“It was my way of helping and contributing in some way in the pandemic”
Optometrist Robert Longhurst on setting up a free patient support line to relieve hospital eye departments during the pandemic
27 November 2021
1. When the pandemic first hit, I was working in eye casualty at the Royal Berkshire Hospital.A lot of patients were coming in with what they thought were serious problems, for example bacterial and viral conjunctivitis or dry eye, which obviously don’t need to be seen in casualty. A lot of cases could have been dealt with by a High Street optician, particularly one with independent prescribing. So, I thought it would be useful if patients were signposted better before they got into secondary care. I had the idea to set up a support service, which I called eye.support. My intention was that it would be a completely free of charge service, like 111 but for eyes.
When a patient calls, they get a pre-recorded message to make sure their condition isn't anything serious. If they do have symptoms that need seeing straightaway, the line advises that the service isn't for them, and that they should call 111 or go to their optician. Other patients speak to a call handler, who takes their name, date of birth, GP's name, and as much detail as possible about the problem. That is then typed up and sent to me in an email. I look at the information and either call the patient back with advice on where to go, or email them with information. I use the College of Optometrists information, or use the Look After Your Eyes service to find a local optician, with independent prescribing if necessary. I can then assure the patient that there is someone available to help. I sometimes call the optician to make sure they're happy to accept the patient, and find out how it would work in terms of payment, and then come back to the patient with all the options on where they can go, how much it will cost, and what the NHS services would be if they didn't want to pay.
2. I set the service up and bought an 0800 number, then found a UK-based company that could answer the phone 24 hours a day to take messages.There is a small monthly fee, but then I pay per call. This works, because I'm not paying too much if people aren't phoning. There are around 15 handlers available, and I spoke to them about what sort of questions they need to ask and red flags that would mean that the patient can't be seen by us, and that they need to go to the hospital. In terms of setting up, I think the hardest part was getting a logo. Getting the call handlers on board was really straightforward.
3. I marketed it entirely through social media.I paid for Facebook adverts, and I also have a friend who does marketing animations. She made a video, with cartoon characters: if you have a problem with your eye but don't know where to go, you can call this free phone service 24/7. We put that on social media, so I think that's where the response came from.
I use Advanced Ophthalmic Systems. I was asking some patients to send pictures, and then I was able to use their software to look at the eye more in detail, so they also ran an advert for me on their social media platforms.
4. In terms of calls coming through, it was really quick – within a week.As soon as the advert went out, people were calling. When someone calls, I get the notification and I'm able to listen. I want to know exactly what the situation is in case it is urgent, so then I can call them straight back if I need to, or I can take a bit of time working out where they can go and what I need to do before I call or email them.
The service works across the whole of the UK. It's a national number, and there are obviously opticians everywhere. We get calls from everywhere. It was quite busy at the start of the pandemic, especially as people were nervous about going out and knowing exactly where to go. I hope that it kept a lot of people out of the hospital, so they could concentrate on more serious things and free up staff to deal with the pandemic.
A lot of the patients were isolating because of underlying health conditions. They didn't want to go out to their doctors or to their opticians
Between patients in my clinics I’m able to read the messages and decide if I need to respond straightaway, and if I don’t then I responded in the evening. The patients are told that they'll receive a response within 12 hours, so that gives me enough time to finish my day's work and then go through all of the patients and respond within that time frame, so they're not worrying.
A lot of the calls are for flashing lights and floaters, which obviously need to be seen to rule out retinal tears. Patients can be seen the same day, or certainly the next day, at a local optician instead of the hospital.
5. I think the biggest call numbers were when the practices were shut.During the height of the pandemic there were times when there were a lot of patients in one go, but I just stayed up to call them all back. Obviously not too late, because then they wouldn't have appreciated the calls. I worked longer hours, because I felt that we all had to step up and do something to help. That was my small contribution, I guess. We've helped about 50 or 60 patients with the line.
6. Quite a few patients have offered positive feedback.There was one patient who phoned a few times about the same issue, because things were changing. She was extremely grateful that the information was so readily available, and for not having to go out. A lot of the patients were isolating because of underlying health conditions. They didn't want to go out to their doctors or to their opticians. It was quite useful for them to be able to have that access on the phone that wasn't going to cost them.
7. I probably will keep it going.
Because I have my own practice, when patients from the area phone I can offer my services in that way, although that wasn't my intention. It's good to have that service for people in general, to be able to signpost them to the right place. I think it is a good thing and worth continuing.
It just seemed like a nice thing to do, and it doesn't cost me too much to run because they're only charging me per phone call. It's only really a few pounds each time. That's the cost of a coffee. I don't mind doing that. If someone needs help and I can help them, then it doesn't really matter to me. It was my way of helping and contributing in some way during the pandemic. There are so many stories of people going out of their way to help others, and support each other. I saw how hard all of my colleagues were working in the hospital, so I wanted to do something myself to help everyone.
• As told to Lucy Miller.