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Specialist services in minor surgery, dermatology and ophthalmology provided in a community setting

Cumbria Medical Services

Community Based Ophthalmology Service

Service Quality Performance Report

October 16 – March 2017

This NHS service is led by Dr Ross Kelly and Dr Richard Barnsley, GPs with special interest in ophthalmology (GPwSI). They are supported by Sister Joy Kerr, ophthalmology nurse specialist.

The service is provided from Spencer House and Arnside House Surgery in Carlisle, Cockermouth Hospital and Workington Community Hospital, and is available to book via Choose and Book following a referral from the patient’s GP surgery or optometrist.

The average waiting time from referral to appointment is 4 weeks with all patients treated within 18 weeks of referral.

We triage all our referrals to make sure they are appropriate for the service and if rejected, we provide guidance as to which is the most appropriate service to refer on to. Only 14 referrals were rejected this year.

 We also undertake the review of patients who have had their cataract surgery done at North Cumbria Acute Hospitals Trust sites. 

Patients are advised they can phone in for advice following their consultation. GPs also phone for advice on a variety of problems which helps cut down on the number of referrals.

There will always be some patients who come to the GPwSI ophthalmology service and need onward referral to the hospital eye service; however these are minimal and based on complications found during the GPwSI consultation.  One of the strengths of the GPwSI service is its ability to provide an alternative service for patients which removes the burden from secondary care and provides a self contained treatment pathway within the community setting.



From April to September 2016 the service was provided by St Pauls Medical Centre but transferred to Cumbria Medical Services in October in order to be able to develop and expand the service further.

For the 12 month period, the GPwSI ophthalmology service provided a total of 4024 appointments, of which 216 were DNA's. The following table illustrates the type of patient appointments provided:



Across our whole activity, there were 1904 discharges (50%) from the service.  The following table illustrates the proportion of discharges from the 4 main groups of patients:


Referrals to the Hospital Eye Service

During the past year, we referred a total of 98 patients (2.6%) to the Hospital Eye Service (HES).    The following table illustrates the proportion of referrals from the 4 main groups of patients:


The 3 referrals following eyelid surgery were for lesions that turned out to be malignant. All malignant results are forwarded to Mr Zaheen, oculoplastic surgeon, for further management, immediately on receipt of the result.

The referral rate following cataract surgery is fairly fixed as we now review all post op cataract patients from the local eye department at Carlisle and Whitehaven and do not triage them.  In the early part of the year, we would routinely refer post op macular oedema.  Now that we have access to OCT scanning in both east and west clinics, we are able to manage the majority of post op macular oedema in the community. 

Patient Satisfaction

A minimum of 50% of patients are provided with a patient survey questioning them on a range of subjects including the booking arrangements, clinic facilities, doctor and nurse manner, and overall satisfaction.

Response rate to date 55%

100% patients said they were extremely likely or likely to recommend the service to their family and friends.

100% patients said they were treated with courtesy throughout from reception to clinician.

100% patients said they were given a clear explanation of their condition and treatment

98% patients said they were involved as much as they wanted to be in their care and treatment.

89% patients rated the service excellent and 11% good

All patients are also given the opportunity to give feedback via ‘iwantgreatcare’ or our website www.cumbriamedicalservices.co.uk

Patient comments include:

October to March 2017

  • Treated in a professional and courteous manner. Felt that I was listened to and given relevant information.
  • I am very pleased regarding treatment. I consider it very successful.
  • From start to finish excellent - thank you
  • Excellent service – great staff
  • Really good - on time was a bonus
  • Wonderful stuff
  • The staff and service is excellent
  • Great service, pleasant staff
  • The treatment I received was excellent
  • Well satisfied
  • Excellent service -caring, understanding. Looked after well.
  • Over the moon with treatment and outcome of surgery - feel very privileged
  • Treatment received very good given by very helpful and friendly staff
  • Good to have services locally
  • Always had a good service since coming to this clinic
  • The treatment we were given today was 100%
  • Everything was better than I expected - no complaints at all.
  • Could not get better treatment
  • Always on time, service very satisfactory
  • Service was first class and very good

For more information on this report please contact Pauline Stuart on paulinestuart@nhs.net