Emergency referral details maintained at bit.ly/EyeCas.

Latest Updates from Essex LOC

The following may be useful if you refer via the O

The following may be useful if you refer via the Opera system:

• Practice clinical staff are responsible for sending the referral to the correct place. ie emergency not to be sent to the hub, correct email address etc

• Once the referral is sent via OPERA/nhs.net to the correct address - Once sent correctly, PES are responsible for referral. (PES upload nhs.net referrals and triage within 24 hours during the working week)

• Returned referrals - If referral returned for more information, the triage has been completed and nothing further will happen with the patient’s referral until the additional information requested is received or an explanation is received as to why that is not possible. Practice is responsible to respond to this query.

After triage:

• Patient sent straight to community provider – Enhanced service practice responsible for checking OPERA and receiving/seeing patients in a timely manner

• Patient sent directly to hospital – As soon as sent on ERS to hospital, the responsibility with hospital

• Patient sent to community or HES but has a patient choice letter- PES responsible until patient directed onwards. Then patient chooses a particular practice/hospital, and responsibility is as above

• Patient sent a patient choice letter to either community or HES but does NOT respond- PES takes responsibility for FTE process, second letter sent, the phone call attempted after this episode is closed down

The referral is often the weak point in a patient’

The referral is often the weak point in a patient’s care journey, and it is not unusual for complaints arising after patients come to harm following referral. This may be due to forgetting to refer or due to a systems issue (incorrect or out-dated referral pathways, locums not having access to electronic referral platforms/practice nhs emails etc). Local commissioning also complicates matters as the referral pathway is based upon where the patient’s GP is based and we still have a complex referral system across Essex and will do for the foreseeable future. Finally, we know huge waiting lists for first appointments are still an issue in Ophthalmology across England with patients waiting longer than they should for eyecare.

As you are aware, the College of Optometrists guidance on referrals states, “C204 When you refer a patient, you also transfer responsibility for the relevant part of the patient’s care.”

However, it is clear that for some patients the issue of responsibility for a patient’s care following a referral may be more complex eg sight threatening referrals or mental health concerns, there may be a reason to chase referrals to ensure these are not missed by the hospitals.

Practitioners are advised to follow up urgent or emergency referrals to ensure hospitals have received and actioned the referral. Patients should always be given clear ‘safety-netting’ advice, so patients know what to do if they don’t hear back from the provider within a certain timeframe suitable for their condition – clearly with huge waiting lists still, this may be a significant time in the future for some subspecialities. The LOC has a section for the different pathways across Essex for expediting patients care within a hospital Expediting Patients – Essex LOC - see bio for link

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