In early 2013 I was given the opportunity to undertake training and a series of assessments that would allow me to deliver the minor eye condition services (MECS) scheme within one of my practices based in Stockport, Cheshire.
The MECS scheme was introduced to allow community optometrists to better manage patients presenting with a range of eye conditions including dry eyes, red eyes, painful/sore eyes, eyelid problems, suspect foreign bodies, flashes and floaters, a sudden drop in vision and visual field defects.
Prior to the scheme being introduced, I noticed that many of my patients complaining of these types of problems would – in the first instance – visit their GP. Having seen their GP, they were typically referred to us for a consultation and this posed a couple of problems. The first was that an appointment with the GP had been wasted and the second was that some of these patients were reluctant to pay for the consultation as they assumed that a referral from their GP meant it would be free of charge.
Whilst most patients would eventually pay for the consultation, it wasn’t uncommon for some to refuse and to visit the Hospital Eye Service (HES) instead when typically it was for something that we could have managed in the practice.
The MECS scheme changed this. Patients get to be seen free of charge as long as their GP practice is within a defined area and most are now signposted to us directly via GP staff and literature available both in the practice, as well as online.
Local pharmacies and non-participating optometrists also refer patients via the scheme pathway, as does the HES. As the scheme has been in place for over five years now, many of our patients self-refer as they have heard about the pathway from friends or family members.
Advantages of the MECS scheme include patients being assessed in a timelier manner, cost savings when compared with the patient visiting their GP or the HES, reduced patient anxiety and reduced referrals to an already overburdened HES.
"Some cases are challenging and will stretch you, but it is these that make you a better and more confident optometrist in the long-run"
Becoming MECS accredited is relatively straightforward. There are currently two parts to this process.
Part one is a series of distance learning lectures and multiple choice examinations that are delivered by the Local Optical Committee Support Unit and Wales Optometry Postgraduate Education Centre. Lecture topics include age-related macular degeneration, red eye, flashes and floaters, dry eye, the cornea and foreign bodies, and sudden loss of vision.
Part two is a practical assessment in which you visit several stations and are assessed in indirect ophthalmoscopy, communication, data interpretation and referral (written or telephone). During this assessment I also undertook a foreign body removal course.
Each station takes no more than five–10 minutes to complete.
In terms of the workload required to secure accreditation, it’s not overwhelming – I think for most practitioners it is stuff that they already know and the process is just making sure they are competent.
I thoroughly enjoy being a MECS-accredited practitioner. On a typical day I see one to two MECS-related cases and it adds a lot of variety to my clinic. While many cases tend to be related to dry eye or red eye, as well as flashes and floaters, I have removed many more foreign bodies and eye lashes than I would have had I not been on the scheme.
My patients also love the convenience of being able to get access to their optometrist within a specified timeframe – 24 hours or five days depending upon the severity of the problem.
I would highly recommend that any practitioner who has a MECS scheme in their practising area consider joining it. Of course, some cases are challenging and will stretch you, but they will make you a better and more confident optometrist in the long-run.