Referral Information

Referral Region
Referral details vary depending upon the hospital / ICB. Region specific information can be found at:

Referral Forms
In Mid & South Essex electronic referrals directly to the hospital are advised via the electronic referral platform – OPERA. Please contact enquiries@essex-loc.org for details. Generally, it’s preferable to use the Ophthalmology referral form to refer (an editable .pdf document), or the old GOS18. (The Ophthalmology referral form is also available as .doc document).

Hospital Exclusion Criteria
Hospitals exclusion criteria for cataract surgery – August 2024

Referral Guidance
Essex LOC produced a cribsheet with Guidance for Referrals for various conditions. This is a guidance only and you should always refer in the best interest of the patient depending on the individual case and symptoms.

Our clinical references at https://essex-loc.org/clinical-references/ contain information about orthoptics, papilloedema and flashes etc.

Practice Clinical Referral lead

Independent Sector Providers (ISPs)

There are numerous ISP’s across Essex. Details of all are gradually being updated here

Expediting Patients

There are increasing numbers of patients reporting to their Optometrists or Optical Practices they are worried about their eyes because they are either increasingly overdue an assessment in a clinic for a previously diagnosed condition, or a recent referral has not yet resulted in an appointment and they feel their eyes are worsening.

The GOS contract says that if any abnormality is identified, the patient should be directed to the appropriate team for care – so if the patient is already in the HES but has waited a long time, the patient can raise this with the appropriate Trust’s Patient Advice and Liaison Service (PALS) team or where available, a hospital Failsafe Officer. As a precaution, the Optical Sector Bodies do recommend Optometrists should write to the patient’s GP to update them too.

For patients who are still waiting for an appointment following their referral, it is important to remember something that was referred as routine previously, might now be more urgent depending on the length of delay.

Recommendation from NHSE regional team is to have an email address where appropriate concerns could be raised.  This would specifically be for patients whose clinical condition has either worsened as determined during their eye examination with an Optometrist, or the patient is reporting worrying symptoms about their condition indicating it has worsened after their earlier referral.

It is important to note; these expedite avenues MUST NOT be used to try and queue jump.

All referrals when they reach the hospital are triaged for suitable timescales to be seen.

The following would be appropriate for potentially sight threatening conditions (with the biggest waiting lists of course). 

Patients already “under the hospital” whose signs or symptoms has worsened:

Glaucoma patients waiting for follow up appointments are currently very behind. Do not refer someone back simply because they are a short period overdue their appointment. It may be that the patient is overdue by many months and in which case, you need to use your own clinical judgement as to whether they should be expedited for their appointments.
However, if you have a patient who at a routine sight test has the following signs, please refer back to their CURRENT HOSPITAL provider:

Glaucoma:
IOP above 21mmHg if diagnosis of NTG
IOP above 23mmHg if diagnosis of glaucoma
IOP above 27mmHg if diagnosis of ocular hypertension
Significant change in disc appearance or disc haemorrhage
Significant change in VF or advanced VF loss in either eye IF you have previous records of their visual fields.

Medical Retina:
Wet AMD recurrence between HES appointments especially if patient reports subjective worsening. 
Any other Medical Retina pathology that is worsening and potentially causing permanent threat to the patient’s eyesight.

Diabetic Eye Disease:
Most patients with worsening background retinopathy simply need referring back to the GP to expedite their diabetic eye screening appointment. However, you may have a patient with more severe sight threatening diabetic eye disease.
Patients under the care of the hospital with diabetic retinal changes that are worsening e.g. proliferative retinopathy but then develop a pre retinal haemorrhage.

Please remember as the responsible clinician at the time of a sight test, you must always work in the patient’s best interest and refer any new pathology according to The College of Optometrists guidelines.

Optometrists need to supply the following information:

Please put the following title for your email:

“Expedite” then add in the patient’s name. So, a header could read as “Expedite Emma Spofforth’s referral/hospital appointment”
Patient’s full given name
Date of Birth
Hospital number/NHS number if known
Hospital patient under
Clinic name/Consultant name patient under, if known
Patient symptomatic/not symptomatic
Current VA
Brief description of signs worsened e.g. IOP over 23mmHg/IOP raised by 8mmHg vs last sight test/Images show ONH or Macula worse
Practice name and address.
Optometrist name.

As always, it is ESSENTIAL to ensure the record keeping of all your actions is fully documented, including the advice given to the patients.

For SNEE:

In Ipswich and Colchester, referrals can be chased via email. Two sets of options:

Queries from Optometrists where the patient is known to have worsening symptoms:

For Colchester queries: Linzi.willsher@esneft.nhs.uk
For Ipswich queries Nikki.Chaplin@esneft.nhs.uk
Can contact Karen Grove directly for both sites: Karen.grove@esneft.nhs.uk

Patient queries to chase appointments etc:

Some patients may want to chase their own appointments. The following are available but do not hand out to all patients unless you feel they would benefit from chasing their appointment.

For Colchester patients can email esneft.eyedepartmentcolchester@nhs.net
For Ipswich patients can email chu-ftr.eyeadmin@esneft.nhs.uk
For Ipswich patients can call 01473 703230 and then select which option they want
For Colchester patient can call 01206 746066 and then select which option they want. 

For MSE Trust Hospitals:

For Broomfield and Southend/Orsett the hospitals have advised use the urgent email addresses:
For Broomfield: mse.urgentophthalmologybroomfield@nhs.net
For Southend/Orsett: mse.urgentophthalmologysouthend@nhs.net

For PAH

PAH do not have a generic failsafe officer’s email but have suggested queries are sent to the generic secretary’s email and this can then be forwarded to the relevant officer. tpa-tr.ophthalmologyadminclinicalcorrespondence@nhs.net